HE Final Exam 2007-2018 Pharmacy Expenditures PDF

FINALEXAWRENFI Phance expenditures are 010 of HCcosts Americaspendsmorethan anyone combined 2007 2018 insulin morethan2002 peoplew no insurance paid more than 1k a month many relyon insulin new competitors 3 majorinsulincompa...

FINALEXAWRENFI Phance expenditures are 010 of HCcosts Americaspendsmorethan anyone combined 2007 2018 insulin morethan2002 peoplew no insurance paid more than 1k a month many relyon insulin new competitors 3 majorinsulincompaniesdid HCspending presygyngeons Factolinkedto inflation inprices U.S population growth Hc professional incomes growth by shiftfromindividualpaymentsto 3ʳᵈpartyfinancing range intensity ofHCservices FDA approves newdrugsevery year life expectancy aging pop by2035 65T to 78 mil phann use adults use meds Plans 501 take prescriptionmeds Americans fill 12 presupperyear develop new drugs PBMs maqgeeopdggfl.ms administerclaims managerelationships w phann companies retailplan  w pham companies manage rela hip p NOTalways distinguisablefrom insurers Aetna Cigna indirect influence overprescribing negotiate largeamounts w manuf 52 152 ofaveragewholesale funds from manuf discount come backas Le ex CVS Formula list of presordrugs insurercovers 3 471 lowcost generic pres w 5 copay preferred brand pres w rebate 20 copay non preferred brand press of rebate 50 copay PBM negot Rebate rebate return ofpartofpurchaseprice bysetterphanncompany to buyer PBM PBMshareportion w insurer mostusedfor Upestbadnamed drugs interchangeable products Cravelyforgenerics aim incentivizePBM's 3insurersto include manufproductsin formula Wholesalers not much power drugfrom manuf holdin warehouse get deliverto plan Mckesson Cardinal Amerisonne Bergen more than802 of payfull wholesale business e Ading average ns price CATI Impatient Pham Thospital reimbursementfordrugutilization 9h T.EE f fttfftitfhngngftp.T.in i1ctoratedtitdaiy It minimize overall budget negotiate discount Pham.Fime.attFaveragesale goto price generis 19 21 212 ofsales pay production R D marketing profits CPurdue MarkengforPham.Poducts OxyContin Phama startedin 1899 Phantastry introduced Bayer aspirin now industrytightly regulated but massive drugdevelopment complexacost Pharm innovations promotesocialwelfare Chew drugdev lifeexpectancy lifecycleofbug. i find them compoundto treat disease teston animals see if not toxic C 3 yrs test on humans 3phase Phase I low doseto healthy v2 yrs Phase 2 doseto unhealthy 2 yrs Phase 3 test effectiveness in preventing 3 4 yrs coming nggTtgidd IIi um when approved for sale companyhastemp legalmonopoly bypatent 17yrs in US backfrom using it ontesting get getattention of drug needsto establishitself in market doctors afterpatentexpires othercompanies make it cheaper profits EFIiiii.it E iaia.mn in R D inventwdings Patent costs Inafforable for some drugprices detersubsequentinnovation pham companiesnot compete w self ofothers risky ifshedfor research buildsoffof research Optimal lengthof Patent patentprotectionRetunebenefits from in us present cost of prices  present or les Non Med Pres Drug NMPD Use use of pus medwho doctor's press Mfpt poblemoucedinotherwaysthandireete.o city for experience feeling CDCsays pres abuseis an epidemicespeciallyopioids pres abuse NOT affectall states abused opioids stimulants commonly tranquilizers sedatives Reasons of misuse reliefphysical pain 652 backpain of painreliever feelgoodI get high relievetension relax 102 12 or older 50.80 gotpiesfrom friend relative gateway habitforming leadto misuseto otherdrugs FL has 40 morethananyone purchases of oxycodone Consequences physical emotional labor market HC productivity crime of of life drugoverdosedeath quality Eb visits substance abusetreatment admin poisonings  I ng overdosedeaths risingsteadily over at yrs han in 8É fÉ 41 tfht.hn aff g Some intentional majority were unintentional poisoning 9110 poisoning deaths are caused bydyshfi.fi SdatcypotsAutipsychotis Categories mostlyinadult mf exposures Substance usedisordertreatment Admin mill admin 11 opiate admin 262 opiate otherthan heroin 102 medical assistant treat phy I psycaspects of addiction counseling medication CBT total ofpues Opioidabuse in the US is 14.6billiongrowing EE.ksi.es Pnes Yl.nawmsue info collected byPDMPs usedto support access to legit medical use of controlledsub ahI.Ifitanu 1ttftet.mg outline druguse abusetrendsto inform PHinitiative am  pharmacists