scholarly journals PMC21 EVALUATING THE DIFFERENCE BETWEEN AVERAGE WHOLESALE PRICE AND WHOLESALE ACQUISITION COST FOR PHARMACEUTICALS IN THE UNITED STATES

2005 ◽  
Vol 8 (6) ◽  
pp. A71
Author(s):  
DC Malone ◽  
M Mahmood
2016 ◽  
Vol 32 (6) ◽  
pp. 385-392
Author(s):  
Bander Balkhi ◽  
Enrique Seoane-Vazquez ◽  
Rosa Rodriguez-Monguio

Background: Despite the cost of pharmaceuticals, studies assessing prices of osteoporosis drugs are lacking. This study examined trends in prices of osteoporosis drugs in the United States in the period 1988–2014, assessed pricing structure of osteoporosis drugs, and evaluated price trends before and after generic drugs market entry.Methods: Data were derived from the U.S. Food and Drug Administration, the RedBook, the Centers for Medicare & Medicaid Services, and the Federal Supply Schedule (FSS). Descriptive statistics and segmented linear regression analyses were performed.Results: In the period 1988–2014, osteoporosis drug prices increased faster than the inflation. The average wholesale price (AWP) of generic products at market entry represented 90 percent of the AWP for the corresponding brand. Prices of brand products continued to increase after generic entry. Drug prices showed a significant variation when compared with the brand AWP. The brand wholesale acquisition cost (WAC) was typically set at 83.3 percent of the AWP. Community pharmacies acquired osteoporosis brand drugs at a median of 80.5 percent of the brand AWP. Significant reductions in brand AWP were observed for Medicare Part B (78.5 percent of the brand AWP), generic National Average Drug Acquisition Cost (33.7 percent), and FSS (22.5 percent).Conclusions: There are significant differences in the manufacturer prices, pharmacy acquisition costs and reimbursement rates of osteoporosis drugs. Pharmaceutical companies listed prices are higher than the pharmacy actual estimated acquisitions costs, and the prices used for reimbursement to providers. Generic drugs entry significantly drives down prices; still, prices of branded drugs facing generic competition continued to increase after generic market entry.


2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.


Criminologie ◽  
2005 ◽  
Vol 30 (1) ◽  
pp. 53-72 ◽  
Author(s):  
Marc Alain

The professional smuggling of mass consumption products develops when demand for a product is not adequately fulfilled by the legitimate market. The difficulties encountered in supplying are, in most contemporary cases, caused by real rarity of the desired product. For other cases, however, the rarity is largely virtual in that government taxes aimed at the product in question lead to increasing the product's price to a prohibitive end. This was the case with cigarettes in Canada between 1985 and 1994. Before both, the federal and provincial, governments decided to drastically decrease cigarette taxes in February 1994, the price for a pack of cigarettes was five to six times higher than the same product in the United States. This article begins with a brief review of the contribution made by economists in regard to contemporary smuggling. Focus will be aimed at common characteristics of the smuggling phenomenon across the world. Elements which are more particular to the Canadian smuggling situation will be identified as well. While the difference in the price of cigarettes between Canada and the United States would seem to be the undeniable driving force behind the development of smuggling activities at the countries ' border, one key question remains unexplained. Why was the volume of contraband unequally distributed across Canada even though the price of cigarettes remained largely consistent throughout all provinces? The level of organization of smuggling networks was much higher in Eastern Canada, and particularly in Quebec, than it was in the western provinces. It is argued that the reasons for this are not only due to price, but to a series of political, historical, and geographical factors which allowed cigarette smugglers to function better in Quebec than in the rest of the country.


1987 ◽  
Vol 5 (1) ◽  
pp. 104-119 ◽  
Author(s):  
James W. Nickel

The United States has never been culturally or religiously homogeneous, but its diversity has greatly increased over the last century. Although the U.S. was first a multicultural nation through conquest and enslavement, its present diversity is due equally to immigration. In this paper I try to explain the difference it makes for one area of thought and policy – equal opportunity – if we incorporate cultural and religious pluralism into our national self-image. Formulating and implementing a policy of equal opportunity is more difficult in diverse, pluralistic countries than it is in homogeneous ones. My focus is cultural and religious diversity in the United States, but my conclusions will apply to many other countries – including ones whose pluralism is found more in religion than in culture.


