Sample records for drug benefit plan

  1. Relative importance of attributes of drug benefit plans: Thai civil servants' perspective.

    PubMed

    Ngorsuraches, Surachat; Wanishayakorn, Tanatape; Tanvejsilp, Pimwara; Udomaksorn, Siripa

    2013-01-01

    The drug benefit plan of Thailand's Civil Servant Medical Benefit Scheme (CSMBS) must be amended to control increasing costs; to that end, it is important to gather the views of beneficiaries before making changes to the benefit plan. To examine the relative importance of attributes of drug benefit plans from the perspective of CSMBS beneficiaries. Attributes and levels adopted from focus group discussions and a preliminary survey were used to develop a questionnaire concerning hypothetical drug benefit plans. A convenience sample of 650 CSMBS beneficiaries in Songkhla province was asked to rate the drug benefit plans. To determine the beneficiaries' decision models, judgment analysis was used. Policy-capturing analysis was used to examine the beneficiaries' preferences, and cluster analysis was conducted to explore the variability among judgment plans. Judgment policy insight was also examined. The results of the study showed that the beneficiaries weighed on cost-sharing as their most important attribute. The results remained unchanged, although only data from the beneficiaries who used the compensatory model were analyzed. The results of the cluster analysis showed that the largest cluster of beneficiaries weighed mostly on the cost-sharing attribute. The judgment policy insight results not only supported the finding that most beneficiaries focused on the cost-sharing attribute but also revealed that they might have the least understanding of how the formulary attribute affected beneficiaries' decision making. Cost-sharing was the most important attribute for the CSMBS beneficiaries. This study indicated that a possible preferred drug benefit plan should have no cost-sharing, permit access only to drugs listed in a closed formulary, allow beneficiaries to obtain 3 months of drugs, and allow them to obtain drugs from either a community pharmacy or a government hospital. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Quantifying Components of Drug Expenditure Inflation: The British Columbia Seniors' Drug Benefit Plan

    PubMed Central

    Morgan, Steven G

    2002-01-01

    Objective To quantify the relative and absolute importance of different factors contributing to increases in per capita prescription drug costs for a population of Canadian seniors. Data Sources/Study Setting Data consist of every prescription claim from 1985 to 1999 for the British Columbia Pharmacare Plan A, a tax-financed public drug plan covering all community-dwelling British Columbians aged 65 and older. Study Design Changes in per capita prescription drug expenditures are attributed to changes to four components of expenditure inflation: (1) the pattern of exposure to drugs across therapeutic categories; (2) the mix of drugs used within therapeutic categories; (3) the rate of generic drug product selection; and (4) the prices of unchanged products. Data Collection/Extraction Methods Data were extracted from administrative claims files housed at the UBC Centre for Health Services and Policy Research. Principal Findings Changes in drug prices, the pattern of exposure to drugs across therapeutic categories, and the mix of drugs used within therapeutic categories all caused spending per capita to increase. Incentives for generic substitution and therapeutic reference pricing policies temporarily slowed the cost-increasing influence of changes in product selection by encouraging the use of generic drug products and/or cost-effective brand-name products within therapeutic categories. Conclusions The results suggest that drug plans (and patients) would benefit from more concerted efforts to evaluate the relative cost-effectiveness of competing products within therapeutic categories of drugs. PMID:12479495

  3. 78 FR 15019 - Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0196] Food and Drug Administration Prescription Drug User Fee Act V Benefit-Risk Plan; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice, request for comments. SUMMARY: The Food and...

  4. 45 CFR 156.122 - Prescription drug benefits.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Prescription drug benefits. 156.122 Section 156... Essential Health Benefits Package § 156.122 Prescription drug benefits. (a) A health plan does not provide... at least the greater of: (i) One drug in every United States Pharmacopeia (USP) category and class...

  5. 45 CFR 156.122 - Prescription drug benefits.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Prescription drug benefits. 156.122 Section 156... Essential Health Benefits Package § 156.122 Prescription drug benefits. (a) A health plan does not provide... at least the greater of: (i) One drug in every United States Pharmacopeia (USP) category and class...

  6. Reforming private drug coverage in Canada: inefficient drug benefit design and the barriers to change in unionized settings.

    PubMed

    O'Brady, Sean; Gagnon, Marc-André; Cassels, Alan

    2015-02-01

    Prescription drugs are the highest single cost component for employees' benefits packages in Canada. While industry literature considers cost-containment for prescription drug costs to be a priority for insurers and employers, the implementation of cost-containment measures for private drug plans in Canada remains more of a myth than a reality. Through 18 semi-structured phone interviews conducted with experts from private sector companies, unions, insurers and plan advisors, this study explores the reasons behind this incapacity to implement cost-containment measures by examining how private sector employers negotiate drug benefit design in unionized settings. Respondents were asked questions on how employee benefits are negotiated; the relationships between the players who influence drug benefit design; the role of these players' strategies in influencing plan design; the broad system that underpins drug benefit design; and the potential for a universal pharmacare program in Canada. The study shows that there is consensus about the need to educate employees and employers, more collaboration and data-sharing between these two sets of players, and for external intervention from government to help transform established norms in terms of private drug plan design. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  7. Drug benefit decisions among older adults: a policy-capturing analysis.

    PubMed

    Cline, Richard R; Gupta, Kiran

    2006-01-01

    Under the Medicare Prescription Drug Improvement and Modernization Act, beneficiaries remaining in the traditional fee-for-service plan will face a variety of drug benefit options provided by private stand-alone prescription drug plans. Although these plans likely will differ with regard to a number of important attributes, little is known about older adults' judgment processes in this context. The objectives of this study were to 1) better understand the manner in which drug insurance attributes are weighted in older adults' judgments of drug benefit suitability, 2) explore variability in judgment strategies among seniors, and 3) assess seniors' insight into their judgment policies. Three focus groups were conducted with 19 older adults to elicit important drug plan attributes. A policy-capturing study with 32 seniors, none of whom had participated in the focus groups, then was employed to quantify the impacts of these attributes on judgments of plan suitability. Focus group participants reported that copayment, monthly premium, deductible, formulary use, and mail-order pharmacy use were important drug insurance attributes. The policy-capturing study showed that deductibles and premiums were weighted most heavily in judgment formation. However, significant variability in judgment policies was apparent, with 3 distinct groups emerging from cluster analysis. The first emphasized deductibles and copayments, the second premiums and deductibles, and the third use of a mail-order pharmacy and deductibles. Study volunteers exhibited insight into the role of some plan attributes in their judgments, but not others. Cost-sharing provisions appear to be most important in older adults' evaluations of drug benefit plans. However, significant heterogeneity in attribute preferences also was apparent in this study. Older adults may not be cognizant of the manner in which some plan attributes affect their evaluations, suggesting a role for decision aids in this process.

  8. Cost-Control Mechanisms in Canadian Private Drug Plans

    PubMed Central

    Kratzer, Jillian; McGrail, Kimberlyn; Strumpf, Erin; Law, Michael R.

    2013-01-01

    Approximately 68% of Canadians receive prescription drug coverage through an employer-sponsored private plan. However, we have very limited data on the structure of these plans. This study aims to identify and describe the use of cost-control mechanisms in private drug plans in Canada and describe what private coverage looks like for the average Canadian. Using 2010 data from over 113,000 different private drug plans, provided by Applied Management Consultants, we determined the overall use of key cost-control measures, and the cost-control tools that appear to be gaining currency compared to a report on benefits coverage in 1998. We found that the use of common cost-control measures is relatively low among Canadian private benefits programs. Co-insurance is much more common in private coverage plans than co-payments. Deductibles are uncommon in Canada and, when in place, are very small. The use of annual and lifetime maximums is increasing. Canadian private benefits programs use few cost-control measures to respond to increasing costs, particularly in comparison to their public counterparts. These results suggest there are ample opportunities for greater efficiency in private sector drug coverage plans. PMID:23968672

  9. Impact of pharmacy benefit design on prescription drug utilization: a fixed effects analysis of plan sponsor data.

    PubMed

    Roebuck, M Christopher; Liberman, Joshua N

    2009-06-01

    To study the impact of various elements of pharmacy benefit design on both the absolute and relative utilization of generics, brands, retail pharmacy, and mail service. Panel data on 1,074 plan sponsors covering 21.6 million individuals over 12 calendar quarters (2005-2007). A retrospective analysis of pharmacy claims. To control for potential endogeneity, linear fixed effects models were estimated for each of six dependent variables: the generic utilization rate, the brand utilization rate, the generic dispensing rate (GDR), the retail pharmacy utilization rate, the mail service utilization rate, and the mail distribution rate. Most member cost-share variables were nonlinearly associated with changes in prescription drug utilization. Marginal effects were generally greater in magnitude for brand out-of-pocket costs than for generic out-of-pocket costs. Time dummies, as well as other pharmacy benefit design elements, also yielded significant results. Prior estimates of the effect of member cost sharing on prescription drug utilization may be biased if complex benefit designs, mail service fulfillment, and unmeasured factors such as pharmaceutical pipelines are not accounted for. Commonly cited relative utilization metrics, such as GDR, may be misleading if not examined alongside absolute prescription drug utilization.

  10. Toward a rational, value-based drug benefit for Medicare.

    PubMed

    Lopert, Ruth; Moon, Marilyn

    2007-01-01

    A major challenge facing Congress is what changes, if any, to make to Medicare Part D. With the apparent failure of the Democrats' attempt to remove the prohibition on government intervention in drug price negotiations, the party's next steps are unclear. One suggested option is a plan administered by the Centers for Medicare and Medicaid Services (CMS), to compete with private plans and facilitate a transition to a more rational structure. We discuss issues surrounding the design of such a mechanism and how it might provide a transition toward a more rational and sustainable drug benefit in the longer term.

  11. Demand for a Medicare prescription drug benefit: exploring consumer preferences under a managed competition framework.

    PubMed

    Cline, Richard R; Mott, David A

    2003-01-01

    Several proposals for adding a prescription drug benefit to the Medicare program rely on consumer choice and market forces to promote efficiency. However, little information exists regarding: 1) the extent of price sensitivity for such plans among Medicare beneficiaries, or 2) the extent to which drug-only insurance plans using various cost-control mechanisms might experience adverse selection. Using data from a survey of elderly Wisconsin residents regarding their likely choices from a menu of hypothetical drug plans, we show that respondents are likely to be price sensitive with respect to both premiums and out-of-pocket costs but that selection problems may arise in these markets. Outside intervention may be necessary to ensure the feasibility of a market-based approach to a Medicare drug benefit.

