Prescription Drug Priorities under the Biden Administration

2021 ◽  
Author(s):  
Kyle A. Gavulic ◽  
Stacie B. Dusetzina
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Insurance Coverage ◽  
Public Support ◽  
Economic Downturn ◽  
Drug Spending ◽  
Drug Prices ◽  
Prescription Drug Spending

Abstract In January 2021, the incoming Biden administration will inherit urgent priorities to curb health care spending and expand health care coverage to millions of Americans while also addressing the COVID-19 pandemic and resulting economic downturn. Among these competing priorities is the issue of access to and affordability of prescription drugs. Here, we outline Biden’s plan to directly lower prescription drug spending for payers and patients and to expand access to prescription medications through improved health insurance coverage. These policies could provide important financial protections for Americans against high prescription drug prices. Despite widespread public support for addressing prescription drug prices, many of Biden’s plans rely on Congressional action, which will be complicated by the narrow majority held by Democrats in the House and an evenly divided Senate. However, there may be other opportunities to reduce prescription drug spending and improve health insurance enrollment among the uninsured. While directly lowering drug prices would provide the most widespread savings for payers and patients alike, any successful effort to increase the number of Americans enrolled in health insurance or render it more affordable will still likely effectively lower patients’ out-of-pocket costs and improve access to prescription drugs.

Introduction

2021 ◽  
pp. 3-13
Author(s):  
Neumann Peter J. ◽  
Cohen Joshua T. ◽  
Ollendorf Daniel A
Keyword(s):  
Pharmaceutical Industry ◽  
Prescription Drug ◽  
Prescription Drugs ◽  
Health Expenditures ◽  
Drug Spending ◽  
Drug Pricing ◽  
Pricing Policies ◽  
Drug Prices ◽  
Financial Difficulties ◽  
Prescription Drug Spending

The pharmaceutical industry has produced wondrous scientific advances, but the progress has come at a cost. US prescription drug spending has increased faster in most recent years than other categories of health and now comprises roughly one-sixth of total health expenditures. Rising costs strain already stretched public budgets. Increasing patient out-of-pocket spending for deductibles and coinsurance has created financial difficulties for many individuals and their families, particularly among the sickest patients. The dueling trends of scientific breakthroughs and ever-rising spending present enduring challenges. On its own, rising spending would not be so concerning, but evidence suggests that drug prices often do not reflect the benefits they provide. Thus, there is an imperative to measure the value of prescription drugs and incorporate such measures into drug pricing policies.

scholarly journals Has The Era Of Slow Growth For Prescription Drug Spending Ended?

2016 ◽  
Vol 35 (9) ◽  
pp. 1595-1603 ◽  
Author(s):  
Murray Aitken ◽  
Ernst R. Berndt ◽  
David Cutler ◽  
Michael Kleinrock ◽  
Luca Maini
Keyword(s):  
Prescription Drug ◽  
Slow Growth ◽  
Drug Spending ◽  
Prescription Drug Spending

scholarly journals Analysis of the Effect of Health Insurance on Health Care Utilization in Rwanda

2021 ◽  
Author(s):  
Roger Muremyi ◽  
Dominique Haughton ◽  
François Niragire ◽  
Ignace Kabano
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Health Care Utilization ◽  
Health Care Services ◽  
Insurance Coverage ◽  
Secondary Data ◽  
Living Condition ◽  
Care Utilization ◽  
Health Coverage

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.

scholarly journals Correlates of health care access problems among reproductive age women in Ethiopia: In-depth analysis of 2016 Ethiopia demographic Health Survey

2019 ◽  
Author(s):  
koku Tamirat ◽  
Zemenu Tadesse Tessema ◽  
Fentahun Bikale Kebede
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Reproductive Age ◽  
Rural Residence ◽  
Factors Associated ◽  
Care Access ◽  
Reproductive Age Women

