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1دورية أكاديمية
المؤلفون: Mulcahy, Andrew W
المصدر: Rand Health Q ; ISSN:2162-8254 ; Volume:11 ; Issue:3
مصطلحات موضوعية: Health Care Costs, Health Care Price Competition, Pharmaceutical Drugs
الوصف: Prescription drug research and development is, particularly in its most expensive later stages, an increasingly global endeavor undertaken by large, multinational firms. However, the availability of the resulting new drugs in individual countries and the timing of their launch can vary because of regulatory differences, business decisions, and other factors. The now-enacted Inflation Reduction Act of 2022 and other policy proposals aim to lower U.S. prices for brand-name drugs that are between three and four times as expensive as in other higher-income countries. Some stakeholders assert that lower U.S. prices will prevent U.S. patients from accessing some drugs sold in other countries or delay the launch of new drugs in the United States. To address these concerns, the author uses 2018 to 2022 data to compare the availability and timing of entry of new prescription drugs between the United States and other high-income countries.
العلاقة: https://pubmed.ncbi.nlm.nih.gov/38855389Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147638Test/
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2دورية أكاديمية
المؤلفون: Mulcahy, Andrew W, Schwam, Daniel, Lovejoy, Susan L
المصدر: Rand Health Q ; ISSN:2162-8254 ; Volume:11 ; Issue:3
مصطلحات موضوعية: Health Care Costs, Health Care Price Competition, Pharmaceutical Drugs
الوصف: Understanding the extent to which prescription drug prices are higher in the United States than in other countries-after accounting for differences in the volume and mix of drugs-is useful when developing and targeting policies to address both growth in drug spending and the financial impact of prescription drugs on consumers. This study summarizes findings from comparisons of drug prices in the United States and other high-income countries based on 2022 data and presents results for specific types of drugs, including brand-name originator drugs and unbranded generic drugs, and from sensitivity analyses.
العلاقة: https://pubmed.ncbi.nlm.nih.gov/38855386Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147645Test/
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3دورية أكاديمية
المؤلفون: Mulcahy, Andrew W.
المصدر: JAMA Health Forum ; volume 5, issue 3, page e234778 ; ISSN 2689-0186
الإتاحة: https://doi.org/10.1001/jamahealthforum.2023.4778Test
https://jamanetwork.com/journals/jama-health-forum/articlepdf/2816954/mulcahy_2024_ic_230009_1711487275.80652.pdfTest -
4دورية أكاديمية
المصدر: JAMA ; volume 326, issue 17, page 1744 ; ISSN 0098-7484
الإتاحة: https://doi.org/10.1001/jama.2021.13338Test
https://jamanetwork.com/journals/jama/articlepdf/2784289/jama_mulcahy_2021_ld_210050_1635806585.76029.pdfTest -
5دورية أكاديمية
المؤلفون: Danzon, Patricia. M, Mulcahy, Andrew W, Towse, Adrian K
المصدر: 238 ; 252 ; 86 ; 2 ; Health Care Management Papers ; Health Economics ; true ; published ; 24
مصطلحات موضوعية: Pharmaceuticals, prices, emerging markets, generics, procurement, Other Public Health, Pharmaceutics and Drug Design, eco, manag
الوصف: This paper analyzes determinants of ex-manufacturer prices for originator and generic drugs across a large sample of countries. We focus on drugs to treat HIV/AIDS, TB and malaria in middle and low income countries (MLICs), with robustness checks to other therapeutic categories and other countries. We examine effects of per capita income, income dispersion, number and type of therapeutic and generic competitors, and whether the drugs are sold to retail pharmacies vs. tendered procurement by NGOs. The cross-national income elasticity of prices is 0.4 across high and low income countries, but is only 0.15 between MLICs, implying that drugs are least affordable relative to income in the lowest income countries. Within-country income inequality contributes to relatively high prices in MLICs. Number of therapeutic and generic competitors only weakly affects prices to retail pharmacies, plausibly because uncertain quality leads to competition on brand rather than price. Tendered procurement attracts multinational generic suppliers and significantly reduces prices for originators and generics, compared to prices to retail pharmacies.