  12. A comparison of mail-service and retail community pharmacy claims in 5 prescription benefit plans.

    PubMed

    Clark, Bartholomew E; Siracuse, Mark V; Garis, Robert I

    2009-06-01

    Little evidence has been presented to date that would either support or refute a widely held belief that mail-service pharmacy utilization routinely produces savings in drug benefit costs for prescription benefit plan sponsors. To present a comparative analysis of mail-service and community pharmacy service drug benefit costs for 5 employer-sponsored prescription drug benefit plans. A cross-sectional comparison of 17,725 matched transaction pairs of community and mail-service prescriptions from a data set comprised 484,987 prescription claims from a convenience sample of 5 employer-sponsored prescription benefit plans. Differences between community pharmacy and mail-service prescription transactions were examined at the per-unit level of analysis for drug ingredient costs, dispensing fees, co-payments, dollar amounts paid by plan sponsor, and total dollar amounts. Overall, the total cost of prescriptions was lower through mail-service pharmacies for all 5 plans studied. Two of 5 plans had co-payment incentives to use mail-service, yet plan sponsors paid more for mail-service drugs; respectively, 4.5% and 8.3% more overall, 25.0% and 21.4% more for generic medications; and 3.0% and 7.0% more for brand name medications. Mail-service co-payments were 48.9% and 51.7% lower. Mail-service utilization rates were 15.2% and 31.5% of the total number of prescriptions dispensed in the period studied. Three of 5 plans had no co-payment incentive to use mail-service and paid less for mail-service drugs; respectively, 18.7%, 6.6%, and 15.7% less overall; 17.4%, 15.6%, and 7.9% less for generic medications; and 18.8%, 5.2%, and 16.6% less for brand name medications. Mail-service co-payments were 10.5% more, 5.2% less, and 1.8% more than community pharmacy co-payments, respectively. Mail-service utilization rates were 0.8%, 1.2%, and 4.4%. Co-payment incentives to use mail-service pharmacies instead of community pharmacies were associated with higher mail-service utilization rates

  13. Comparing employer-sponsored and federal exchange plans: wide variations in cost sharing for prescription drugs.

    PubMed

    Buttorff, Christine; Andersen, Martin S; Riggs, Kevin R; Alexander, G Caleb

    2015-03-01

    Just under seven million Americans acquired private insurance through the new health insurance exchanges, or Marketplaces, in 2014. The exchange plans are required to cover essential health benefits, including prescription drugs. However, the generosity of prescription drug coverage in the plans has not been well described. Our primary objective was to examine the variability in drug coverage in the exchanges across plan types (health maintenance organization or preferred provider organization) and metal tiers (bronze, silver, gold, and platinum). Our secondary objective was to compare the exchange coverage to employer-sponsored coverage. Analyzing prescription drug benefit design data for the federally facilitated exchanges, we found wide variation in enrollees' out-of-pocket costs for generic, preferred brand-name, nonpreferred brand-name, and specialty drugs, not only across metal tiers but also within those tiers across plan types. Compared to employer-sponsored plans, exchange plans generally had lower premiums but provided less generous drug coverage. However, for low-income enrollees who are eligible for cost-sharing subsidies, the exchange plans may be more comparable to employer-based coverage. Policies and programs to assist consumers in matching their prescription drug needs with a plan's benefit design may improve the financial protection for the newly insured. Project HOPE—The People-to-People Health Foundation, Inc.

  14. The new medicare drug benefit: formularies and their potential effects on access to medications.

    PubMed

    Huskamp, Haiden A; Keating, Nancy L

    2005-07-01

    During congressional debate over the Medicare Part D prescription drug benefit, much attention was focused on nominal benefit design. Relatively little attention was paid to details about how plans would operate, such as the design of drug formularies. Yet, formularies will be important tools for controlling costs, and may be as important as nominal benefit design in determining enrollees' access to medications and out-of-pocket costs. We describe Part D plan incentives and how they may influence formulary design, and then provide recommendations for Part D formulary implementation. We encourage the Centers for Medicare & Medicaid Services (CMS) to develop standardized tools to provide physicians and patients with up-to-date and easily accessible information about covered drugs on each plan's formulary (perhaps via a central website) and a national set of easy-to-follow procedures for reconsideration and appeals. Such efforts should reduce administrative burden and better allow physicians to help patients obtain needed medications.

  15. Drug Plan Coverage Rules

    MedlinePlus

    ... the first time Filling a prescription without your new plan card Costs for Medicare drug coverage Joining a health or drug plan How Part D works with other insurance Find health & drug plans Drug plan coverage rules Note Call your Medicare drug plan to find ...

  16. The Effect of Benefits, Premiums, and Health Risk on Health Plan Choice in the Medicare Program

    PubMed Central

    Atherly, Adam; Dowd, Bryan E; Feldman, Roger

    2004-01-01

    Objective To estimate the effect of Medicare+Choice (M+C) plan premiums and benefits and individual beneficiary characteristics on the probability of enrollment in a Medicare+Choice plan. Data Source Individual data from the Medicare Current Beneficiary Survey were combined with plan-level data from Medicare Compare. Study Design Health plan choices, including the Medicare+Choice/Fee-for-Service decision and the choice of plan within the M+C sector, were modeled using limited information maximum likelihood nested logit. Principal Findings Premiums have a significant effect on plan selection, with an estimated out-of-pocket premium elasticity of −0.134 and an insurer-perspective elasticity of −4.57. Beneficiaries are responsive to plan characteristics, with prescription drug benefits having the largest marginal effect. Sicker beneficiaries were more likely to choose plans with drug benefits and diabetics were more likely to pick plans with vision coverage. Conclusions Plan characteristics significantly impact beneficiaries' decisions to enroll in Medicare M+C plans and individuals sort themselves systematically into plans based on individual characteristics. PMID:15230931

  17. [Interplay between marketing authorization and early benefit assessment of drugs].

    PubMed

    Beinlich, Peggy; Müller-Berghaus, J; Sudhop, T; Vieths, S; Broich, K

    2015-03-01

    The early benefit assessment of newly approved drugs with new active substances or new applications that came into force on 1 January 2011 still presents a challenge to the parties involved. This article highlights the interplay between drug marketing approval and early benefit assessment. The constellation of a European, and even an international, largely harmonized, drug authorization process, with a mostly nationally regulated drug reimbursement situation causes inevitably friction, which could be reduced through joint advice discussions during the planning phase for pivotal studies. In 2013, the Federal Institute for Drugs and Medical Devices (BfArM) and the Paul Ehrlich Institute (PEI) provided 439 scientific advice procedures, compared with 98 advice meetings held at the Federal Joint Committee (G-BA), for 12 of which the BfArM or PEI provided written advice. The numbers of advice meetings held at the G-BA are increasing; however, the national competent authorities are involved in only a fraction of these. From the perspective of the national competent authorities, prompt and consistent involvement in the advice procedures regarding early benefit assessment would be useful and desirable.

  18. Beneficiary price sensitivity in the Medicare prescription drug plan market.

    PubMed

    Frakt, Austin B; Pizer, Steven D

    2010-01-01

    The Medicare stand-alone prescription drug plan (PDP) came into existence in 2006 as part of the Medicare prescription drug benefit. It is the most popular plan type among Medicare drug plans and large numbers of plans are available to all beneficiaries. In this article we present the first analysis of beneficiary price sensitivity in the PDP market. Our estimate of elasticity of enrollment with respect to premium, -1.45, is larger in magnitude than has been found in the Medicare HMO market. This high degree of beneficiary price sensitivity for PDPs is consistent with relatively low product differentiation, low fixed costs of entry in the PDP market, and the fact that, in contrast to changing HMOs, beneficiaries can select a PDP without disrupting doctor-patient relationships.

  19. First-line medications for alcohol use disorders among public drug plan beneficiaries in Ontario.

    PubMed

    Spithoff, Sheryl; Turner, Suzanne; Gomes, Tara; Martins, Diana; Singh, Samantha

    2017-05-01

    To examine use of first-line alcohol use disorder (AUD) medications (naltrexone and acamprosate) among public drug plan beneficiaries in the year following an AUD diagnosis. Retrospective population-based cohort study. Ontario. Individuals eligible for public drug plan benefits who had an AUD diagnosis at a hospital visit between April 1, 2011, and March 31, 2012. Number of AUD medications dispensed to public drug plan beneficiaries who had a recent hospital visit with an AUD diagnosis, and number of prescriptions dispensed per person. A total of 10 394 Ontarians between 18 and 65 years of age were identified who had a hospital visit with an AUD diagnosis and were eligible for public drug plan benefits. The rate of AUD medications dispensed in the subsequent year was 3.56 per 1000 population (95% CI 2.51 to 4.91; n = 37). This rate did not differ significantly by sex ( P = .83). Very few public drug plan beneficiaries are dispensed first-line AUD medications in the year following an AUD diagnosis. Copyright© the College of Family Physicians of Canada.

  20. Impact of multi-tiered pharmacy benefits on attitudes of plan members with chronic disease states.

    PubMed

    Nair, Kavita V; Ganther, Julie M; Valuck, Robert J; McCollum, Marianne M; Lewis, Sonya J

    2002-01-01

    To evaluate the effects of 2- and 3-tiered pharmacy benefit plans on member attitudes regarding their pharmacy benefits. We performed a mail survey and cross-sectional comparison of the outcome variables in a large managed care population in the western United States. Participants were persons with chronic disease states who were in 2- or 3-tier copay drug plans. A random sample of 10,662 was selected from a total of 25,008 members who had received 2 or more prescriptions for a drug commonly used to treat one of 5 conditions: hypertension, diabetes, dyslipidemia, gastroesophageal reflux disease (GERD), or arthritis. Statistical analysis included bivariate comparisons and regression analysis of the factors affecting member attitudes, including satisfaction, loyalty, health plan choices, and willingness to pay a higher out-of-pocket cost for medications. A response rate of 35.8% was obtained from continuously enrolled plan members. Respondents were older, sicker, and consumed more prescriptions than nonrespondents. There were significant differences in age and health plan characteristics between 2- and 3-tier plan members: respondents aged 65 or older represented 11.7% of 2-tier plan members and 54.7% of 3-tier plan members, and 10.0% of 2-tier plan members were in Medicare+Choice plans versus 61.4% in Medicare+Choice plans for 3-tier plan members (P<0.05). Controlling for demographic characteristics, number of comorbidities, and the cost of health care, 2-tier plan members were more satisfied with their plan, more likely to recommend their plan to others, and less likely to switch their current plans to obtain better prescription drug coverage than 3-tier plan members. While members were willing to purchase higher cost nonformulary and brand-name medications, in general, they were not willing to pay more than 10 dollars (in addition to their copayment amount) for these medications. Older respondents and sicker individuals (those with higher scores on the Chronic

  1. Benefit Plans in Higher Education.

    ERIC Educational Resources Information Center

    King, Francis P.; Cook, Thomas J.

    Fifth in a series and the latest of several studies on employee benefits in higher education, this book constitutes a full-scale revision of the earlier "Benefit Plans in American Colleges" (1969). The principal benefit plans provided by U.S. colleges and universities are described, analyzed, and evaluated. Included are retirement…

  2. [Comprehensive drug safety plan in a health department].

    PubMed

    Bujaldón-Querejeta, N; Aznar-Saliente, T; Esplá-González, S; Ruíz-Darbonnéns, S; Pons-Martínez, L; Talens-Bolos, A; Martínez-Ramírez, M; Camacho-Romera, D; Aranaz-Andrés, J M

    2014-01-01

    To develop and implement a comprehensive drug safety plan in a hospital for the years 2009-2011. Applying the Strengths Weaknesses/Limitations Opportunities Threats (SWOT) methodology, the baseline situation was analyzed and a broad strategy or plan was subsequently developed, defining the scope, responsibilities, objectives and strategic actions and indicators in order to measure the achievement of the results. A comprehensive drug safety plan with the main objective of identifying and reducing the medication-related problems in patients treated in the Hospital de San Juan in Alicante has been developed. The plan contains five strategic objectives, twenty strategic actions and the indicators to assess its outcomes. It also contains a timetable for its establishment and evaluation. Developing a comprehensive strategic plan allows the current situation relating to drug safety to be determined. The results obtained after its introduction will define its applicability. Due to the lack of publications of similar plans and results, the evaluation of this plan will be useful whether it is favorable or not. As a side benefit of the development, the multidisciplinary team continues to work on improving patient safety in the care process, and the safety culture continues to grow among the professionals. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  3. Use of Product Listing Agreements by Canadian Provincial Drug Benefit Plans

    PubMed Central

    Friesen, Melissa K.; Thomson, Paige A.; Daw, Jamie R.

    2013-01-01

    Background: Product listing agreements (PLAs) between drug manufacturers and drug plans are increasingly common worldwide. Use of PLAs by Canadian provinces has not previously been documented. Methods: We collected data from all provinces on funding and PLA use for 25 drugs that were reviewed by the Common Drug Review (CDR) in 2010 or 2011 and funded by at least one province as of May 2012. We measured correlations between coverage and PLA use, and CDR recommendations and PLA use. Results: The number of drugs from our sample funded by provinces ranged from three in Prince Edward Island to 21 in Ontario. PLA use ranged from zero in Quebec, Prince Edward Island, and Newfoundland and Labrador to 20 in Ontario. The correlation between drugs funded and PLAs used by each province was statistically significant (r=0.57, p=0.04); excluding Ontario, however, the correlation was not significant (r=0.10, p=0.40). There was a stronger correlation between the number of provinces funding a drug and the number using PLAs among the subset of drugs with negative CDR recommendations (r=0.87, p<0.01) versus those with positive recommendations (r=0.52, p=0.03). Of the 12 drugs sampled with a negative CDR recommendation, 10 were funded with a PLA in at least one province. Interpretation: There is wide interprovincial variation in PLA use and evidence that PLAs may be used to fund drugs that are not otherwise cost-effective. If global pricing strategies are making PLAs necessary, Canadian governments should collaborate to improve the equity, transparency and effectiveness of PLAs across provinces. PMID:23968637

  4. Cost-benefit analysis of drug treatment services: review of the literature*

    PubMed

    Cartwright, William S.

