The Cost Savings of Biosimilars Can Help Increase Patient Access and Lift the Financial Burden of Health Care Systems

Introduction Asynchronous teledermatology (TD) has undergone exponential growth in the past decade, allowing better diagnosis. Moreover, it saves both cost and time and reduces the number of visits involving travel and opportunity cost of time spent on visits to the hospital. The present study performed a cost-saving analysis of TD units and assessed whether they offered a cheaper alternative to conventional monitoring (CM) in hospitals from the perspective of public health-care systems (PHS) and patients. Methods This study was a retrospective assessment of 7030 patients. A cost-saving analysis comparing TD units to CM for patients at the Hospital de Poniente was performed over a period of one year. The TD network covered the Hospital de Poniente reference area (Spain) linked to 37 primary care (PC) centres that belonged to the Poniente Health District of Almeria. Results We observed a significant cost saving for TD units compared to participants in the conventional follow-up group. From the perspective of a PHS, there was a cost saving of 31.68% in the TD group (€18.59 TD vs. €27.20 CM) during the follow-up period. The number of CM visits to the hospital reduced by 38.14%. From the patients’ perspective, the costs were lower, and the cost saving was 73.53% (€5.45 TD vs. €20.58 CM). Discussion The cost-saving analysis showed that the TD units appeared to be significantly cheaper compared to CM.

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How to assess the value of low-value care

BMC Health Services Research ◽

10.1186/s12913-020-05825-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

José Antonio Sacristán

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Health Care Services ◽

Health Care Systems ◽

Effective Intervention ◽

Use Of Resources ◽

True Value ◽

Care Systems ◽

Definition Of ◽

The Cost

Abstract Background Many of the strategies designed to reduce “low-value care” have been implemented without a consensus on the definition of the term “value”. Most “low value care” lists are based on the comparative effectiveness of the interventions. Main text Defining the value of an intervention based on its effectiveness may generate an inefficient use of resources, as a very effective intervention is not necessarily an efficient intervention, and a low effective intervention is not always an inefficient intervention. The cost-effectiveness plane may help to differentiate between high and low value care interventions. Reducing low value care should include three complementary strategies: eliminating ineffective interventions that entail a cost; eliminating interventions whose cost is higher and whose effectiveness is lower than that of other options (quadrant IV); and eliminating interventions whose incremental or decremental cost-effectiveness is unacceptable in quadrants I and III, respectively. Defining low-value care according to the efficiency of the interventions, ideally at the level of subgroups and individuals, will contribute to develop true value-based health care systems. Conclusion Cost-effectiveness rather than effectiveness should be the main criterion to assess the value of health care services and interventions. Payment-for-value strategies should be based on the definition of high and low value provided by the cost-effectiveness plane.

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Health equality, social justice and the poverty of autonomy

Health Economics Policy and Law ◽

10.1017/s1744133117000093 ◽

2017 ◽

Vol 12 (4) ◽

pp. 411-433 ◽

Cited By ~ 3

Author(s):

Christopher Newdick

Keyword(s):

Public Health ◽

Health Care ◽

Health Care Systems ◽

Public Health Care ◽

Public Health Policies ◽

Public Health Systems ◽

Care Systems ◽

Health Equality ◽

The Cost ◽

Lifestyle Diseases

AbstractHow does the concept of autonomy assist public responses to ‘lifestyle’ diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a ‘nanny’ state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.

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Bariatric Surgery can Lead to Net Cost Savings to Health Care Systems: Results from a Comprehensive European Decision Analytic Model

Obesity Surgery ◽

10.1007/s11695-014-1567-5 ◽

2015 ◽

Vol 25 (9) ◽

pp. 1559-1568 ◽

Cited By ~ 46

Author(s):

Oleg Borisenko ◽

Daniel Adam ◽

Peter Funch-Jensen ◽

Ahmed R. Ahmed ◽

Rongrong Zhang ◽

...

Keyword(s):

Bariatric Surgery ◽

Health Care ◽

Health Care Systems ◽

Cost Savings ◽

Decision Analytic Model ◽

Analytic Model ◽

Care Systems

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Outpatient Stereotactic Brain Biopsies

10.21203/rs.3.rs-419258/v1 ◽

2021 ◽

Author(s):

Bertrand MATHON ◽

Pauline MARIJON ◽

Maximilien RICHE ◽

Vincent DEGOS ◽

Alexandre CARPENTIER

Keyword(s):

Health Care ◽

Medical Center ◽

Health Care Systems ◽

Cost Savings ◽

Brain Biopsy ◽

Outpatient Setting ◽

Stereotactic Brain Biopsy ◽

Same Day Discharge ◽

Care Systems ◽

Few Data

Abstract BackgroundOutpatient neurosurgery is rising popularity leading to patients’ satisfaction and cost-savings. Although several North-American teams have shown the safety of outpatient stereotactic brain biopsies, few data from other countries with different health care systems are available. ObjectiveWe therefore conducted a feasibility and safety study on the outpatient stereotactic brain biopsies. MethodsWe prospectively examined all the consecutive stereotactic brain biopsies performed in an outpatient setting at our tertiary medical center, between June 2018 and September 2020.ResultsAmong the 437 patients who underwent stereotactic brain biopsy during the study period, 40 (9.2%) patients were enrolled for an outpatient management. The sex ratio was 1 and the median age on biopsy day was 55 [41-66] years. The median distance from patients’ home to hospital was 17 kms [3-47]. 95% of patients had prebiopsy ASA score of 1 or 2 and mRs equal to 2 or less. The rate of same-day discharge was 100%. No patient experienced post-biopsy symptomatic complication necessitating readmission within the month following the biopsy. One patient (2.5%) resorted to an unplanned consultation. Histological findings obtained from brain biopsy led to a diagnosis in all patients; the most frequently found were neoplastic lesions (77.5%)ConclusionStereotactic brain biopsies can therefore be safely achieved on an outpatient setting in carefully selected patients. This process could be more widely adopted in other neurosurgical centers, without affecting the quality of patient’s health care and safety. In this article, we propose management guidelines and pre-biopsy checklist for performing ambulatory stereotactic brain biopsies.