dispensers requiredto enter inelectronicdatabase of pres controlledsubstances patient ID info prescriberdispenser name of med dose 3 amount Statehouse law Physicalexamrequirements require before to exam patient lightggger from dispensing certaintypesof may prohibitpham phys drugs if douts the drugswerepres followingexam Pusfei.IE EI days tosupplycontroud subs amounteng setunity of pills of ex phonon in FL notdispense more than 30daysupply of subs in schedule111 uponoral pres Tarthquittsfiythmattt tan Controvedsub prevent IDRegauntlaws patient requireIDpriorsfiring controlledsubs states included have attIlowe mandating pharm request ID before dispensing I reque fore spensing DPEITshhlg.ptentgetcontrovdsubfrom multiple HCpractionerswho prescribes knowledgeoffhus law prohibits DS them antifraud state or mandate disclosure law Pain ManagementClinic Laws i doroffec HC facilitythat conspires in prescribing dispensing is outside scope of standards of med practice in community violatelaw Key presidugepidentic require state oversight ownership operation of pain management clinics facilities or practice locations Ph xEgtews Tandteropidautidote commtiflist reversefatal resp depression caused by heroin other opioids FDA approved 1971 pres med NICs 1 Third party prescribing person notmakingphys knowthey're overdoserist 2 Standing orders for Naloxone distr of med to authorize provision someone who meetcriteria 3Expandedaccessthenpharm Naloxone access I  I 4 Immunityprovisionsforprescriberdispenser admin civil criminal immunityto licensed HC providers or giveresponders to naloxone admin ask.iemg tm eea sina.it aim eliminatebarrierstooverdosetreatment case fatality rate whenoverdose occur Health Economics Questions Health Economics studychoice of people to providers policymakers make regardinghealth HC w care resources Ex of HEOwes why limited sources of choices tradeoffs Individual level shouldyoureturntothedoctorsince themedicine isn't working HCproviderlevel whichpatientgetsthekidneytransplant balancejustice medical utility Insurer level whyonlyI presdrugcovered s not theother Orincludedintiersof Medicare LocalState Nationallevel policy screening earlydetectionprog Bhmore movescreenity changescreenguidelines changeallocationof state Medicarebudgetforadd Moneytaken from other HCservices  Shouldsubuseamentalhealthdisordertreat becoveredbyMedicaid reallocation ofstateMedicaidbudgets Opioid epid 2021 81 000overdose State laws curtailingopioidepi PDMPs doctorshoppinglaws 3physicalexamreq entact state laws implementenforcestatelawsis statebudgetislimited reallocatestatebudget moneyawayfromother things Lexeducation EowYhiÑhEwYs at choices involve theft choose best alt alt w good benefit decisionaltradoff use economicevalanalysis Cost Benefit Analysis CBA pro conof choice balance ex.pro mightainstop about making choices con cost 100 Tewkmosttimphitt benefitof treatmentis yearsadded no markt totrade yearsgained pain suffering observeprize Economist putvalueon life 3illness measurevalueon life andinnessby buyingsmokedetectors behavior buyingcheaper canthatslesssafe jobfor acceptingdangerous Valueof life fT fYtd 1551 1.170.00 Qua faE fIfd yrbadhealth accountbothquality quantity length oflifewhenaccessingthe outcome of new treatments researchers use statisticssurveys professionaljudgementto estimatevalue of year a spent in diff statesofdisability lifequality QALYs ofyrsgained weightlady.factors monetiyff.IE tn of life 100.00 assume usingding against cancer 2 yrs assume patientlikelylives w depression QALY 2x 44 value of 2 yns 2 yrs 44 100000 888,000 EconEval Cost 2 Benefit of Sub AbuseTreat in FL Itoftreatingalcoholusedsoders in FL benefits of treating alcohol use in disorders in FL Value consegof alcohol misuse in state cost areted benefitforstate contractedservicesbuilding costinclude personnel supplies materials 3facilities equipment miscellanens totalannual of SUD in FL 216 Mill Theoriesthat explain health disparities Adherenceto medical advice Chowto take meds elderlynotcomebacktorefillwed earlylifeevents Cexposureto traumaticevent on early income levels stressof being poor work capacity calso unemployed impatience future patienceto invest in health Socio economicstatus SES socialstanding measured byeducating Cloweducation low SE incomemployment Health disparity diff in health incidenceprevalence mortality burdenof disease betal populations ex death rate in cancer