    2000-03-01

    BACKGROUND: How valuable is public investment in treatment for drug abuse and dependency in the real world of everyday practice? Does drug abuse treatment provide benefits and how are they valued? What are the costs of obtaining outcomes and benefits? Cost-benefit analysis attempts to answer these questions in a standard analytic framework. AIMS: This paper reviews cost-benefit analyses with scientific merit so that analysts will have a current picture of the state of the research. It will also give public decision-makers information with regards to the available evidence for policy purposes. METHOD: Bibliographic searches were performed. Studies were obtained through the assistance of the Parklawn Health Library system, a component of the US Public Health Service. Selected studies were from the scientific literature with the exception of eight studies published as governmental reports. RESULTS: Cost-benefit studies have fallen into the following categories: (i) planning models for delivery systems in states and cities; (ii) short-term follow-up studies of individuals, (iii) single individual programs and (iv) state system's monitoring of outcomes. In 18 cost-benefit studies, a persistent finding is that benefits exceed costs, even when not all benefits are accounted for in the analysis. Much variation is found in the implementation of cost-benefit methods, and this is detailed across discussions of effectiveness, benefits and costs. Studies have emphasized the cost savings to society from the reduction in external costs created by the behavioral consequences of addiction and drug use. DISCUSSION: Economic analysis of drug treatment requires sophisticated conceptualization and measurement. Cost-benefit analysis of drug treatment has been a significant analytical exercise since the early 1970s when the public drug treatment system was founded in the United States. CONCLUSION: Drug abuse treatment services may be considered as contributing positive economic returns

  5. Impacts of generic competition and benefit management practices on spending for prescription drugs: evidence from Medicare's Part D benefit.

    PubMed

    Sheingold, Steven; Nguyen, Nguyen Xuan

    2014-01-01

    This study estimates the effects of generic competition, increased cost-sharing, and benefit practices on utilization and spending for prescription drugs. We examined changes in Medicare price and utilization from 2007 to 2009 of all drugs in 28 therapeutic classes. The classes accounted for 80% of Medicare Part D spending in 2009 and included the 6 protected classes and 6 classes with practically no generic competition. All variables were constructed to measure each drug relative to its class at a specific plan sponsor. We estimated that the shift toward generic utilization had cut in half the rate of increase in the price of a prescription during 2007-2009. Specifically, the results showed that (1) rapid generic penetration had significantly held down costs per prescription, (2) copayment and other benefit practices shifted utilization to generics and favored brands, and (3) price increases were generally greater in less competitive classes of drugs. In many ways, Part D was implemented at a fortuitous time; since 2006, there have been relatively few new blockbuster drugs introduced, and many existing high-volume drugs used by beneficiaries were in therapeutic classes with multiple brands and generic alternatives. Under these conditions, our paper showed that plan sponsors have been able to contain costs by encouraging use of generics or drugs offering greater value within therapeutic classes. It is less clear what will happen to future Part D costs if a number of new and effective drugs for beneficiaries enter the market with no real competitors.

  6. 76 FR 67105 - Cash Balance Plans; Benefit Determinations and Plan Valuations for Statutory Hybrid Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-31

    ... Balance Plans; Benefit Determinations and Plan Valuations for Statutory Hybrid Plans; Pension Protection... rules for determining benefits upon the termination of a statutory hybrid plan, such as a cash balance... cash balance plan presents unique issues for PBGC.\\2\\ In contrast to a traditional defined benefit plan...

  7. 29 CFR 778.214 - Benefit plans; including profit-sharing plans or trusts providing similar benefits.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Benefit plans; including profit-sharing plans or trusts providing similar benefits. 778.214 Section 778.214 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL POLICY OR INTERPRETATION NOT DIRECTLY RELATED...

  8. [Requirements for drug approval and additional benefits assessment: Regulatory aspects and experiences].

    PubMed

    Broich, K; Löbker, W; Schulte, A; Beinlich, P; Müller, T

    2016-04-01

    The early assessment of benefits of newly approved drugs with novel active substances or new applications, which came into force on 1 January 2011 still represents a challenge to all parties involved. This article highlights the definitions, regulatory requirements and interaction between drug marketing approval and early assessment of benefits in Germany. The constellation of an extensively harmonized European and even international drug authorization process with a predominantly national regulation of drug reimbursement situation inevitably causes friction, which could be markedly reduced through early joint advisory discussions during the planning phase for pivotal clinical trials. During the year 2015 the Federal Institute for Drugs and Medical Devices (BfArM) carried out 300 scientific advice procedures of which 34 were concerned with applications in the field of indications for the central nervous system (CNS). In comparison 98 advisory meetings were held by the Federal Joint Committee (G-BA) of which the BfArM provided advice in 12 instances and in 2 cases on CNS indications. Study design, endpoints and appropriate comparative therapies are the key issues in exchanges and discussions between the BfArM, the G‑BA and applicants. Under these aspects the BfArM and G‑BA promote an early and consistent involvement in early advice procedures regarding the prerequisites for drug approval and assessment of additional benefits.

  9. 48 CFR 1602.170-9 - Health benefits plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy, contract...

  10. 48 CFR 1602.170-9 - Health benefits plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy, contract...

  11. 48 CFR 1602.170-9 - Health benefits plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy, contract...

  12. 48 CFR 1602.170-9 - Health benefits plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy, contract...

  13. 48 CFR 1602.170-9 - Health benefits plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Health benefits plan. 1602... EMPLOYEES HEALTH BENEFITS ACQUISITION REGULATION GENERAL DEFINITIONS OF WORDS AND TERMS Definitions of FEHBP Terms 1602.170-9 Health benefits plan. Health benefits plan means a group insurance policy, contract...

  14. Nurse manager succession planning: A cost-benefit analysis.

    PubMed

    Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

    2018-03-01

    This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

  15. Prescription Drug Benefits: Cost Management Issues for Medicare

    PubMed Central

    Fox, Peter D.

    2003-01-01

    Little attention has been devoted in policy circles as to how Medicare would manage an outpatient prescription drug benefit. This article, first, discusses the role of the pharmacy benefits manager (PBM), the entity that processes claims and otherwise helps administer the benefit. It then discusses the major decisions that will be necessary regarding such matters as: which drugs should be covered; how broad should the pharmacy network be; whether there should be incentives to obtain generic rather than brand-name drugs when available; for drugs with no generic equivalent, should there be incentives to obtain less expensive, medically appropriate brand-name drugs; and how should prescription drug utilization be managed. PMID:15124374

  16. Medicare Part D and the Federal Employees Health Benefits Program: A Comparison of Prescription Drug Coverage

    PubMed Central

    Lovett, Annesha

    2013-01-01

    Background There is much debate currently about how to restructure the Medicare program to achieve better value for the money. Many have cited the Federal Employees Health Benefits Program (FEHBP) as a model for reform. Objective To compare drug coverage and cost-sharing between Medicare Part D and the FEHBP plans. Methods A cross-sectional comparison was conducted of January 2009 data obtained from the Centers for Medicare & Medicaid Services, the Office of Personnel Management, and 3 health plan websites. Regression analysis and t-tests were used to examine drug coverage, copayment, and coinsurance amounts among Medicare Part D and FEHBP plans. The final study sample of Medicare Part D plans consisted of 19 formularies, covering 63% of total Part D enrollment. These 19 formularies represented 232 stand-alone prescription drug plans. In addition, 5 prescription drug plans or formularies in the FEHBP plans were included, which represents 70% of total FEHBP enrollment. Results The results of this study reveal that formulary coverage of the top drugs dispensed and sold in the United States in 2009 ranged from 72% to 94% (average, 84%) in Medicare Part D plans and from 85% to 99% (average, 94%) in the FEHBP plans (P <.01). The mean copayment for generic drugs in Medicare Part D plans was $4.53 compared with a mean of $7.67 (P <.05) in the FEHBP plans. The difference between the 2 programs in mean copayment for brand-name drugs was nonsignificant. For generic drugs, the mean coinsurance rate was 17% for Medicare Part D plans and a mean of 20% for the FEHBP plans (P <.05). Conclusions This analysis shows that there are differences in prescription drug coverage and cost-sharing among plans within Medicare Part D and the FEHBP. To avoid extreme increases in payroll taxes and other revenues or major cutbacks in services, Medicare must explore ways to change the healthcare system to achieve better value for the money. The experience of the FEHBP suggests a possible means of

  17. Health plan approach to operationalizing a specialty drug management program.

    PubMed

    Tegenu, Mesfin

    2008-05-01

    Expenditures related to specialty drugs consume a significant percentage of available health care resources. Explain the process of transitioning the management of specialty drugs from medical services to pharmacy services in 2 managed care plans and provide insight into the issues encountered and solutions implemented based on 6 years of experience using traditional and innovative pharmacy utilization management tools to insure appropriate specialty drug use and reimbursement. The level of involvement in a specialty management program varies from managing only products dispensed by the retail, mail, and specialty pharmacy vendor to encompassing a broad list of specialty drugs distributed through a variety of channels. Efficient administrative, operational, and clinical processes are critical to the success of the program. Additionally, an accurate and timely claims processing procedure is also essential for success as is the ability to mine data and effectively report on the use of specialty products. A clinically sound, cost-effective, and patient-friendly program requires input from health plan members, pharmacy service leaders, and physician providers, and must overcome challenges associated with disrupting current relationships and removing competing incentives. A well-constructed and properly funded specialty drug management program results in clinical and financial benefits for the plan.

  18. The Military Survivor Benefit Plan: How Much Does It Benefit the Retiree?

    DTIC Science & Technology

    1979-12-01

    advantages . Chapter V offers conclusions and recommendations. 4 I II. What is the Survivor Benefit Plan This chapter briefly traces military survivor...basis, founded upon the relation of parties to each other, either pecuniary or of blood or affinity, to expect some benefit or advantage from the...AFIT/GOR/SM/79D-9 THE MILITARY SURVIVOR BENEFIT PLAN: HOW MUCH DOES IT BENEFIT THE RETIREE THESIS AFIT/GOR/SM /79D-9 Thomas L. Wade Captain USAF ,zkC

  19. 49 CFR 199.101 - Anti-drug plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Anti-drug plan. 199.101 Section 199.101... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.101 Anti-drug plan. (a) Each operator shall maintain and follow a written anti-drug plan that...

  20. 49 CFR 199.101 - Anti-drug plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Anti-drug plan. 199.101 Section 199.101... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.101 Anti-drug plan. (a) Each operator shall maintain and follow a written anti-drug plan that...

  1. 49 CFR 199.101 - Anti-drug plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Anti-drug plan. 199.101 Section 199.101... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.101 Anti-drug plan. (a) Each operator shall maintain and follow a written anti-drug plan that...

  2. 29 CFR 2510.3-3 - Employee benefit plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... section clarifies the definition in section 3(3) of the term “employee benefit plan” for purposes of title... receive any benefit under the plan even if the contingency for which such benefit is provided should occur... 29 Labor 9 2010-07-01 2010-07-01 false Employee benefit plan. 2510.3-3 Section 2510.3-3 Labor...

  3. Flexible benefits plans. Perceptions of their effectiveness.

    PubMed

    Agho, A O

    1995-01-01

    Flexible benefits plans have been used in businesses since the 1970s to control healthcare costs and meet the needs of an increasingly diverse work force. More recently, healthcare organizations have begun to implement the flexible benefits concept. This study collected data from human resources executives at hospitals with and without flex plans to investigate how they perceive the effectiveness of and the problems associated with such plans.

  4. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Minimum standards for health benefits... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.201 Minimum standards for health benefits plans. (a) To qualify for approval by OPM, a health benefits plan...

  5. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Minimum standards for health benefits... SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.201 Minimum standards for health benefits plans. (a) To qualify for approval by OPM, a health benefits plan...

