J Am Pharm Assoc (2003). 2019 Jan-Feb;59(1):121-124. doi: 10.1016/j.japh.2018.10.015. Epub 2018 Dec 4.
To describe roles for pharmacists to facilitate payer-initiated value-based contracts within state Medicaid programs.
According to the Centers for Medicare and Medicaid Services, prescription drug expenditures are expected to see the fastest annual growth in the health care sector over the next decade owing to a greater number of costly specialty medications and overall higher drug prices. Increased prescription costs make value-based contracts particularly compelling opportunities for payers. Pharmacists, as formulary subject-matter experts, have unique skills that are beneficial to value-based contract designs. Much like their role in formulary development, pharmacists' clinical knowledge of evidence-based medicine and cost-effective medication use ensures that contract negotiations are both clinically appropriate and address cost-savings components. Well designed value-based contracts can potentially improve the quality of care without increasing overall health care expenditures. Other potential benefits of value-based contracts include reducing waste, achieving cost predictability, and achieving fiscal responsibility for high-cost drugs while supporting patient access.
描述药剂师在州医疗补助计划中促进支付方发起的基于价值的合同的作用。
根据医疗保险和医疗补助服务中心的数据，由于更多昂贵的专科药物和整体更高的药物价格，预计在未来十年内，处方药支出将成为医疗保健领域增长最快的领域。由于处方药成本的增加，基于价值的合同对于支付方来说是特别有吸引力的机会。药剂师作为处方药物的主题专家，拥有独特的技能，这对基于价值的合同设计非常有益。就像他们在处方开发中的作用一样，药剂师在循证医学和成本效益药物使用方面的临床知识可以确保合同谈判既具有临床适宜性，又能解决节省成本的部分。精心设计的基于价值的合同可以在不增加总体医疗保健支出的情况下提高护理质量。基于价值的合同的其他潜在好处包括减少浪费、实现成本可预测性、为高成本药物承担财政责任，同时支持患者获得药物。
