The social impact of the Out of Pocket costs for medications may lead to non-compliance. In the article review, written by Michelle Andrews she explores the impact of out of pocket costs on prescriptions influence whether a patient fills them. The potentially lifesaving cholesterol lowering drugs such as PcSK9 inhibitors. PCSK9 inhibitors are a set of cholesterol lowering agents that particularly are used in high risk patient populations. "PCSK9 inhibitors fill an obvious therapeutic niche in selective high-risk patients, such as FH or statin-intolerant patients, who are not able to achieve the desired LDL-C level with conventional treatments," (Iftikhar J. Kullo, 2015) The patients whom noted to have a lower cost share or co-pay were 81%
Ace Inhibitors are used to treat hypertension and congestive heart failure (CHF). Most of the drugs that are Ace Inhibitors have the common ending –pril. It inhibits an enzyme; that decreases the tension of blood vessels and the blood volume, thus lowering blood pressure. Lotensin (benzapril) comes in tablets and is used for oral administration. It is one of the ace inhibitors that are indicated for treating hypertension. There is warning while using Lotensin when pregnant, it indicates to stop using immediately when pregnancy is detected. Vasotec (enalpril) comes in tablets and injection. It is indicated for the treatment of hypertension and is effective alone or in combination with other Ace Inhibitors agents, especially thiazide-type diuretics. There is a warning for fetal toxicity; when pregnancy is detected; stop using.
It is generally accepted that the method of payment to physicians affect their professional attitude and behaviour. Consequently, health policy makers manipulate payment system in an attempt to achieve optimal health care for their citizens such as improve accessibility, quality of care, patient’s satisfaction and cost containment. In Ontario, there are a wide range of mechanisms that are used to pay physicians for their services that are funded by both federal and provincial government. According to Canada Health Act annual report (2013), the majority of primary healthcare physicians are funded using the fee for service payment arrangement but of that majority, only less than 30% are compensated exclusively according the fee for service plan. The remaining physicians are funded using one of the following mixed compensation models:
This patient has been seen every 6 months for a focused physical examination with a total cholesterol, liver function panel and a FPG to evaluate his diabetes status and cholesterol management program. He has attended nutrition counseling in the past and has complied with lifestyle modifications including diet and exercise resulting in a weight loss of eight pounds over the past year. Over the pasts twelve months, this patient’s total cholesterol levels have significantly improved from 280 mg/dL to 190 mg/dL. This is the second time h...
The United States of America accounts for only 5% of the world’s population, yet as a nation, we devour over 50% of the world’s pharmaceutical medication and around 80% of the world’s prescription narcotics (American Addict). The increasing demand for prescription medication in America has evoked a national health crisis in which the government and big business benefit at the expense of the American public.
... (2013) IMS health study points to a declining cost curve for U.S. medicines in 2012 Retrieved from http://www.imshealth.com/portal/site/ims/menuitem.d248e29c86589c9c30e81c033208c22a/?vgnextoid=8659cf4add48e310VgnVCM10000076192ca2RCRD&vgnextchannel=437879d7f269e210VgnVCM10000071812ca2RCRD&vgnextfmt=default
Part 3: Discuss why there is a difference between facility and non-facility reimbursement rates. • Reimbursement rates are determined by the place of service or where the service was provided. The difference between facility and non-facility reimbursement rates and depended on the place of service. Facility price or reimbursement rate is based on the fee schedule amount when a physician provides the service in a facility setting, such as a hospital, Ambulatory Surgical Center, or skilled nursing facility. Non-facility price or reimbursement rate is based on the fee schedule amount when a physician performs a procedure in a non-facility setting such as an office.
In America, it has become a battle to earn a high paying job to cope with the expenses of a typical American. It has become even more of a battle for some people to afford medical prescriptions to keep healthy. Health becomes a crucial issue when discussed among people. No matter what, at one point or another, everyone is going to stand as a victim of the pharmaceutical industry. The bottom line is Americans are paying excessive amounts of money for medical prescriptions. Health-Care spending in the U.S. rose a stunning 9.3% in 2002, which is the greatest increase for the past eleven years. (Steele 46) Many pharmaceutical companies are robbing their clients by charging extreme rates for their products.
There are several basic approaches that can be utilized when conducting economic evaluations for any new health care intervention; which can include medications that are designed for the treatment and prevention of disease and how to relate the effectiveness with the overall monetary value of the new treatment. The economic tools that can be employed to perform such an analysis can be broken down into four basic parts that consist of cost-minimization analysis (CMA), cost-effectiveness analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA). These four categories will contain the major financial analytical techniques employed when evaluating medical treatments and interventions along with other types termed cost-consequence
While many low-income families obtain prescription coverage through government programs and may receive relatively generous drug benefits, those who have no prescription coverage are required to pay the full retail price charged at their pharmacies. Because the cash-paying customers are
Some people get stuck with a bill they must pay out of pocket after thinking that Medicare had their back when they didn’t. That’s why patients must always ask what their insurance does and doesn’t cover especially because most of the people on Medicare are old and non-working citizens that don’t have money to be paying out of pocket. The most important things that Medicare doesn’t care are most dental care, eye exams for glasses, and hearing aids. These are things that many older people which make up roughly 46 out of the 55 million of those on Medicare really need but can’t afford. But there’s also things that Medicare doesn’t cover that is implied for example cosmetic surgery, acupuncture and
Phillips, K. (2009, September 1). Catastrophic Drug Coverage in Canada (PRB 09-06E). Parliament of Canada . Retrieved March 12, 2012, from http://www.parl.gc.ca/Content/LOP/ResearchPublications/prb0906-e.htm
Long range BMI target/goal is less than 25. If lifestyle changes are not enough, than drugs that help lower cholesterol levels, high blood pressure and blood sugar can be used such as statins, fibrates or nicotinic acid. 4Other things that can be done include trying to fight the insulin resistance by starting thiazolidinedione. Also, treating the different risk factors like elevated blood pressure, prothrombotic and proinflammatory state independently. Our patient has 4 of the 5 risk factors: low HDL, high triglycerides, high fasting blood glucose, and central obesity.
There are three issues when it comes to the health care cost rising. The first is the rising cost in prescription drugs. The second area of rising cost is the increased technologies when it comes to the medical industry. The third problem is the aging population. Prescription drugs are the area of the fastest growing health care expense, and it is projected to grow at 20 to 30 percent each year over the next several years. There are many newer, more expensive drugs on the market, and the use of these prescriptions is exploding. In addition, with so much television advertising, many consumers ask their doctors for expensive, brand name drugs when there may actually be a generic drug that works just as well.
Russell, L. B. (2009). Preventing chronic disease: an important investment, but don’t count on cost savings. Health Affairs, 28(1), p. 42-45.
Arguably, all three situations met by the end of the 20th century. The rise of managed care, the increase of health care costs, and the growing number of uninsured patients place economic and political pressures on individuals (and governments) to find a cost-containment resolution. Additionally, since the late 1970s, the medical profession has faced the dominating principle of patient independence as a challenge – first to medical paternalism and then extending even to the principle of beneficence. More so, the usage of the Internet and other global media has expanded the ability of patients to access an...