BACKGROUND The rate of increase in spending on specialty pharmaceuticals is outpacing by far the rate of increase in spending for other drugs. OBJECTIVE To explore the strategies payers are using in response to challenges related to coverage, cost, clinical management, and access of specialty pharmaceuticals and to describe the potential implications for key stakeholders, including patients, ...

OBJECTIVES Prescription opioid abuse and addiction are serious problems with growing societal and medical costs, resulting in billions of dollars of excess costs to private and governmental health insurers annually. Although difficult to accurately assess, prescription opioid abuse also leads to increased insurance costs in the form of property and liability claims, and costs to state and local...

REQUIRED) To facilitate superior healthcare delivery and address current challenges facing healthcare today a plethora of pervasive ehealth solutions are emerging. However, existing regulatory regimes are ill-equipped for dealing with them. This not only causes frustration to various stakeholders including patients, providers, healthcare organizations and payers, not to mention vendors but also...

objectives: the present study aimed to provide an estimation of the current financial burden of renal transplantation therapy for insurance organisations.methods: an excel-based model was developed to determine the treatment costs of current clinical practice in renal transplantation therapy (rtt). inputs were derived from ministry of health and insurance organizations` database, hospital and p...

BACKGROUND Colorectal cancer (CRC) incidence rises with age, and most CRC arises from adenomatous polyps. It was therefore hypothesized that increased use of CRC screening and polypectomy in younger persons might yield CRC-related savings later in life for payers such as Medicare. METHODS Using a decision analytic Markov model, the impact of increased CRC screening uptake on healthcare payers...

Biosimilars represent a potential savings opportunity for both payers and patients, but how and when the new agents will be accepted and prescribed is uncertain.

Immunotherapy vaccines could extend survival in a handful of cancers. But personalizing treatment, payers argue, is not sustainable. Where should the line be drawn?