  6. 29 CFR 778.214 - Benefit plans; including profit-sharing plans or trusts providing similar benefits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... fide plan for providing old age, retirement, life, accident, or health insurance or similar benefits for employees * * *.” Such sums may not, however, be credited toward overtime compensation due under... matching employee contributions or otherwise encourages thrift or savings. Where such a plan or trust is...

  7. Claims Procedure for Plans Providing Disability Benefits. Final rule.

    PubMed

    2016-12-19

    This document contains a final regulation revising the claims procedure regulations under the Employee Retirement Income Security Act of 1974 (ERISA) for employee benefit plans providing disability benefits. The final rule revises and strengthens the current rules primarily by adopting certain procedural protections and safeguards for disability benefit claims that are currently applicable to claims for group health benefits pursuant to the Affordable Care Act. This rule affects plan administrators and participants and beneficiaries of plans providing disability benefits, and others who assist in the provision of these benefits, such as third-party benefits administrators and other service providers.

  8. Using a drug facts box to communicate drug benefits and harms: two randomized trials.

    PubMed

    Schwartz, Lisa M; Woloshin, Steven; Welch, H Gilbert

    2009-04-21

    Direct-to-consumer prescription drug ads typically fail to provide fundamental information that consumers need to make informed decisions: data on how well the drug works. To see whether providing consumers with a drug facts box-a table quantifying outcomes with and without the drug-improves knowledge and affects judgments about prescription medications. Two randomized, controlled trials conducted between October 2006 and April 2007: a symptom drug box trial using direct-to-consumer ads for a histamine-2 blocker and a proton-pump inhibitor to treat heartburn, and a prevention drug box trial using direct-to-consumer ads for a statin and clopidogrel to prevent cardiovascular events. National sample of U.S. adults identified by random-digit dialing. Adults age 35 to 70 years who completed a mailed survey; the final samples comprised 231 participants with completed surveys in the symptom drug box trial (49% response rate) and 219 in the prevention drug box trial (46% response rate). In both trials, the control group received 2 actual drug ads (including both the front page and brief summary). The drug box group received the same ads, except that the brief summary was replaced by a drug facts box. Choice between drugs (primary outcome of the symptom drug box trial) and accurate perceptions of drug benefits and side effects (primary outcome of the prevention drug box trial). In the symptom drug box trial, 70% of the drug box group and 8% of the control group correctly identified the PPI as being "a lot more effective" than the histamine-2 blocker (P < 0.001), and 80% and 38% correctly recognized that the side effects of the 2 drugs were similar (P < 0.001). When asked what they would do if they had bothersome heartburn and could have either drug for free, 68% of the drug box group and 31% of the control group chose the proton-pump inhibitor, the superior drug (P < 0.001). In the prevention drug box trial, the drug box improved consumers' knowledge of the benefits and

  9. [Assessment of actual benefits of new drugs by the Transparency Committee].

    PubMed

    Le Jeunne, C

    2008-01-01

    When a drug has been granted a marketing authorization, if the pharmaceutical company wants it to be covered by the National Health Insurance, the company has to submit a file with all the studies concerning the drug, especially drug-drug comparative studies, to be assessed by the Transparency Committee. Drugs are assessed on two criteria: actual or expected benefit (AB) and improvement in actual benefit (IAB). Actual benefit mainly takes into account the severity of the disease concerned, the level of efficacy relative to known side effects (risk-benefit ratio), and the place the drug is intended to take in the therapeutic strategy. At the end of the assessment, AB is considered as important, moderate, poor or insufficient (to justify inclusion of the drug on the list of products to be reimbursed). After actual benefit is determined, improvement of actual benefit is assessed, comparing the estimated benefit of this drug with one of drugs with the same indication that is already reimbursed, to assess whether this drug will improve the patient's disease. This can be assessed by direct comparison (two drugs compared in the same clinical trial) or by indirect comparison (separate studies with the same design). There are four levels of added value, from I (major improvement) to IV (minor improvement). Level V represents no improvement. This second assessment is always relative to another drug. It never provides an absolute score. However, IAB is very important for pharmaceutical companies, because it is a fundamental criterion to determine the price of the drug, which is discussed with the Economic Committee of Health Products in a final phase. Actual benefit and improvement in actual benefit are allocated for each indication of a drug.

  10. 29 CFR 1625.10 - Costs and benefits under employee benefit plans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) Cost data—Individual benefit basis and “benefit package” basis. Cost comparisons and adjustments under... are set forth below. (1) Cost data—general. Cost data used in justification of a benefit plan which... met where an employer has cost data which show the actual cost to it of providing the particular...

  11. 29 CFR 1625.10 - Costs and benefits under employee benefit plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) Cost data—Individual benefit basis and “benefit package” basis. Cost comparisons and adjustments under... are set forth below. (1) Cost data—general. Cost data used in justification of a benefit plan which... met where an employer has cost data which show the actual cost to it of providing the particular...

  12. 29 CFR 1625.10 - Costs and benefits under employee benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) Cost data—Individual benefit basis and “benefit package” basis. Cost comparisons and adjustments under... are set forth below. (1) Cost data—general. Cost data used in justification of a benefit plan which... met where an employer has cost data which show the actual cost to it of providing the particular...

  13. 29 CFR 1625.10 - Costs and benefits under employee benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) Cost data—Individual benefit basis and “benefit package” basis. Cost comparisons and adjustments under... are set forth below. (1) Cost data—general. Cost data used in justification of a benefit plan which... met where an employer has cost data which show the actual cost to it of providing the particular...

  14. PEL Benefits: Measuring the Benefits of Planning and Environmental Linkages (PEL)

    DOT National Transportation Integrated Search

    2015-10-01

    The Federal Highway Administration (FHWA) commissioned this report to explore and document the benefits stemming from the incorporation of Planning and Environmental Linkage (PEL) strategies into State, regional, and local planning and project develo...

  15. Which Benefits Are Mentioned Most Often in Drug Development Publications?

    PubMed

    Strüver, Vanessa

    2017-01-01

    The aim was to identify theoretically expected as well as actually reported benefits from drug development and the importance of individual patient benefits compared to the collective benefits to society in general. Ethical guidelines require that clinical research involving humans offer the potential for benefit. A number of characteristics can be applied to define research benefit. Often benefit is categorized as being either direct or indirect. Indirect benefits can involve collective benefits for society rather than any benefits to the trial patient or subject. The purpose of this review was to examine which potential individual and societal benefits were mentioned as being expected in publications from government experts and which were mentioned in publications describing completed drug development trial results. Literature on research benefit was first identified by searching the PubMed database using several combinations of the key words benefit and clinical research . The search was limited to articles published in English. A Google search with the same combinations of key words but without any language limitation was then performed. Additionally, the reference lists of promising articles were screened for further thematically related articles. Finally, a narrative review was performed of relevant English- and German-language articles published between 1996 and 2016 to identify which of several potential benefits were either theoretically expected or which were mentioned in publications on clinical drug development trial results. The principal benefits from drug development discussed included 2 main types of benefit, namely individual benefits for the patients and collective benefits for society. Twenty-one of an overall total of 26 articles discussing theoretically expected benefits focused on individual patient benefits, whereas 17 out of 26 articles mentioned collective benefits to society. In these publications, the most commonly mentioned theoretically

  16. The value of benefit data in direct-to-consumer drug ads.

    PubMed

    Woloshin, Steven; Schwartz, Lisa M; Welch, H Gilbert

    2004-01-01

    Direct-to-consumer (DTC) pharmaceutical ads typically describe drug benefits in qualitative terms; they rarely provide data on how well the drug works. We describe an evaluation of a "prescription drug benefit box"-data from the main randomized trials on the chances of various outcomes with and without the drug. Most participants rated the information as "very important" or "important"; almost all found the data easy to understand. Perceptions of drug effectiveness were much lower for ads that incorporated the benefit box than for ads that did not. Most people we interviewed want benefit data in drug ads, can understand these data, and are influenced by them.

  17. Health plans keeping drug cost increases in check with programs that promote generics.

    PubMed

    2002-07-01

    To counter the massive amount of drug company detailing and marketing that is partly responsible for driving up pharmaceutical costs, health plans and some independent practice associations are promoting the use of generics to physicians in their networks. While most physicians in capitated contracts don't directly benefit from the movement to encourage generics unless they have pharmacy risk, some health plans are paying physicians financial incentives to increase generic prescribing.

  18. Do Medicare Beneficiaries Living With HIV/AIDS Choose Prescription Drug Plans That Minimize Their Total Spending?

    PubMed

    Desmond, Katherine A; Rice, Thomas H; Leibowitz, Arleen A

    2017-01-01

    This article examines whether California Medicare beneficiaries with HIV/AIDS choose Part D prescription drug plans that minimize their expenses. Among beneficiaries without low-income supplementation, we estimate the excess cost, and the insurance policy and beneficiary characteristics responsible, when the lowest cost plan is not chosen. We use a cost calculator developed for this study, and 2010 drug use data on 1453 California Medicare beneficiaries with HIV who were taking antiretroviral medications. Excess spending is defined as the difference between projected total spending (premium and cost sharing) for the beneficiary's current drug regimen in own plan vs spending for the lowest cost alternative plan. Regression analyses related this excess spending to individual and plan characteristics. We find that beneficiaries pay more for Medicare Part D plans with gap coverage and no deductible. Higher premiums for more extensive coverage exceeded savings in deductible and copayment/coinsurance costs. We conclude that many beneficiaries pay for plan features whose costs exceed their benefits.

  19. Do Medicare Beneficiaries Living With HIV/AIDS Choose Prescription Drug Plans That Minimize Their Total Spending?

    PubMed Central

    Desmond, Katherine A.; Rice, Thomas H.; Leibowitz, Arleen A.

    2017-01-01

    This article examines whether California Medicare beneficiaries with HIV/AIDS choose Part D prescription drug plans that minimize their expenses. Among beneficiaries without low-income supplementation, we estimate the excess cost, and the insurance policy and beneficiary characteristics responsible, when the lowest cost plan is not chosen. We use a cost calculator developed for this study, and 2010 drug use data on 1453 California Medicare beneficiaries with HIV who were taking antiretroviral medications. Excess spending is defined as the difference between projected total spending (premium and cost sharing) for the beneficiary’s current drug regimen in own plan vs spending for the lowest cost alternative plan. Regression analyses related this excess spending to individual and plan characteristics. We find that beneficiaries pay more for Medicare Part D plans with gap coverage and no deductible. Higher premiums for more extensive coverage exceeded savings in deductible and copayment/coinsurance costs. We conclude that many beneficiaries pay for plan features whose costs exceed their benefits. PMID:28990452

  20. 49 CFR 199.101 - Anti-drug plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing § 199.101 Anti-drug plan. (b) The Associate Administrator or the State Agency that has submitted a... 49 Transportation 3 2013-10-01 2013-10-01 false Anti-drug plan. 199.101 Section 199.101...

  1. 29 CFR 4281.16 - Benefit valuation methods-plans closing out.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., as determined under this subpart. (b) Valuation rule. The present value of nonforfeitable benefits... 4281(b) of ERISA, the plan sponsor shall value the plan's benefits in accordance with paragraph (b) of... 29 Labor 9 2010-07-01 2010-07-01 false Benefit valuation methods-plans closing out. 4281.16...

  2. Benefit and harms of new anti-cancer drugs.

    PubMed

    Vera-Badillo, Francisco E; Al-Mubarak, Mustafa; Templeton, Arnoud J; Amir, Eitan

    2013-06-01

    Phase III randomized controlled trials (RCTs) assess clinically important differences in endpoints that reflect benefit to and harm of patients. Defining benefit of cancer drugs can be difficult. Overall survival and quality of life are the most relevant primary endpoints, but difficulty in measuring these mean that other endpoints are often used, although their surrogacy or clinical relevance has not always been established. In general, advances in drug development have led to numerous new drugs to enter the market. Pivotal RCT of several new drugs have shown that benefit appeared greater for targeted anticancer agents than for chemotherapeutic agents. This effect seems particularly evident with targeted agents evaluated in biomarker-driven studies. Unfortunately, new therapies have also shown an increase in toxicity. Such toxicity is not always evident in the initial reports of RCTs. This may be a result of a statistical inability to detect differences between arms of RCTs, or occasionally due to biased reporting. There are several examples where reports of new toxicities could only be found in drug labels. In some cases, the small improvement in survival has come at a cost of substantial excess toxicity, leading some to consider such therapy as having equipoise.

