Pharmaceutical Technology Assessment for Managed Care: Current Practice and Suggestions for Improvement

Abstract

Increasingly powerful pharmaceuticals are of increasing clinical and economic importance to managed care organizations. Expenditures on pharmaceuticals have also been increasing, a trend driven by a number of factors, including the accelerating development of more-innovative and more- expensive agents; rising pharmaceutical prices; and higher utilization due to the aging of the population, direct-to-consumer advertising, and other factors. More often today, health plans and provider organizations are responsible for managing and paying for these cost increases, which creates an incentive for them to go beyond a focus on clinical effectiveness and safety to evaluate the cost-effectiveness of new drugs. In addition, the development of drug formularies and the current focus on best practices require that each new drug be assessed relative to available alternatives. The formal controls and guidelines resulting from managed care processes can increase quality and cost efficiency, but can also be a barrier to desirable innovations. Together, these developments have caused managed care organizations to realize that making good decisions on new pharmaceuticals is to their immediate financial and clinical benefit. Accordingly, many have expressed interest in improving their ability to evaluate new pharmaceuticals.

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Document Details

Document Type
Technical Report
Publication Date
Jan 01, 2001
Accession Number
ADA399257

Entities

People

  • Katherine Harris
  • Rebecca D'amato
  • Robin Meili
  • Sally Morton
  • Samuel A. Bozzette

Organizations

  • RAND Corporation

Tags

DTIC Thesaurus Topics

  • Biomedical Technology
  • Business Administration
  • Commerce
  • Computer Programming
  • Delphi Method
  • Drug Therapy
  • Economic Analysis
  • Health Care
  • Health Services
  • Management Personnel
  • Mathematical Models
  • Medical Personnel
  • Organizational Structure
  • Public Health
  • Surgery
  • Therapy
  • United States

Fields of Study

  • Medicine
  • Political science

Readers

  • Government Contracting/Procurement.
  • Medical or Health Care Field.
  • Systems Analysis and Design