2008 ◽  
Vol 38 (2) ◽  
pp. 267-292 ◽  
Author(s):  
Regina Madalozzo

Unmarried cohabitation has become a more frequently observed phenomenon over the last three decades, and not only in the United States. The objective of this work is to examine income differentials between married women and those who remain single or cohabitate. The empirical literature shows that, while the marriage premium is verified in different studies for men, the result for women is not conclusive. The main innovation of my study is the existence of controls for selection. In this study, we have two sources of selectivity: into the labor force and into a marital status category. The switching regressions and the Oaxaca decomposition results demonstrate the existence of a significant penalty for marriage. Correcting for both types of selection, the difference in wages varies between 49% and 53%, when married women are compared with cohabiting ones, and favors non-married women. This result points to the existence of a marriage penalty.


2020 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Nanda Alfarina ◽  
Hasdi Aimon

This study aims to determine the effect of monetary policy measured by the central bank’s policy rate (X1) on portfolio investment (Y) in Indonesia and United States in the long run. The data used are secondary data seouced from SEKI BI, FRED The FEd, coinmarketcap.com, and investing.com, with the VECM (Vector Error Correction Mechanism) analysis methode. The study show The study shows the differences between the results that occur in Indonesia and the United States. The policy interest rate has a significant positive effect on portfolio investment in the long run in Indonesia, while in the United States the interest rate in the long run has a significant negative effect on portfolio investment. The difference in research results between the two countries shows the need for different treatment for monetary authorities in encouraging portfolio investment 


2020 ◽  
Vol 9 (2) ◽  

Americans typically view the United States as a democracy and are rightly proud of that. Of course, as those of a more precise nature, along with smug college students enrolled in introductory American government classes, are quick to point out, the United States is technically a republic. This is a bit too clever by half since James Madison, in The Federalist Papers, defined a republic the way most people think of a democracy—a system of representative government with elections: “[The]… difference between a Democracy and a Republic are, first the delegation of the Government, in the latter, to a small number of citizens elected by the rest.” What the framers thought of as democracy is today referred to as direct democracy, the belief that citizens should have more direct control over governing. The Athenian assembly was what the framers, Madison in particular, saw as the paragon of direct democracy—and as quite dangerous. While direct democracy has its champions, most Americans equate democracy with electing officials to do the business of government.


PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 836-837
Author(s):  
GERALD KATZMAN

To the Editor.— There have been several attempts to define the person-power needs for neonatologists in the United States.1-3 The reports by Merenstein et al2 and the AAP Committee on Fetus and Newborn1 maintain that there is presently an adequate number of neonatologists, whereas in a 1981 editorial, Robertson3 predicted increasing shortages of neonatologists. Why the difference between the conclusions? My answer to this question is that the reports by Merenstein et al and the AAP used calculated ratios of neonatologists to live births or lengths of stay, whereas the Robertson editorial expressed concern about the critical care needs of the physiologically unstable neonate.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Andrew R Pines ◽  
Jack Haglin ◽  
Bart Demaerschalk

Introduction: There is a lack of data regarding financial trends for procedural reimbursement in stroke care. An understanding of such trends is important as progress is made to advance agreeable reimbursement models in the care of stroke patients. The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for commonly utilized procedures in stroke care from 2000 to 2019. Methods: Reimbursement data for Current Procedural Terminology (CPT) codes was extracted from the Centers for Medicare & Medicaid Services. CPT codes were determined by frequency of procedures for Stroke-related ICD codes at our institution. All monetary data was adjusted for inflation to 2019 US dollars utilizing changes to the United States consumer price index. Results: After adjusting for inflation, the average reimbursement for all four included procedures within hemorrhagic stroke (ICD I60-I62) decreased by 18.4% from 2000 to 2019. The average reimbursement for two procedures within ischemic stroke (ICD I63), craniotomy and thrombectomy, increased by 3.5% (2003 -2019) and increased 3.0% (2016-2019), respectively. Data was not available for craniotomy prior to 2003, and not available for thrombectomy prior to 2016. Further, the adjusted reimbursement rate for included telestroke codes decreased by 12.1% from 2010-2019. All other included procedures decreased by 3.5% throughout this time. The difference in reimbursement rate between telestroke and other stroke-related procedures was statistically significant (p < .0001). Conclusion: To our knowledge, this is the first study to evaluate trends in Medicare reimbursement for stroke care. When adjusted for inflation, Medicare reimbursement for included procedures has steadily decreased from 2000 to 2019. Increased awareness of these trends is important to assure continued access to quality stroke care in the United States.


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