June/July 2009, Vol 2, No 4

In March 2009, the Institute of Medicine (IOM) undertook a study, requested by Congress in the American Recovery and Reinvestment Act of 2009, to determine national priorities for comparative effectiveness research. The Committee on Comparative Effectiveness Research Prioritization will have issued its final report by June 30, 2009.

By mid-June, the shapes in the fog have been emerging in the Senate Healthcare Reform proposals. The stakeholder coalition of providers, insurers, consumers, and employers that were all on stage at the White House “photo op” is starting to fray. One after the other, the list of “must haves” is spooling out.With partisan tensions high and interest group organizing mounting, the art of compromise is going to be very difficult on this massive bill.

Robert Henry: Our goal is to draw on your current position at the Center for Medical Technology Policy (CMTP), as well as your previous experience at the Centers for Medicare & Medicaid Services (CMS), to discuss private payer initiatives for medical technologies research and development (R&D) and the role of evidence in developing new technologies.

Policy Considerations in Evidence-Based Coverage Decisions

Based on the Forum on Regulation of Follow-On Biologics: Ensuring Quality and Patient Safety that was held at the National Press Club in Washington, DC, in April 2009, to review current issues related to biosimilars legislation. The forum was sponsored by the Jefferson School of Population Health, with a grant support from sanofi-aventis.

Advances in the diagnosis and treatment of cancer in recent decades have dramatically improved the life expectancy, quality of life, and productivity of patients with cancer. Today, a growing number of employees remain in the workforce while they are being treated for cancer or return to work after their treatments are completed. Cancer is being seen as a chronic and manageable disease in the workforce, similar to diabetes or asthma.

Data-Driven Benefit Design for Chronic Diseases

Adherence to prescribed medications is necessary to improve outcomes.

Medication Adherence: Is Lower Copay the Best Strategy to Improve Care and Reduce Costs?

The first 100 days of the new administration have produced significant pieces of new legislation that include components of proposed healthcare reform, such as initial funding for comparative effectiveness research (CER). However, many questions remain about the potential scope of healthcare reform and how the new focus on areas such as comparative effectiveness will affect public and private health plans.

Bipolar disorder (BPD) is a chronic, recurrent psychiatric illness characterized by episodes of bothmania and depression. It is estimated that up to 2.6% of the US adult population is affected by this disorder,1 and that the lifetime prevalence rate for bipolar spectrum disorders ranges from 3.0% to 6.5%.2 Direct treatment costs are sizable, at $11,600 per patient-year.3 Medication is an essential part of successful treatment for BPD.

Health Plans’ Approaches to Managing Appropriate Use of Antipsychotic Drugs

In the United States, chronic obstructive pulmonary disease (COPD), characterized by airflow limitation that is not fully reversible, is the fourth leading cause of death, after heart disease, cancer, and cerebrovascular disease.1,2 An estimated 12 million Americans are currently diagnosed with COPD, but at least an equal number of people are believed to have the disease and have not been diagnosed.3 More than 90% of cases of COPD are caused by smoking,2 and therefore smoking cessation is a crucial strategy in the effort to reduce the incidence of COPD.

In this interview, Dr Tinkelman discusses the clinical approach to the diagnosis and treatment of chronic obstructive pulmonary disease and the effects of this airways disease on employees and employers. He stresses that smoking, much more than occupational exposure, causes this chronic and irreversible lung disease. Progressive loss of lung function reduces productivity in workers whose jobs require physical exertion. A significant number of employees with this disease become disabled.

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  •  Association for Value-Based Cancer Care
  • Oncology Practice Management
  • Value-Based Cancer Care
  • Value-Based Care in Rheumatology
  • Rheumatology Practice Management
  • Urology Practice Management
  • Lynx CME