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Financing Integrated Care Models

10.1093/med/9780190276201.003.0006 ◽

2017 ◽

Author(s):

Bruce J. Schwartz ◽

Gillian Stein ◽

Scott Wetzler

Keyword(s):

Health Care ◽

Behavioral Health ◽

Integrated Care ◽

Health Care Systems ◽

Cost Savings ◽

Behavioral Health Care ◽

Fee For Service ◽

Cost Offset ◽

Medical Sector ◽

Care Systems

The idea that addressing behavioral health issues will generate sufficient cost savings in the general medical sector to reduce overall health care spending is a poignant argument for integrating primary care and behavioral health care programs. The enactment of recent health care legislation, particularly the Mental Health Parity and Addiction Equity Act (2008) and the Affordable Care Act (2010), affords a unique opportunity to transform the way in which care is funded. This transformation is vital to the integrated care project. This chapter outlines the history of integrated care financing and the separation of mental and physical health care systems and discusses reimbursement strategies that have been suggested to replace fee-for-service models. The authors argue that the success of the medical cost offset hypothesis depends on targeting high-cost patients, as well as moving away from siloed reimbursement toward global budgeting.

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Redefinition of the notion of Universal Access to the health care

Macedonian Pharmaceutical Bulletin ◽

10.33320/maced.pharm.bull.2014.60.02.007 ◽

2014 ◽

Vol 60 (02) ◽

pp. 67-73

Author(s):

Rubin Zareski

Keyword(s):

Health Care ◽

Universal Access ◽

Health Care Systems ◽

Sustainable Growth ◽

Developed Economies ◽

Long Run ◽

State Budgets ◽

Care Systems ◽

Increasing Demand ◽

The Cost

In the last 10 years we are experiencing hidden debate where decision makers do not want to opt for the “unpopular” decisions, which need to be taken if we need a sustainable health systems on a long run. Lessons from the 2008 crisis have proven that policy decisions driven by external global forces that are beyond our controlwere inconsistent and reasonable damaging also on a mid term run. Instead of addressing the core of the problem, in the attempt to reply to the old/new challenges, governments were “fanning the fire”. It becomes obvious that spending more money in uncoordinated way will not solve the problem. Reducing the cost by cutting the fiscal budgets, would further ”squeeze” the capacity of the economies and reduce the demand, which has to be driver to the solution and not the problem. Consequently in a high market developed economies, cutting the health budgets will only temporarily “make up” the state budgets, creating structural financial instability of the Funds both private and State. In this lose-lose situation, with existing misbalances, contracting budgets, increasing demand and sensitive market players responses, there is a high time for redefinition of the Universal access to the health care systems and global policy responses which will on long term create balanced and sustainable growth of health markets.

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The cost of being transgender: where socio-economic status, global health care systems, and gender identity intersect

Psychology and Sexuality ◽

10.1080/19419899.2019.1660705 ◽

2019 ◽

Vol 11 (1-2) ◽

pp. 103-119 ◽

Cited By ~ 1

Author(s):

Julie M. Koch ◽

Chris/tine McLachlan ◽

Cornelius J. Victor ◽

Jess Westcott ◽

Christina Yager

Keyword(s):

Health Care ◽

Global Health ◽

Gender Identity ◽

Economic Status ◽

Health Care Systems ◽

Socio Economic Status ◽

Care Systems ◽

Global Health Care ◽

And Gender ◽

The Cost

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Is There Evidence to Support Brand to Generic Interchange of the Mycophenolic Acid Products?

Journal of Pharmacy Practice ◽

10.1177/0897190015585758 ◽

2016 ◽

Vol 30 (1) ◽

pp. 9-16 ◽

Cited By ~ 3

Author(s):

Karen Phillips ◽

Prabashni Reddy ◽

Steven Gabardi

Keyword(s):

Renal Allograft ◽

Health Care Systems ◽

Graft Function ◽

Cost Savings ◽

Regulatory Requirements ◽

Organ Rejection ◽

Drug Classes ◽

Care Systems ◽

The Cost ◽

Viable Method

The uptake of generic immunosuppressants lags comparatively to other drug classes, despite that the Food and Drug Administration (FDA) uses identical bioequivalence standards for all drugs. Transplant societies acknowledge the cost savings associated with generic immunosuppressants and support their use following heart, lung, kidney, or bone marrow transplantation. Seven studies of the pharmacokinetics or clinical efficacy of generic mycophenolate mofetil compared to the innovator product are published; all studies and products were ex-United States. Three studies did not demonstrate any pharmacokinetic differences between generic and innovator products in healthy subjects, achieving FDA bioequivalence requirements. Two studies in renal allograft recipients demonstrated no difference in area under the curves between generic and innovator products, and in one, the maximum concentration (Cmax) fell outside the FDA regulatory range. Two studies revealed no difference in acute organ rejection or graft function in renal allograft recipients. Patient surveys indicate that cost is a barrier to immunosuppressant adherence. Generics present a viable method to reduce costs to payers, patients, and health care systems. Adherence to immunosuppressants is crucial to prevent graft failure. An affordable regimen potentially confers greater adherence. Concerns regarding the presumed inferiority of generic immunosuppressants should be assuaged by regulatory requirements for bioequivalency testing, transplant society position statements, and pharmacokinetic and clinical studies.

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