  3. Excess Benefit Plans and Other Nonqualified Deferred Compensation Palns Under ERISA

    ERIC Educational Resources Information Center

    Vogel, Mark A.

    1977-01-01

    The benefits of and restrictions imposed on qualified pension and profit-sharing plans are discussed in terms of Excess Benefit Plans (EPB), a type of deferred compensation plan. EPBs and unfunded deferred compensation plans offer flexible methods of providing additional benefits for executives and key employees. (LBH)

  4. 76 FR 13304 - Benefits Payable in Terminated Single-Employer Plans; Limitations on Guaranteed Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 RIN 1212-AB18 Benefits Payable in Terminated Single-Employer Plans; Limitations on Guaranteed Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Proposed rule. SUMMARY: This is a proposed rule to amend PBGC's regulation on Benefits Payable in...

  5. 20 CFR 1002.260 - What pension benefit plans are covered under USERRA?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What pension benefit plans are covered under... REEMPLOYMENT RIGHTS ACT OF 1994 Reemployment Rights and Benefits Pension Plan Benefits § 1002.260 What pension...) defines an employee pension benefit plan as a plan that provides retirement income to employees, or defers...

  6. Ten Benefits of Participant Action Planning.

    ERIC Educational Resources Information Center

    Youker, Robert B.

    1985-01-01

    Describes the Participant Action Planning Approach (PAPA) process that requires each trainee to prepare a list of concrete actions or changes he or she plans to make back on the job once the training program is over. Benefits of PAPA are discussed, including transfer of learning, verbalization, and commitment. (CT)

  7. 20 CFR 1002.171 - How does the continuation of health plan benefits apply to a multiemployer plan that provides...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false How does the continuation of health plan benefits apply to a multiemployer plan that provides health plan coverage through a health benefits account... benefits apply to a multiemployer plan that provides health plan coverage through a health benefits account...

  8. 20 CFR 1002.171 - How does the continuation of health plan benefits apply to a multiemployer plan that provides...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false How does the continuation of health plan benefits apply to a multiemployer plan that provides health plan coverage through a health benefits account... benefits apply to a multiemployer plan that provides health plan coverage through a health benefits account...

  9. 20 CFR 1002.171 - How does the continuation of health plan benefits apply to a multiemployer plan that provides...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false How does the continuation of health plan benefits apply to a multiemployer plan that provides health plan coverage through a health benefits account... benefits apply to a multiemployer plan that provides health plan coverage through a health benefits account...

  10. 20 CFR 1002.171 - How does the continuation of health plan benefits apply to a multiemployer plan that provides...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false How does the continuation of health plan benefits apply to a multiemployer plan that provides health plan coverage through a health benefits account... benefits apply to a multiemployer plan that provides health plan coverage through a health benefits account...

  11. Formulation approaches to pediatric oral drug delivery: benefits and limitations of current platforms

    PubMed Central

    Lopez, Felipe L; Ernest, Terry B; Tuleu, Catherine; Gul, Mine Orlu

    2015-01-01

    Introduction: Most conventional drug delivery systems are not acceptable for pediatric patients as they differ in their developmental status and dosing requirements from other subsets of the population. Technology platforms are required to aid the development of age-appropriate medicines to maximize patient acceptability while maintaining safety, efficacy, accessibility and affordability. Areas covered: The current approaches and novel developments in the field of age-appropriate drug delivery for pediatric patients are critically discussed including patient-centric formulations, administration devices and packaging systems. Expert opinion: Despite the incentives provided by recent regulatory modifications and the efforts of formulation scientists, there is still a need for implementation of pharmaceutical technologies that enable the manufacture of licensed age-appropriate formulations. Harmonization of endeavors from regulators, industry and academia by sharing learning associated with data obtained from pediatric investigation plans, product development pathways and scientific projects would be the way forward to speed up bench-to-market age appropriate formulation development. A collaborative approach will benefit not only pediatrics, but other patient populations such as geriatrics would also benefit from an accelerated patient-centric approach to drug delivery. PMID:26165848

  12. Reading and understanding employee benefit plan financial statements.

    PubMed

    Lee, David C; Van Sertima, Michael A

    2004-03-01

    If your employee benefit plan has more than 100 participants, chances are you've had to work your way through the audited financial statements you're required to include with your Form 5500 filing. These statements contain a wealth of information about the financial health of your plan, and understanding them is an important fiduciary responsibility. To strengthen your grasp of financial statements, this article gives an overview that will make a plan's financial statements more informative, explains their basic structure and provides information on some of the more arcane aspects (such as actuarial tables). While this article focuses on Taft-Hartley (multiemployer) plans, much of it applies to other types of employee benefit plans.

  13. An early examination of access to select orphan drugs treating rare diseases in health insurance exchange plans.

    PubMed

    Robinson, Sandy W; Brantley, Kelly; Liow, Christine; Teagarden, J Russell

    2014-10-01

    Patients with rare diseases often face significant health care access challenges, particularly since the number of available treatment options for rare diseases is limited. The implementation of health insurance exchanges promises improved access to health care. However, when purchasing a plan, patients with rare diseases need to consider multiple factors, such as insurance premium, access to providers, coverage of a specific medication or treatment, tier placement of drug, and out-of-pocket costs.  To provide an early snapshot of the exchange plan landscape from the perspective of patients with select rare diseases by evaluating the degree of access to medications in a subset of exchange plans based on coverage, tier placement, associated cost sharing, and utilization management (UM) applied.  The selection of drugs for this analysis began by identifying rare diseases with FDA-approved treatment options using the National Institutes of Health Office of Rare Diseases' webpage and further identification of a subset of drugs based on select criteria to ensure a varied sample, including the characteristics and prevalence of the condition. The medications were categorized based on whether alternative therapies have FDA approval for the same indication and whether there are comparators based on class or therapeutic area. The list was narrowed to 11 medications across 7 diseases, and the analysis was based on how these drugs are listed in exchange plan outpatient pharmacy benefit formularies. This analysis focused on 84 plans in 15 states with the highest expected exchange enrollment and included a variety of plan types to ensure that variability in the marketplace was represented. To best approximate plans that will have the greatest enrollment, the analysis focused on silver and bronze plan formularies because consumers in this market are expected to be sensitive to premiums. Data on drug coverage, tier placement, cost, and UM were collected from these plans

  14. 78 FR 49682 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. [[Page 49683

  15. 77 FR 74353 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-14

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. [[Page 74354

  16. 26 CFR 1.436-1 - Limits on benefits and benefit accruals under single employer defined benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... reduce funding balances. (b) Limitation on shutdown benefits and other unpredictable contingent event... effect. (6) Treatment of mergers, consolidations, and transfers of plan assets into a plan. [Reserved] (d... accruals for plans with severe funding shortfalls. (1) In general. (2) Exemption if section 436...

  17. 26 CFR 1.436-1 - Limits on benefits and benefit accruals under single employer defined benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... reduce funding balances. (b) Limitation on shutdown benefits and other unpredictable contingent event... effect. (6) Treatment of mergers, consolidations, and transfers of plan assets into a plan. [Reserved] (d... accruals for plans with severe funding shortfalls. (1) In general. (2) Exemption if section 436...

  18. 78 FR 8985 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-07

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule; correction. SUMMARY: The Pension Benefit Guaranty Corporation published in the...

  19. Scaling up family planning in Sierra Leone: A prospective cost-benefit analysis.

    PubMed

    Keen, Sarah; Begum, Hashina; Friedman, Howard S; James, Chris D

    2017-12-01

    Family planning is commonly regarded as a highly cost-effective health intervention with wider social and economic benefits. Yet use of family planning services in Sierra Leone is currently low and 25.0% of married women have an unmet need for contraception. This study aims to estimate the costs and benefits of scaling up family planning in Sierra Leone. Using the OneHealth Tool, two scenarios of scaling up family planning coverage to currently married women in Sierra Leone over 2013-2035 were assessed and compared to a 'no-change' counterfactual. Our costing included direct costs of drugs, supplies and personnel time, programme costs and a share of health facility overhead costs. To monetise the benefits, we projected the cost savings of the government providing five essential social services - primary education, child immunisation, malaria prevention, maternal health services and improved drinking water - in the scale-up scenarios compared to the counterfactual. The total population, estimated at 6.1 million in 2013, is projected to reach 8.3 million by 2035 in the high scenario compared to a counterfactual of 9.6 million. We estimate that by 2035, there will be 1400 fewer maternal deaths and 700 fewer infant deaths in the high scenario compared to the counterfactual. Our modelling suggests that total costs of the family planning programme in Sierra Leone will increase from US$4.2 million in 2013 to US$10.6 million a year by 2035 in the high scenario. For every dollar spent on family planning, Sierra Leone is estimated to save US$2.10 in expenditure on the five selected social sector services over the period. There is a strong investment case for scaling up family planning services in Sierra Leone. The ambitious scale-up scenarios have historical precedent in other sub-Saharan African countries, but the extent to which they will be achieved depends on a commitment from both the government and donors to strengthening Sierra Leone's health system post-Ebola.

  20. The Effect of Florida Medicaid's State-Mandated Formulary Provision on Prescription Drug Use and Health Plan Costs in a Medicaid Managed Care Plan.

    PubMed

    Munshi, Kiraat D; Mager, Douglas; Ward, Krista M; Mischel, Brian; Henderson, Rochelle R

    2018-02-01

    Formulary or preferred drug list (PDL) management is an effective strategy to ensure clinically efficient prescription drug management by managed care organizations (MCOs). Medicaid MCOs participating in Florida's Medicaid program were required to use a state-mandated PDL between May and August 2014. To examine differences in prescription drug use and plan costs between a single Florida Medicaid managed care (MMC) health plan that implemented a state-mandated PDL policy on July 1, 2014, and a comparable MMC health plan in another state without a state-mandated PDL, controlling for sociodemographic confounders. A retrospective analysis with a pre-post design was conducted using deidentified administrative claims data from a large pharmacy benefit manager. The prepolicy evaluation period was January 1 through June 30, 2014, and the postpolicy period was January 1 through June 30, 2015. Continuously eligible Florida MMC plan members were matched on sociodemographic and health characteristics to their counterparts enrolled in a comparable MMC health plan in another state without a state-mandated formulary. Outcomes were drug use, measured as the number of 30-day adjusted nonspecialty drug prescriptions per member per period, and total drug plan costs per member per period for all drugs, with separate measures for generic and brand drugs. Bivariate comparisons were conducted using t-tests. Employing a difference-in-differences (DID) analytic approach, multivariate negative binomial regression and generalized estimating equation models were used to analyze prescription drug use and costs. The final analytical sample consisted of 18,372 enrollees, evenly divided between the 2 groups. In the postpolicy evaluation period, overall and generic use declined, while brand use increased for members in the Florida health plan. Drug costs, especially for brands, significantly increased for Florida health plan members. No significant changes were observed over the same time period

  1. 76 FR 50413 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  2. 78 FR 68739 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  3. 76 FR 8649 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends Pension Benefit Guaranty Corporation's regulation on...

  4. 77 FR 22215 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-13

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  5. 76 FR 27889 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  6. 76 FR 63836 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-14

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  7. 78 FR 11093 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  8. 76 FR 21252 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends Pension Benefit Guaranty Corporation's regulation on...

  9. 77 FR 41270 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-13

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  10. 76 FR 2578 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends Pension Benefit Guaranty Corporation's regulation on...

  11. 78 FR 62426 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  12. 77 FR 28477 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  13. 78 FR 42009 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  14. 78 FR 2881 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  15. 76 FR 70639 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  16. 75 FR 69588 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends Pension Benefit Guaranty Corporation's regulation on...

  17. 77 FR 68685 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  18. 76 FR 41689 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  19. 78 FR 28490 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  20. 77 FR 2015 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-13

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  1. 77 FR 8730 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  2. 78 FR 22192 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  3. 77 FR 62433 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends the Pension Benefit Guaranty Corporation's regulation...