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6
المصدر: Rand Health Q
مصطلحات موضوعية: Health Policy and Health Economics
الوصف: Medicare payments for most surgical procedures cover both procedures and post-operative visits occurring within a global period of either 10 or 90 days following procedures. There have been concerns that fewer post-operative visits are provided than the number of post-operative visits considered when the procedure was valued. To help inform accurate valuation of procedures with global periods, the Centers for Medicare & Medicaid Services (CMS) required select practitioners to report on post-operative visits after select procedures with 10- or 90-day global periods. The authors of this article summarize patterns of post-operative visits for procedures furnished during calendar year 2019, building on prior research that analyzed data for procedures furnished from July 1, 2017, through June 30, 2018, and for the entire 2018 calendar year. During calendar year 2019, 96.5 percent of procedures with 10-day global periods did not have an associated post-operative visit. Approximately two-thirds of procedures with 90-day global periods had an associated post-operative visit; however, the ratio of observed to expected post-operative visits provided for 90-day global period procedures was only 0.38. Underreporting of post-operative visits might be driving these low rates. However, in sensitivity analyses limited to practitioners who were actively reporting their post-operative visits, post-operative patterns were largely similar to the main analysis. Collectively, these findings suggest that many expected post-operative visits are not delivered and that underreporting is unlikely to fully explain the low ratio of expected post-operative visits provided.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::968108ccabcf761d1b17758f1deed7faTest
https://europepmc.org/articles/PMC9519106Test/ -
7دورية أكاديمية
المؤلفون: Mulcahy, Andrew W., Gracner, Tadeja, Finegold, Kenneth
المصدر: JAMA Internal Medicine ; volume 178, issue 8, page 1042 ; ISSN 2168-6106
الإتاحة: https://doi.org/10.1001/jamainternmed.2018.2610Test
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2687526Test -
8
المؤلفون: Mulcahy, Andrew W., Ruder, Teague, Lovejoy, Susan L., Crespin, Daniel J., Rasmussen, Petra, Merrell, Katie, Mehrotra, Ateev
المصدر: Rand Health Q
مصطلحات موضوعية: Health Policy and Health Economics
الوصف: Medicare payment for many health care procedures covers not only the procedure itself but also most post-operative care over a fixed period of time (the “”global period””). The Centers for Medicare & Medicaid Services (CMS) sets payment rates assuming that a certain number and type of post-operative visits specific to each procedure typically occur. This article describes how CMS might use claims-based data on the number of post-operative visits to adjust valuation for procedures with 10- and 90-day global periods. There are links between the number of bundled post-operative visits and the components of valuation addressed in this study: work, practice expense (PE), and malpractice relative value units (RVUs). There is some ambiguity regarding how a reduction in post-operative visits translates into changes in work RVUs. In contrast, a reduction in post-operative visits has clear implications on physician time and direct PE. Changes in physician work, physician time, and direct PE will, in turn, affect the allocation of pools of PE and malpractice RVUs to individual services. The idiosyncrasies of the resource-based relative value scale system used to determine payment for Medicare services result in some ambiguity about how procedures should be revalued to reflect reductions in post-operative visits. These results may inform further policy development around revaluation for global procedures.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid________::d164392e843ba3ceea207bfc166cffc5Test
https://europepmc.org/articles/PMC9242560Test/ -
9دورية أكاديميةVariation in Estimated Surgical Procedure Times Across Patient Characteristics and Surgeon Specialty
المؤلفون: Crespin, Daniel J., Ruder, Teague, Mulcahy, Andrew W., Mehrotra, Ateev
المصدر: JAMA Surg
مصطلحات موضوعية: Original Investigation, envir, manag
الوصف: IMPORTANCE: The time involved in performing a procedure is a key factor in determining physician payments by Medicare. However, there are long-standing concerns regarding the accuracy of the time estimates generated by the American Medical Association/Specialty Society Relative Value Scale Update Committee surveys that are used in the valuation process, and there have been calls to use other data sources to estimate procedure times. OBJECTIVE: To compare estimated procedure times that come from claims with the times used in Medicare’s valuation process. DESIGN AND SETTING: Building off prior work using Medicare fee-for-service claims, procedure times were estimated from linked anesthesia claims data for 1349 different Current Procedure Terminology codes that are typically performed with anesthesia. All procedures in the nation performed in 2018 for Medicare fee-for-service beneficiaries were included in the analysis. These estimated times were compared with the times used in the valuation process. Analysis took place from February to November 2021. MAIN OUTCOMES AND MEASURES: Estimated procedure times using anesthesia claims were compared with the procedure time used in valuation by calculating an estimated-to-valuation procedure time ratio for each code. The valuation procedure time is publicly reported by Medicare. The mean and median ratio are presented over all procedures and for select high-volume codes as well as by patient characteristics (age, sex, and risk score) and specialty of the physician performing the procedure. RESULTS: Across 4.9 million procedures in this analysis, the mean estimated procedure time was 27% lower than the time used in the valuation process. There were notable exceptions, for which the mean estimated procedure time equaled or exceeded the valuation time including total hip arthroplasty (5% longer) and total knee arthroplasty (equal duration). Within a given code, older patients and those with more illness had longer procedure times. There was substantial variation across .
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10دورية أكاديمية
المؤلفون: Danzon, Patricia M., Mulcahy, Andrew W., Towse, Adrian K.
المساهمون: Eli Lilly Inc.
المصدر: Health Economics ; volume 24, issue 2, page 238-252 ; ISSN 1057-9230 1099-1050
الوصف: This paper analyzes determinants of ex‐manufacturer prices for originator and generic drugs across countries. We focus on drugs to treat HIV/AIDS, TB, and malaria in middle and low‐income countries (MLICs), with robustness checks to other therapeutic categories and the full income range of countries. We examine the effects of per capita income, income dispersion, competition from originator and generic substitutes, and whether the drugs are sold to retail pharmacies versus tendered procurement by non‐government organizations. The cross‐national income elasticity of prices is 0.27 across the full income range of countries but is 0.0–0.10 between MLICs, implying that drugs are least affordable relative to income in the lowest income countries. Within‐country income inequality contributes to relatively high prices in MLICs. Although generics are priced roughly 30% lower than originators on average, the variance is large. Additional generic competitors only weakly affect prices, plausibly because generic quality uncertainty leads to competition on brand rather than price. Tendered procurement that imposes quality standards attracts multinational generic suppliers and significantly reduces prices of originator and generic drugs, compared with their respective prices to retail pharmacies. ©2013 The Authors. Health Economics Published by John Wiley & Sons Ltd.
الإتاحة: https://doi.org/10.1002/hec.3013Test
