A Review of US Drug Costs Relevant to Medicare, Medicaid, and Commercial Insurers Post-Affordable Care Act Enactment, 2010-2016
| Autor: | F Randy Vogenberg, Laura T. Pizzi, Stefan Varga, Elizabeth S. Mearns, Silky Webb Beaty, Jacquelyn McRae |
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| Rok vydání: | 2016 |
| Předmět: |
Prescription drug
Prescription Drugs Insurance Carriers Medicare Drug Costs Reimbursement Mechanisms 03 medical and health sciences 0302 clinical medicine Patient Protection and Affordable Care Act Humans 030212 general & internal medicine Economics Pharmaceutical health care economics and organizations Reimbursement Pharmacology Actuarial science Health economics Medicaid 030503 health policy & services Health Policy Public Health Environmental and Occupational Health Insurance Pharmaceutical Services Medicaid Drug Rebate Program United States Prescription costs Managed care Business 0305 other medical science |
| Zdroj: | PharmacoEconomics. 35(2) |
| ISSN: | 1179-2027 |
| Popis: | Since passage of the Affordable Care Act (ACA) in 2010, US stakeholders are increasingly being held accountable for the value of healthcare services and drugs administered to patients. Pharmacoeconomic analyses offer one method of demonstrating a product's value, yet there is a lack of resources specific to US drug costs relevant to each stakeholder. The aim of this study was to review current US drug costs (post-ACA). A literature review aimed at finding evidence on outpatient prescription drug costs was performed using the following sources: PubMed, governmental agencies, news websites, the Academy of Managed Care Pharmacy (AMCP) website, and Google Scholar. Articles were limited to those published in the years "2010-2016" and the "English" language, and those that described drug acquisition costs, reimbursement costs, and rebates or discounting for Medicare, Medicaid, and commercial payors. The Drug Cost Focus Group (DCFG) was convened to supplement the literature review; the DCFG provided their expertise on US drug costs and emerging issues affecting drug costs. ACA legislation increased drug rebates for manufacturers participating in the Medicaid Drug Rebate Program. Acquisition costs commonly referred to in the literature include the wholesale acquisition cost and average manufacture price. Drugs reimbursed by Medicaid are currently based on the actual acquisition cost and ACA-Federal Upper Limit. Evidence suggests that reimbursement methods in the public market are varied. Current gaps in the literature regarding commercial insurers' drug costs (post-ACA) present barriers to the application of relevant drug costs to pharmacoeconomic analyses. |
| Databáze: | OpenAIRE |
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