Abstract Background Health care access is timely use of personal health services to achieve best health outcomes. Difficulties to access health care among reproductive age women may led to different negative health outcomes to death and disability. Therefore, this study aimed to assess factors associated with problems of accessing health care among reproductive age women in Ethiopia.Method This study was based on 2016 Ethiopia Demography and Health Survey. Individual women record (IR) file was used to extract the dataset and 15, 683 women were included in the final analysis. A composite variable of problem of accessing health care were created from four questions used to rate problem of accessing health care among reproductive age women. Generalized estimating equation (GEE) model was fitted to identify factors associated with problem of accessing health care. Crude and Adjusted odds ratio with a 95%CI computed to assess the strength of association between independent and outcome variables.Result In this study the magnitude of problem in accessing health care among reproductive age women was 69.9% of with 95%CI (69.3 to 70.7). Rural residence (AOR= 2.13, 95%CI: 1.79 to 2.53), women age 35-49 years (AOR= 1.24, 95%CI: 1.09 to 1.40), married/live together (AOR= 0.72, 95%CI: 0.64 to 0.81), had health insurance coverage (AOR=0.83, 95%CI: 0.70 to 0.95), wealth index [middle (AOR=0.75,95%CI: 0.66 to 0.85) and rich (AOR=0.47,95%CI:0.42 to 0.53)], primary education(AOR= 0.80, 95%CI: 0.73 to 0.88), secondary education (AOR= 0.57, 95%CI:0.50 to 0.64) and diploma and higher education (AOR= 0.43, 95%CI: 0.37 to 0.50) were factors associated with problem of health care access among reproductive age women.Conclusion Despite better coverage of health system, problems of health care access among reproductive age women were considerably high. Health insurance coverage, middle and rich wealth, primary and above educational level were negatively associated with problems health care access. In contrast, older age and rural residence were positively associated with problems of health care access among reproductive age women. This suggests that further interventions are necessary to increase universal reproductive health care access for the achievement of sustainable development goals.

Prescription Drug Spending Trends For The Privately Insured In Maryland, 2000–2001

2004 ◽  
Vol 23 (5) ◽  
pp. 226-232
Author(s):  
Fadia T. Shaya ◽  
Steven Blume ◽  
C. Daniel Mullins
Keyword(s):  
Prescription Drug ◽  
Drug Spending ◽  
Prescription Drug Spending ◽  
Privately Insured

Health Care Financing for the Child With Catastrophic Costs

PEDIATRICS ◽  
1987 ◽  
Vol 80 (5) ◽  
pp. 752-757
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Medical Care ◽  
Insurance Coverage ◽  
Chronically Ill ◽  
Medical Needs ◽  
Structural Problems ◽  
Medical Care Costs ◽  
Private And Public ◽  
Care Costs

PURPOSE Historically, health insurance has not treated children fairly. Insured services have been oriented to the medical needs of adults, with children's unique needs given poor coverage or, in the instance or preventive care, rare coverage. These biases inherent in private and public health insurance also manifest themselves in the coverage of catastrophic care for children. The objectives of the following recommendations are to rectify some of the structural problems of health insurance that are faced by children, to ensure access to all needed health care services for all children, and to protect families from overwhelming out-of-pocket medical care costs. PRINCIPLES To address the needs of children through 21 years of age with illnesses that lead to catastrophic costs, all insurance plans must (1) be available to all children (and pregnant women) without regard to race, religion, national origin, economic status, health or functional status, or existing health insurance coverage; (2) include participation of both private and public sectors; (3) support the development of comprehensive, community-based systems of personal health care for the chronically ill child; (4) cover a broad array of child-specific health services; (5) contain costs through managed care and other means; and (6) require some financing from the child's family in proportion to their ability to pay. DEFINITION OF CATASTROPHIC NEED The American Academy of Pediatrics (AAP) defines catastrophic need by relative economic distress. Generally, a child whose family's out-of-pocket medical care costs reach a maximum of 10% of their annual adjusted gross income as reported to the Internal Revenue Services is one who, regardless of health status, income level, or existing insurance coverage, is in need of financial support for further medical expenses.

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