  4. 75 FR 63380 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final rule amends Pension Benefit Guaranty Corporation's regulation on...

  5. Harms and benefits associated with psychoactive drugs: findings of an international survey of active drug users

    PubMed Central

    Morgan, Celia JA; Noronha, Louise A; Muetzelfeldt, Mark; Fielding, Amanda

    2013-01-01

    There have been several recent efforts in the UK and the Netherlands to describe the harms of psychoactive substances based on ratings of either experts or drug users. This study aimed to assess the perceived benefits as well as harms of widely used recreational drugs, both licit and illicit, in an international sample of drug users. The survey was hosted at https://www.internationaldrugsurvey.org/ and was available in three languages. Residents reported their experience of 15 commonly used drugs or drug classes; regular users then rated their harms and benefits. In all, 5791 individuals from over 40 countries completed the survey, although the majority were from English speaking countries. Rankings of drugs differed across 10 categories of perceived benefits. Skunk and herbal cannabis were ranked consistently beneficial, whilst alcohol and tobacco fell below many classified drugs. There was no correlation at all between users’ harm ranking of drugs and their classification in schedules of the USA or ABC system in the UK. Prescription analgesics, alcohol and tobacco were ranked within the top 10 most harmful drugs. These findings suggest that neither the UK nor US classification systems act to inform users of the harms of psychoactive substances. It is hoped the results might inform health professionals and educators of what are considered to be both the harms and benefits of psychoactive substances to young people. PMID:23438502

  6. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Minimum standards for health benefits plans. 890.201 Section 890.201 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.201...

  7. 5 CFR 890.201 - Minimum standards for health benefits plans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Minimum standards for health benefits plans. 890.201 Section 890.201 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.201...

  8. 42 CFR 422.103 - Benefits under an MA MSA plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Benefits under an MA MSA plan. 422.103 Section 422... Benefits under an MA MSA plan. (a) General rule. An MA organization offering an MA MSA plan must make...) Countable expenses. An MA organization offering an MA MSA plan must count toward the annual deductible at...

  9. 42 CFR 422.103 - Benefits under an MA MSA plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Benefits under an MA MSA plan. 422.103 Section 422... § 422.103 Benefits under an MA MSA plan. (a) General rule. An MA organization offering an MA MSA plan... deductible. (b) Countable expenses. An MA organization offering an MA MSA plan must count toward the annual...

  10. 42 CFR 422.103 - Benefits under an MA MSA plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Benefits under an MA MSA plan. 422.103 Section 422... § 422.103 Benefits under an MA MSA plan. (a) General rule. An MA organization offering an MA MSA plan... deductible. (b) Countable expenses. An MA organization offering an MA MSA plan must count toward the annual...

  11. 42 CFR 422.103 - Benefits under an MA MSA plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Benefits under an MA MSA plan. 422.103 Section 422... Benefits under an MA MSA plan. (a) General rule. An MA organization offering an MA MSA plan must make...) Countable expenses. An MA organization offering an MA MSA plan must count toward the annual deductible at...

  12. 42 CFR 422.103 - Benefits under an MA MSA plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Benefits under an MA MSA plan. 422.103 Section 422... § 422.103 Benefits under an MA MSA plan. (a) General rule. An MA organization offering an MA MSA plan... deductible. (b) Countable expenses. An MA organization offering an MA MSA plan must count toward the annual...

  13. Conditional rights, benefit reform, and drug users: reducing dependency?

    PubMed

    Harris, Neville

    2010-01-01

    United Kingdom government policy to increase social security claimants' entry to the labour market through conditions attached to unemployed, sickness and incapacity benefits now includes additional measures to activate particular groups such as lone parents and drug users. The latter are a prime target because of their high level of dependency on benefits and because social security rules are seen as having the potential to modify the behaviour of individuals with a lifestyle regarded as being at odds with the moral obligations of citizenship and incompatible with the government's realization of its wider economic and social goals. There are strict procedures for the identification of drug-user claimants, enabling additional conditions to be attached to their benefit rights. This article discusses the general trend in benefit reform towards increased conditionality and evaluates the reforms affecting drug users, considering human rights and other implications. It concludes by reflecting on the status of conditional rights to social security as social rights.

  14. 20 CFR 404.480 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... addiction or alcoholism. 404.480 Section 404.480 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL... Benefits § 404.480 Paying benefits in installments: Drug addiction or alcoholism. (a) General. For disabled beneficiaries who receive benefit payments through a representative payee because drug addiction or alcoholism...

  15. 20 CFR 404.480 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... addiction or alcoholism. 404.480 Section 404.480 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL... Benefits § 404.480 Paying benefits in installments: Drug addiction or alcoholism. (a) General. For disabled beneficiaries who receive benefit payments through a representative payee because drug addiction or alcoholism...

  16. 20 CFR 404.480 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... addiction or alcoholism. 404.480 Section 404.480 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL... Benefits § 404.480 Paying benefits in installments: Drug addiction or alcoholism. (a) General. For disabled beneficiaries who receive benefit payments through a representative payee because drug addiction or alcoholism...

  17. 20 CFR 404.480 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... addiction or alcoholism. 404.480 Section 404.480 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL... Benefits § 404.480 Paying benefits in installments: Drug addiction or alcoholism. (a) General. For disabled beneficiaries who receive benefit payments through a representative payee because drug addiction or alcoholism...

  18. 12 CFR 330.14 - Retirement and other employee benefit plan accounts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Retirement and other employee benefit plan... STATEMENTS OF GENERAL POLICY DEPOSIT INSURANCE COVERAGE § 330.14 Retirement and other employee benefit plan accounts. (a) “Pass-through” insurance. Any deposits of an employee benefit plan in an insured depository...

  19. 26 CFR 1.436-1 - Limits on benefits and benefit accruals under single employer defined benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... take effect in a plan year if the adjusted funding target attainment percentage for the plan year is... provides rules relating to funding-based limitations on certain benefits under section 436, and the... limitations in effect immediately before the termination of a plan do not cease to apply thereafter. (B...

  20. DEFINED CONTRIBUTION PLANS, DEFINED BENEFIT PLANS, AND THE ACCUMULATION OF RETIREMENT WEALTH

    PubMed Central

    Poterba, James; Rauh, Joshua; Venti, Steven; Wise, David

    2010-01-01

    The private pension structure in the United States, once dominated by defined benefit (DB) plans, is currently divided between defined contribution (DC) and DB plans. Wealth accumulation in DC plans depends on the participant's contribution behavior and on financial market returns, while accumulation in DB plans is sensitive to a participant's labor market experience and to plan parameters. This paper simulates the distribution of retirement wealth under representative DB and DC plans. It uses data from the Health and Retirement Study (HRS) to explore how asset returns, earnings histories, and retirement plan characteristics contribute to the variation in retirement wealth outcomes. We simulate DC plan accumulation by randomly assigning individuals a share of wages that they and their employer contribute to the plan. We consider several possible asset allocation strategies, with asset returns drawn from the historical return distribution. Our DB plan simulations draw earnings histories from the HRS, and randomly assign each individual a pension plan drawn from a sample of large private and public defined benefit plans. The simulations yield distributions of both DC and DB wealth at retirement. Average retirement wealth accruals under current DC plans exceed average accruals under private sector DB plans, although DC plans are also more likely to generate very low retirement wealth outcomes. The comparison of current DC plans with more generous public sector DB plans is less definitive, because public sector DB plans are more generous on average than their private sector counterparts. PMID:21057597

  1. 42 CFR 423.415 - Temporary waivers for entities seeking to offer a prescription drug plan in more than one State...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Organization Compliance with State Law and Preemption by Federal Law § 423.415 Temporary waivers for entities seeking to offer a prescription drug plan in more...

  2. Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya

    PubMed Central

    Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

    2016-01-01

    drug shops in both countries indicate the need for additional support from family planning programs to leverage this important access point. Conclusions: Drug shops and pharmacies offer an important and under-leveraged mechanism for expanding family planning access to women in urban Nigeria and Kenya, and potentially elsewhere. Vulnerable and harder-to-reach groups such as younger, unmarried women and women who do not yet have children are the most likely to benefit from increased access to family planning at drug shops and pharmacies. PMID:28031299

  3. Key Role of Drug Shops and Pharmacies for Family Planning in Urban Nigeria and Kenya.

    PubMed

    Corroon, Meghan; Kebede, Essete; Spektor, Gean; Speizer, Ilene

    2016-12-23

    the need for additional support from family planning programs to leverage this important access point. Drug shops and pharmacies offer an important and under-leveraged mechanism for expanding family planning access to women in urban Nigeria and Kenya, and potentially elsewhere. Vulnerable and harder-to-reach groups such as younger, unmarried women and women who do not yet have children are the most likely to benefit from increased access to family planning at drug shops and pharmacies. © Corroon et al.

  4. 75 FR 70625 - Annual Funding Notice for Defined Benefit Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ...This document contains a proposed regulation that, on adoption, would implement the annual funding notice requirement in the Employee Retirement Income Security Act of 1974 (ERISA), as amended by the Pension Protection Act of 2006 (PPA) and the Worker, Retiree, and Employer Recovery Act of 2008 (WRERA). As amended, section 101(f) of ERISA generally requires the administrators of all defined benefit plans, not just multiemployer defined benefit plans, to furnish an annual funding notice to the Pension Benefit Guaranty Corporation (PBGC), participants, beneficiaries, and certain other persons. A funding notice must include, among other information, the plan's funding target attainment percentage or funded percentage, as applicable, over a period of time, as well as other information relevant to the plan's funded status. This document also contains proposed conforming amendments to other regulations under ERISA, such as the summary annual report regulation, which became necessary when the PPA amended section 101(f) of ERISA. The proposed regulation would affect plan administrators and participants and beneficiaries of defined benefit pension plans, as well as labor organizations representing participants and beneficiaries and contributing employers of multiemployer plans.

  5. 20 CFR 416.544 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... addiction or alcoholism. 416.544 Section 416.544 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Underpayments § 416.544 Paying benefits in installments: Drug addiction or alcoholism. (a) General. For disabled recipients who receive benefit payments through a representative payee because drug addiction or alcoholism...

  6. 20 CFR 416.544 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... addiction or alcoholism. 416.544 Section 416.544 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Underpayments § 416.544 Paying benefits in installments: Drug addiction or alcoholism. (a) General. For disabled recipients who receive benefit payments through a representative payee because drug addiction or alcoholism...

  7. 20 CFR 416.544 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... addiction or alcoholism. 416.544 Section 416.544 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Underpayments § 416.544 Paying benefits in installments: Drug addiction or alcoholism. (a) General. For disabled recipients who receive benefit payments through a representative payee because drug addiction or alcoholism...

  8. 20 CFR 416.544 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... addiction or alcoholism. 416.544 Section 416.544 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Underpayments § 416.544 Paying benefits in installments: Drug addiction or alcoholism. (a) General. For disabled recipients who receive benefit payments through a representative payee because drug addiction or alcoholism...

