William H. Shrank, MD, MSHS

High co-payments for potentially curative cell and gene therapies create avoidable access barriers; value-based insurance design should eliminate patient cost sharing for these therapies.

This study provides insight on the experiences of patients of a national health plan with 2 structural determinants of health—health care discrimination and health literacy—and how those interact with social determinants of health and patient demographics.

Several physician and payer characteristics are associated with physician satisfaction with health plans. There is opportunity to improve physician satisfaction with payers, specifically in pharmacy.

Regardless of the number of manufacturers, generic drug prices presented double-digit average increases from 2012 to 2015.

The results of the study demonstrate the potential of provider-led health plans to deliver high-quality care and patient satisfaction. The relationships between these plans and outcomes differed by plan size, nonprofit status, and region.

Genomics-based precision medicine has the potential to transform healthcare delivery. However, effective collaborations among scientists, clinicians, and payers are needed to accelerate the translation of precision medicine to clinical practice and ensure its sustainability.

The annual price of monoclonal antibody therapies used in oncology and hematology is about $100,000 higher than those used in other disease states.

The results of this simulation model suggest that implementing a pharmacist-led medication reconciliation intervention at hospital discharge could be cost-saving compared with usual care.

The authors found that comorbidity burden and the direction of behavioral change influence the relationship between adherence and medical spend. This could affect the cost-benefit considerations of medication adherence programs.

Evaluation of a national retail pharmacy automatic refill program for patients on medication for chronic disease demonstrated significantly improved patient adherence and reduced medication oversupply.

This study examined patterns of medication adherence after a reduction in medication co-payment amount among privately insured patients living in racially diverse neighborhoods.

Initial medication filling during the first 2 to 4 months following initiation of a statin strongly predicted adherence patterns during the following year.

Only 1.2% of community-dwelling Medicare beneficiaries who received hospital-based observation services in 2010 were discharged to an SNF not covered by Medicare.

The release of the ATP-4 guidelines meaningfully changes the way the authors manage cholesterol and prevent cardiovascular disease. The broad footprint of retail pharmacies, with their ability to assess risk, prescribe, and manage adherence, allow them to be unique partners in cholesterol management and cardiovascular disease prevention.

Quality of care for 3 conditions, based on widely accepted objective measures, was superior in MinuteClinics compared with ambulatory care facilities or emergency departments.

Both potential benefits and unexpected consequences were found as a result of the rollout of electronic prescribing.

Reference pricing is an effective cost-containment tool widely used in other countries; it may be an attractive policy strategy for the US healthcare system.

Despite increasing availability of healthcare information technology, a literature review showed few clinical data on medication adherence interventions using this technology.

In this review of randomized controlled trials designed to improve adherence to cardiovascular medications, electronic interventions and in-person, pharmacy-based interventions showed the highest success rates.

This study compares the performance of several definitions of concurrent adherence to related medications.

Pharmacy benefit managers can increase value through promoting use of cost-effective medications, timely initiation of essential therapy, and adherence to that therapy.