in bothmen women in AA measure pop health by lifeexpectancy incidenceofdiseases Chewcases dis morbidity selfreportedhealth Pygledfinest status 1949 income healthstatus disparities may bebeforebirth infants in poorfamilies tohave poorhealthlaterintife gapin health widensafter age Hypotherftimhllitheatti feasoieties Broadtheories forpottystoolsto address disparities Efficientproducerlyp better educated moreefficientproducers of health comelation school lessonsteachtotakegood levelofhealth care of self schoolmakesthem more patient bettereducated more likelyto do regimens reverse causality asthma missedschooldays thirdfactor unobserved traits timepreferencepatience Goldman s Smith 202 studyof HIV 4TypeI diabetes lesseducated helpedthem moreeducated don'tneedextrasupport UHU Thriftyphenotypehyp.fm is for inefficientatproducinghealth lack of resolved in utero inearly Iff ggfd childhood scare environment forabundance neeytodevelopdabsityto.ir laterinlife exp goldstandard cause and effectrelations he adf.fi y totesthyp Usenaturaliments environmentalshocks earthquakefamine DutchFamine study in WWII in uteroduringfamiliarity afterfamine  inadulthood Directincometyp.ISpanties exist cause richhavemore Lindahl 2005 http ttfyktt byioa 5 yr mortalityrate betterfoodlivingconditions 62 42 stress Allostatioloadhyp.sulonged repeated unfty 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stockdeterivatesovertime maintainstock investin health health as consumption goodallowstodojoyful things moretimeto work Implication don'tdesirehealth healthallows a joyfullife FtdTmental Developmentaytf.to financed health infectionsdisease bydonations DevelopModern hosp advance technology surgery antisepsis industrialization urban wealthy middleclass third party workerscomp privateins JohnHopkins researchteachings Tychosp length ofstay Short 630days long 30days type community commonlargerteachingCresidency health mental disordertreatment ownership private non forprofit public federal VAhosp statecounty local  1 P y size ofbeds short 200beds large 200 beds hosp W uni medschool ultentiarycare.ME petulant transplant Hosposts labor 532of supplies 34 402 of healthpersonnel employedbyhosp phys paidseparately privatepractice cut controlsalaryorfive pople CA who quality Competitions consumershaveoptions thmiied.ttms contributed Race compete for patients Unnecessary onads physicians x2 of 8equip Contracts questionable adminto extend stay consequences costs forall overuseservices inequality fragmentedcave resourcemisallocation Markett sp.ve perfectcomp market takepriceasgiven many buyerssellers subst options monopoly influenceprice 1seller NDsubst barriertoentry fixedcost barrier WTVgal ownerofnaturalresource ORgrantedgovlien patentorcopyright Oligopoly influenceprice  goply p Chosp Services small ofsellers naturallegalbarriersofentry HOSP.iqguEsty differentiated product oligopoly strictbarrier to entry buildingtechstaff 60 198mil certif of need CON approvebeforebuilding Servicesnotperfectsubst have myffeeiqa.IE social mane collusion hosp agree keep prices Herfindahl Hirschman Index HHI Esi Si marketshareforfirm HHIcloseto 1 fewerfirms inmarketChighcare O large HH1 0.33 average in metropolitan highlycone if HHI 0.21 WmtedGp_ insurance needto lookforlowdhost inelastic demand gov prisveimburse rates Medicareaid pricecomp not gonein emergency nature copayments managedcare org select hosp on PriceY.mg te goodvariety Cpublicpricelists ins3patientsrarelypaythemdirectly hosp4 ins negotiate rates varyw barginawing power samehosp diff rate diff ins hosp like blocks change ClevelandCli Memorials  Cleveland Memorials main UYYE.IE IEsmnoitia Itm Medicaid Disproportionate Share DHS medicaid give foruncompcame unpaidhosp care paid MIfff.IEy ins pay forwww.ccross subsidiatt David etall 204 Colorado Arizonafacenew campfromcardiaccenters Melnick Forkych 2008 studybilling paymentfromCAbetal2001 05 Demandfiff.FI sae.tastapuefer.Cforspindoctors Economic prices income insurance typeof rMaTymare entrepreneurs wl PH Curlyanins buthave 301 self control overpricing patient employed ladyon add changesare 1 than payment restof employees 3ʳᵈpartymost frominsu morethan812 private CEIId.li mveneinn Medicare reimb rate 3Lowacceptance out of pocket Changes billLoinsurancemb.byins rest outofpocket Feefor Servicespecifiedpaymentforeach unit ofsenprovidedCphyspaidbyeach 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