  9. Comparison of Drug Benefits Provided by Veterans Affairs Canada and the Canadian Forces Health Services Group.

    PubMed

    Chow, Matthew; Wicks, Charles J; Ma, Janice; Grenier, Sylvain

    2017-05-23

    Drug benefits are provided at public expense to all actively serving Canadian Armed Forces (CAF) personnel, with ongoing drug coverage offered by Veterans Affairs Canada (VAC) for selected conditions following termination of employment. Differences in drug coverage between these programs could introduce risks for treatment disruption. Work was undertaken to establish a process that would allow systematic comparison of the entire VAC and CAF formularies, and to identify and explain discordant listings in 14 therapeutic categories that pose risk of adverse outcomes with sudden treatment interruption. Lists of medications were created for each program, including regular benefit and restricted use drugs, using files obtained from the claims processor in January 2015. Products were coded using the Anatomic-Therapeutic-Chemical (ATC) system. Degree of alignment within therapeutic categories was assessed based on the percentage of fifth-level ATCs that were covered in common. Discordantly listed drugs in 14 categories of concern were reviewed to identify similarities in product characteristics. A total of 1124 medications were identified in 80 therapeutic categories. Coverage of medications was identical in 11 categories, and overall, almost three-quarters of identified drugs (73.4%, n = 825) were covered in common by both plans. Many discordant listings reflected known differences in the programs' operating procedures. A number of discrepancies were also identified in newer therapeutic categories. There is significant overlap in the medications covered by the CAF and VAC drug benefit programs. Application of the ATC coding system allowed for discrepancies to be readily identified across the entire formulary, and in specific therapeutic categories of concern. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

  10. Analysis of Survivor Benefit Plan - Acceptance and Comparison with Private Sector

    DTIC Science & Technology

    1989-01-01

    I COPY AIU WAR COLLEGE ,.SEARCH REPORT ,YSIS OF SURVIVOR BENEFIT PLAN-__CCEPTANCE ’-U AND COMPARISON WITH PRIVATE SECTOR LIEUENNT COLONEL JOHN R...AAA AIR WAR COLLEGE AIR UNIVERSITY ANALYSIS OF SURVIVOR BENEFIT PLAN--ACCEPTANCE AND COMPARISON WITH PRIVATE SECTOR by John R. Adams Lieutenant...Survivor Benefit Plan (SBP)--Acceptance and Comparison With Private Sector . AUTHORS: John R. Adams, Lieutenant Colonel, USAF; Daniel 3. Kohn

  11. 5 CFR 890.205 - Nonrenewal of contracts of health benefits plans.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Nonrenewal of contracts of health benefits plans. 890.205 Section 890.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans...

  12. 5 CFR 890.205 - Nonrenewal of contracts of health benefits plans.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Nonrenewal of contracts of health benefits plans. 890.205 Section 890.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans...

  13. 5 CFR 890.205 - Nonrenewal of contracts of health benefits plans.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Nonrenewal of contracts of health benefits plans. 890.205 Section 890.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans...

  14. Evaluation of health plan member use of an online prescription drug price comparison tool.

    PubMed

    Carroll, Norman V; Mitchell, Matthew P; Cannon, H Eric; York, Bryan W York; Oscar, Robert S

    2010-01-01

    Health plans have implemented tiered copayment systems to incentivize members to use less expensive medications. However, members need drug price information to make comparisons among therapeutic alternatives. Many health plans and pharmacy benefit management companies have implemented online prescription drug price comparison tools to provide such information. There has been little published evaluation of these tools. To evaluate use of an online price comparison tool- MyPharmacyTools (MPT)- by the measures of (a) the extent to which the tool was used, (b) changes in use over the first year after implementation, and (c) the types of members who were most likely to use the tool. Data were provided by a 500,000-member integrated health plan with approximately 156,250 enrolled families. The sample included only families with continuous eligibility for all members from July 1, 2006, through June 30, 2008; use of 1 of 7 common copayment structures; and use of the pharmacy benefit in every quarter of the study period. Data collected on each member, using pharmacy claims for the time period July 1, 2007, through June 30, 2008, included annual drug costs (total, out-of-pocket, plan-paid, and mail order) and number of unique drugs and unique generic drugs taken during the third quarter of 2007. Data collected also included whether the member had each of several selected chronic diseases (as inferred from drug claims for the third quarter of 2007) and demographics. Age, gender, and family size were taken from eligibility files. Other demographic data were imputed to members from the demographics of the ZIP code in which they resided. MPT was made available to members on July 1, 2007. Use of MPT was measured as the number of times members logged into the site for each quarter during the subsequent year. Statistical analyses were conducted at the family rather than at the individual level, and families were defined as users if any family member used MPT at least once during

  15. The Relationship of Social Security Benefits and the Military Survivors Benefit Plan.

    DTIC Science & Technology

    1980-07-09

    profound effect on the social security offset from the military survivors benefit plan (SBP). This study demonstrates the new social security computation...AD-ABO 088 AIR FORCE INST OF TECH WRIGHT-PATTERSON AFB ON SCHOOL-ETC F/B 513 THE RELATIONSHIP OF SOCIAL SECURITY BENEFITS AND THE MILITARY S-ETC(U...JUL 80 W C LETZKUS. C R MARGENTHALER UNCLASSIFIED AFIT-LS-80-3 I fllflfflffl..fl fl ’IilllllNO] LEVE1L 0 9THE RELATIONSHIP OF SOCIAL SECURITY BENEFITS

  16. 26 CFR 1.411(b)(5)-1 - Reduction in rate of benefit accrual under a defined benefit plan.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... describes safe harbors for certain plan designs (including statutory hybrid plans) that are deemed to... this section. (b) Safe harbors for certain plan designs—(1) Accumulated benefit testing—(i) In general... a participant. Thus, this test involves a comparison of the accumulated benefit of an individual who...

  17. Ecosystem Services in Conservation Planning: Targeted Benefits vs. Co-Benefits or Costs?

    PubMed Central

    Chan, Kai M. A.; Hoshizaki, Lara; Klinkenberg, Brian

    2011-01-01

    There is growing support for characterizing ecosystem services in order to link conservation and human well-being. However, few studies have explicitly included ecosystem services within systematic conservation planning, and those that have follow two fundamentally different approaches: ecosystem services as intrinsically-important targeted benefits vs. substitutable co-benefits. We present a first comparison of these two approaches in a case study in the Central Interior of British Columbia. We calculated and mapped economic values for carbon storage, timber production, and recreational angling using a geographical information system (GIS). These ‘marginal’ values represent the difference in service-provision between conservation and managed forestry as land uses. We compared two approaches to including ecosystem services in the site-selection software Marxan: as Targeted Benefits, and as Co-Benefits/Costs (in Marxan's cost function); we also compared these approaches with a Hybrid approach (carbon and angling as targeted benefits, timber as an opportunity cost). For this analysis, the Co-Benefit/Cost approach yielded a less costly reserve network than the Hybrid approach (1.6% cheaper). Including timber harvest as an opportunity cost in the cost function resulted in a reserve network that achieved targets equivalently, but at 15% lower total cost. We found counter-intuitive results for conservation: conservation-compatible services (carbon, angling) were positively correlated with each other and biodiversity, whereas the conservation-incompatible service (timber) was negatively correlated with all other networks. Our findings suggest that including ecosystem services within a conservation plan may be most cost-effective when they are represented as substitutable co-benefits/costs, rather than as targeted benefits. By explicitly valuing the costs and benefits associated with services, we may be able to achieve meaningful biodiversity conservation at lower cost

  18. 5 CFR 890.205 - Nonrenewal of contracts of health benefits plans.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.205 Nonrenewal of contracts of health benefits plans. (a) Either OPM or the carrier may terminate... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Nonrenewal of contracts of health...

  19. 5 CFR 890.205 - Nonrenewal of contracts of health benefits plans.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.205 Nonrenewal of contracts of health benefits plans. (a) Either OPM or the carrier may terminate... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Nonrenewal of contracts of health...

  20. [Post-marketing drug safety-risk management plan(RMP)].

    PubMed

    Ezaki, Asami; Hori, Akiko

    2013-03-01

    The Guidance for Risk Management Plan(RMP)was released by the Ministry of Health, Labour and Welfare in April 2012. The RMP consists of safety specifications, pharmacovigilance plans and risk minimization action plans. In this paper, we outline post-marketing drug safety operations in PMDA and the RMP, with examples of some anticancer drugs.

  1. Claims procedures for employee benefit plans--Pension and Welfare Benefits Administration, Department of Labor. Request for information.

    PubMed

    1997-09-08

    This document requests information from the public concerning the advisability of amending the existing regulation under the Employee Retirement Income Security Act of 1974 (ERISA) that establishes minimum requirements for employee benefit plan claims procedures. The term "claims procedure" refers to the process that employee benefit plans must provide for participants and beneficiaries who seek to obtain pension or welfare plan benefits, including requests for medical treatment or services, consideration of claims, and review of denials of claims by plans. The primary purpose of this notice is to obtain information to assist the Department of Labor (the Department) in evaluating (1) the extent to which the current claims procedure regulation assures that group health plan participants and beneficiaries are provided with effective and timely means to file and resolve claims for health care benefits, and (1) whether and in what way the existing minimum requirements should be amended with respect to group health plans covered by ERISA. The furnished information also will assist the Department in determining whether the regulation should be amended with respect to pension plans covered by ERISA and in developing legislative proposals to address any identified deficiencies relating to the claims procedures that cannot be addressed by amending the current regulation.

  2. Five-year examination of utilization and drug cost outcomes associated with benefit design changes including reference pricing for proton pump inhibitors in a state employee health plan.

    PubMed

    Johnson, Jill T; Neill, Kathryn K; Davis, Dwight A

    2011-04-01

    The Arkansas State Employee Benefits Division (EBD) is a self-insured program comprising public school and other state employees, their spouses, and dependents. Previous research published in JMCP (2006) showed drug cost savings of $2.20 per member per month (PMPM; 37.6%) or annualized savings of $3.4 million associated with a benefit design change and coverage of the proton pump inhibitor (PPI) omeprazole over-the-counter (OTC) beginning in March 2004. On May 1, 2005, brand esomeprazole was excluded from coverage, with current users grandfathered for 4 months until September 2005. Reference pricing for PPIs, including esomeprazole but excluding generic omeprazole, was implemented on September 1, 2005, and the beneficiary cost share for all PPIs except generic omeprazole was determined from comparison of the PPI actual price to the $0.90 omeprazole OTC reference price per unit. To examine PPI utilization and drug costs before and after (a) excluding esomeprazole from coverage (with grandfathering current users) and (b) implementing a therapeutic maximum allowable cost (TMAC), or reference-pricing benefit design, for the PPI class in a large state employee health plan with fairly stable enrollment of approximately 127,500 members in 2005 through 2008 and approximately 128,000 members in 2009 Q1. The pharmacy claims database for the EBD was used to examine utilization and cost data for PPIs in a longitudinal analysis for the 61-month period from March 1, 2004, through March 31, 2009. Pharmacy claims data were compared for the period 14 months prior to esomeprazole exclusion (preperiod), 4 months during the esomeprazole exclusion (postperiod 1), and the ensuing 43 months of PPI reference pricing (postperiod 2). PPI cost and utilization data for the intervention group of approximately 127,500 beneficiaries were compared with a group of 122 self-insured employers with a total of nearly 1 million beneficiaries whose pharmacy benefits did not include reference pricing for

  3. 12 CFR 745.9-2 - Retirement and other employee benefit plan accounts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Retirement and other employee benefit plan... Coverage § 745.9-2 Retirement and other employee benefit plan accounts. (a) Pass-through share insurance. Any shares of an employee benefit plan in an insured credit union shall be insured on a “pass-through...

  4. Planning deficits in polysubstance dependent users: Differential associations with severity of drug use and intelligence.

    PubMed

    Valls-Serrano, C; Verdejo-García, A; Caracuel, A

    2016-05-01

    Polysubstance use is associated with alterations in different components of executive functioning such as working memory and response inhibition. Nevertheless, less attention has been given to executive planning skills, which are required to benefit of low structured interventions. This study examines the association between severity of use of cocaine, heroin, alcohol, fluid and crystallized intelligence and planning tasks varying on degree of structure. Data were collected from 60 polysubstance users and 30 healthy controls. Cognitive assessment consisted of three planning tasks with different structure levels: Stockings of Cambridge, Zoo Map test, and Multiple Errands Test. Polysubstance users had significant planning deficits across the three tasks compared to healthy controls. Hierarchical regression models showed that severity of drug use and fluid and crystallized intelligence significantly explained performance in all the planning tasks. However, these associations were higher for low-structured real world tasks. These low-structured tasks also showed a unique association with crystallized but not fluid intelligence. Drug abuse is negatively associated with planning abilities, and intelligence is positively associated with planning performance in real-world tasks. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Choice Set Size and Decision-Making: The Case of Medicare Part D Prescription Drug Plans

    PubMed Central

    Bundorf, M. Kate; Szrek, Helena

    2013-01-01

    Background The impact of choice on consumer decision-making is controversial in U.S. health policy. Objective Our objective was to determine how choice set size influences decision-making among Medicare beneficiaries choosing prescription drug plans. Methods We randomly assigned members of an internet-enabled panel age 65 and over to sets of prescription drug plans of varying sizes (2, 5, 10, and 16) and asked them to choose a plan. Respondents answered questions about the plan they chose, the choice set, and the decision process. We used ordered probit models to estimate the effect of choice set size on the study outcomes. Results Both the benefits of choice, measured by whether the chosen plan is close to the ideal plan, and the costs, measured by whether the respondent found decision-making difficult, increased with choice set size. Choice set size was not associated with the probability of enrolling in any plan. Conclusions Medicare beneficiaries face a tension between not wanting to choose from too many options and feeling happier with an outcome when they have more alternatives. Interventions that reduce cognitive costs when choice sets are large may make this program more attractive to beneficiaries. PMID:20228281

  6. 49 CFR 199.101 - Anti-drug plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing...; (2) The name and address of each laboratory that analyzes the specimens collected for drug testing... 49 Transportation 3 2014-10-01 2014-10-01 false Anti-drug plan. 199.101 Section 199.101...

