Specific Issue Areas
Choose an issue area from the list below.
Aging
Individual physical and medical differences increase as people age. The
prevalence of multiple chronic diseases is much higher in older individuals,
metabolism rates change, organ function declines, and reactions to medications
may vary. As a result, multiple treatment options are necessary for safe,
effective, and individualized therapy, especially for our fastest growing
elderly population, those above age 85.
Cultural Diversity
Pharmacogenetic research in the past few decades has uncovered significant
differences among population groups in the metabolism, clinical effectiveness,
and side effect profiles of many clinically important drugs. In addition,
differences in how various populations view and respond to medicines underscores
the need for an individualized approach to pharmaceutical therapy.
Direct-to-Consumer Advertising
Direct-to-consumer advertising (DTCA) of prescription medications has
increased considerably since 1997 when the Food and Drug Administration
(FDA) clarified its guidelines relating to such advertisements. Along
with this growth has come controversy as society struggles to understand
the impact of this growth on patients’ health. Critics argue DTCA
drives patients into the doctor’s office, where they demand unneeded
medication and waste physicians’ time. Proponents claim DTCA educates
patients about conditions and treatments, facilitates doctor-patient communication,
and leads to new diagnoses.
Disease Management and Medicaid
Health Outcomes Management
Payers and providers are increasingly adopting
disease management programs in order to improve care for patient with
complex or chronic diseases. Good management of chronic disease can enhance
patient health outcomes and reduce overall costs.
Drawbacks of Component Management
In an effort to control costs, many payers and plans have tried
to aggressively manage individual components of care, typically restricting
coverage or limiting payments for individual types of services. But component
management fails to recognize that pressure on one type of service may
increase the use of other health care services, sometimes resulting in
higher overall costs and lower quality of care.
Drug Spending Trends
Advances in science and technology as well as changing patient
demographics are resulting in increased use of pharmaceuticals. Efforts
to ensure that patients receive health care that meets the standards of
national guidelines suggest that this increased use of pharmaceuticals
is appropriate.
Ensuring Quality of Care
Quality health care is universally desired, but it is difficult
to measure in a meaningful way that allows for comparisons between patients,
across providers and over time. Several national organizations are building
performance measures intended to reflect quality of care and to build
greater accountability into the system.
Evidence-based Medicine (EBM)
There is little consensus on what constitutes good evidence and how it is generated, evaluated and applied to benefit design. NPC is participating with other health care stakeholders in research, dialogue and education to ensure the process of evidence based medicine is inclusive, transparent and based on sound methods to best improve patient care.
Individualized Care
Addressing individual patient needs can provide better overall
utilization of health care resources and improve health outcomes.
Medicaid Pharmaceutical
Plan Resources
Statistical data on Medicaid pharmaceutical programs is available
in several formats.
Medication Compliance
Breakdowns in compliance with prescribed treatments can occur
at many levels. Physicians may not adhere to practice guidelines and thus
may not prescribe appropriate treatments. Patients may choose not to fill
or refill prescriptions due to cost, side effects, or the perception that
a medication is no longer necessary. Even when medications are prescribed
and obtained, patients may fail to take them as directed. When a patient
does not receive appropriate medications for any of these reasons, negative
health outcomes may result and additional expenditures incurred.
Value of Pharmaceuticals
Pharmaceuticals play a crucial role in maintaining good health.
The pharmaceutical industry is a leader in the development of new technologies
that improve health outcomes and quality of life. In many instances, these
same innovations have cost-saving effects.
|