  7. 49 CFR 199.101 - Anti-drug plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Drug Testing...; (2) The name and address of each laboratory that analyzes the specimens collected for drug testing... 49 Transportation 3 2013-10-01 2013-10-01 false Anti-drug plan. 199.101 Section 199.101...

  8. Flexible Fringe Benefit Plans Save You Money and Keep Employees Happy.

    ERIC Educational Resources Information Center

    Johnson, Rob

    1987-01-01

    This fringe benefit plan saves money for both employers and employees, provides a better fit for employees' actual benefit needs, and allows employees to choose options from a menu of benefits. One option is a flexible spending plan. Employees place a portion of their before-tax income into a special account from which allowable expenses are paid…

  9. Benefit-Cost Analysis of Drug Abuse Prevention Programs: A Macroscopic Approach.

    ERIC Educational Resources Information Center

    Kim, Sehwan; And Others

    1995-01-01

    Determines the overall strategy for initiating benefit-cost analysis (BCA) in relation to drug abuse prevention programs, followed by definitions of BCA and cost-effectiveness analysis. Determines the most likely population benefit-cost efficiency ratio of 15:1, indicating that there is a $15 savings on every dollar spent on drug abuse education.…

  10. Comparing Pharmacy Benefit Managers: Moving Well Beyond the Simple Spreadsheet Analysis

    PubMed Central

    Calabrese, David

    2008-01-01

    Unabated increases in prescription drug demands, advancing technology, and rising drug inflation rates combined with a sagging economy, continue to intensify budget pressures for payors responsible for delivering pharmacy benefits to plan members. At the same time, high levels of complexity and resource requirements in drug benefit administration have led to a state in which plan sponsors remain heavily dependent on pharmacy benefit managers to assist in these efforts. With pharmacy representing such a critical component of healthcare delivery from clinical and economic perspectives, it is essential that sponsors exercise high levels of due diligence in pharmacy benefit manager review and appraisal to ensure proper balance of quality clinical care, sufficient access, and optimal cost-efficiency in the delivery of such benefits. This review is designed to provide a comprehensive understanding of current pharmacy benefit management business practices and help equip plan sponsors with the knowledge, strategies, and safeguards to drive a well-informed pharmacy benefit selection process and, inevitably, a better-aligned pharmacy benefit management–payor relationship. PMID:25126235

  11. Older adults' drug benefit beliefs: construct definition and measure development.

    PubMed

    Cline, Richard R; Gupta, Kiran; Singh, Reshmi L

    2008-03-01

    The Medicare Prescription Drug, Improvement and Modernization Act of 2003 provides coverage of outpatient prescription drugs for Medicare beneficiaries. Although much has been learned since the program's implementation, a context within which this information can be understood is lacking. The purpose of this study was to develop a reliable and valid multi-item instrument measuring beliefs about Medicare prescription drug benefits. Survey items were generated using focus group transcripts, other surveys on the Medicare Part "D" program, and past studies of choice and satisfaction in drug insurance programs. Using data from the survey pilot test, item and reliability analyses were used to reduce and refine an initial pool of items. Data then were collected from a cross-sectional, mail survey of older adults living in Minnesota. Data were analyzed using exploratory factor analysis. Summated rating scales then were constructed and assessed further using reliability analyses. Construct validity of summated scales was examined by comparing scale scores across response categories of survey items that collected information on general political attitudes, perceptions of the Medicare Part "D" program, health status, and health care utilization and demographics. The adjusted response rate for the main survey was 55.98% (744/1329). Iterative factor analysis produced 2 interpretable scales. The first, termed "access/equity" (13 items, Cronbach's alpha=0.89) measures beliefs that a Medicare drug benefit should both provide affordable prescription drugs for beneficiaries and do this in a manner that is equitable for all participants. The second, termed "comprehensibility" (6 items, Cronbach's alpha=0.80) assesses beliefs that regulations governing a Medicare drug benefit should be easily understood. Discriminant validity tests suggest that these measures behave in a manner consistent with related research in these areas. Measures of 2 facets of older adults' drug benefit beliefs

  12. How excluding some benefits from value assessment of new drugs impacts innovation.

    PubMed

    Cook, Joseph P; Golec, Joseph

    2017-12-01

    Payers often assess the benefits of new drugs relative to costs for reimbursement purposes, but they frequently exclude some drugs' option-related benefits, reducing their reimbursement chances, and making them less attractive R&D investments. We develop and test a real options model of R&D investment that shows that excluding option-related benefits heightens drug developers' incentives to avoid high-risk (volatile) R&D investments and instead encourages them to focus on "safer" (positively skewed) investments. Our model and empirical results could partly explain the decline in the number of risky new molecular entities. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Cost-Benefit Analysis of the Officer Career Information and Planning System

    DTIC Science & Technology

    1980-08-01

    information without the use of a computer. - vii COST-BENEFIT ANALYSIS OF THE OFFICER CAREER INFOýKATTON AND PLANNING SYSTEM CONTENTS Page INTRODUCTION ...OF THE OFFICER CAREER INFORMATION AND PLANNING SYSTEM INTRODUCTION The implementation of the Officer Personnel Management System (OPMS) has...Research Report 1256 I / COST-BENEFIT ANALYSIS OF THE OFFICER CAREER INFORMATION AND PLANNING SYSTEM Roger A. Myers, Peter C. Cairo, K - Jon A

  14. Computerized Production Process Planning. Volume 2. Benefit Analysis.

    DTIC Science & Technology

    1976-11-01

    advantage , in the long term, Systems 2 and 3 will return greater economic benefits . Plots of the cumulative present value of the cash flow by year are...is economically viable for large parts manufac- turers and does offer significant advantages over Systems I and 2 in terms of intangible benefits ...AD-RI51 996 COMPUTERIZED PRODUCTION PROCESS PLANNING VOLUME 2 i/1.. BENEFIT ANRLYSIS(U) IIT RESEARCH INST CHICRGO IL SH H HU ET AL. NOV 76 DAAHNi-76

  15. 5 CFR 890.204 - Withdrawal of approval of health benefits plans or carriers.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Withdrawal of approval of health benefits... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.204 Withdrawal of approval of health benefits plans or carriers. (a) The Director may...

  16. 5 CFR 890.204 - Withdrawal of approval of health benefits plans or carriers.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Withdrawal of approval of health benefits... (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits Plans § 890.204 Withdrawal of approval of health benefits plans or carriers. (a) The Director may...

  17. Information for Consumers (Drugs)

    MedlinePlus

    ... Evaluation and Mitigation Strategies (REMS) REMS is a risk management plan required by FDA for certain prescription drugs, that uses tools beyond routine professional labeling to ensure that the benefits of the drug outweigh its risks. Index to Drug - Specific Information List of drugs ...

  18. [Drug registries: post-marketing evaluation of the benefit-risk profile and promotion of appropriateness. The regional point of view].

    PubMed

    Martelli, Luisa; Venegoni, Mauro

    2013-06-01

    Italian Regions and the Italian regulatory agency share a common interest in promoting the appropriateness of drug use, containing drug expenditure and acquiring additional evidence on the effectiveness and safety of drugs. Drug registries can help attaining these objectives. Specifically, the registries implemented in Italy were able to cover the first two objectives, whereas some critical issues were raised on the third one. For instance, the data recorded in the registries are not available at regional level to conduct safety and effectiveness investigations. This is a paradox, when considering that drugs included in the registries have a risk-benefit profile that is only partially defined at the moment of marketing. Currently, researchers and regions can conduct epidemiological research (cohort and case control studies), on the basis of record-linkage procedures, on all drugs prescribed in general practice (which are older drugs with a better defined risk-benefit profile). The expected outcomes of registries should be more clearly defined: when the main aim is to promote appropriateness, the recording of only a very limited amount of data should be required (to avoid a bureaucratic burden on clinicians).The Italian centers of the ENCePP network might play an important role in planning and conducting drug registries: through the presence in the steering committees of the registries, and in conducting epidemiological studies that make the most of this powerful instrument.

  19. The Survivor Benefit Plan (SBP) Friend or Foe?

    DTIC Science & Technology

    1987-01-01

    SBP BENEFITS AND COSTS Chapter Two THE ADVANTAGES OF SBP As seen in chapter one, the objective of SBP it: to provide an annuity income up to a... benefits f beneficiar applicable r advantage is that the dollars r SBP protection are not subject decreases the actual "out of po be especially...m ^co0 o rs oo 0) < i Q < AIR COMMAND AND STAFF COLLECrE STUDENT REPORT THE SURVIVOR BENEFIT PLAN (SBP) FRIEND OR FOE? MAJOR MICHAEL J

  20. 29 CFR 4041.24 - Notices of plan benefits.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... lump sum and the age at which, or form in which, the plan benefits will be paid differs from the normal retirement benefit— (i) The age or form stated in the plan; and (ii) The age or form adjustment factors; and... for the third month before the month in which the lump sum is distributed), a reference to the...

  1. 76 FR 77543 - Quantitative Summary of the Benefits and Risks of Prescription Drugs: A Literature Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ...] Quantitative Summary of the Benefits and Risks of Prescription Drugs: A Literature Review AGENCY: Food and Drug... availability of a draft report entitled ``Quantitative Summary of the Benefits and Risks of Prescription Drugs... ``Quantitative Summary of the Benefits and Risks of Prescription Drugs: A Literature Review.'' A literature...

  2. Early benefit assessment of new drugs in Germany - results from 2011 to 2012.

    PubMed

    Hörn, Helmut; Nink, Katrin; McGauran, Natalie; Wieseler, Beate

    2014-06-01

    Rising drug costs in Germany led to the Act on the Reform of the Market for Medicinal Products (AMNOG) in January 2011. For new drugs, pharmaceutical companies have to submit dossiers containing all available evidence to demonstrate an added benefit versus an appropriate comparator therapy. The Federal Joint Committee (G-BA), the main decision-making body of the statutory healthcare system, is responsible for the overall procedure of "early benefit assessment". The Institute for Quality and Efficiency in Health Care (IQWiG) largely conducts the dossier assessments, which inform decisions by the G-BA on added benefit and support price negotiations. Of the 25 dossiers (excluding orphan drugs) assessed until 31 December 2012, 14 contained sufficient data from randomized active-controlled trials investigating patient-relevant outcomes or at least acceptable surrogates; 11 contained insufficient data. The most common indications were oncology (6) and viral infections (4). For the 14 drugs assessed, the extent of added benefit was rated as minor, considerable, and non-quantifiable in 3, 8, and 2 cases; the remaining drug showed no added benefit. Despite some shortcomings, for the first time it has been possible in Germany to implement a systematic procedure for assessing new drugs at market entry, thus providing support for price negotiations and informed decision-making for patients, clinicians and policy makers. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. 20 CFR 404.480 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Paying benefits in installments: Drug addiction or alcoholism. 404.480 Section 404.480 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Deductions; Reductions; and Nonpayments of Benefits § 404.480 Paying benefits in installments:...

  4. 20 CFR 416.544 - Paying benefits in installments: Drug addiction or alcoholism.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Paying benefits in installments: Drug addiction or alcoholism. 416.544 Section 416.544 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Payment of Benefits, Overpayments, and Underpayments § 416.544 Paying benefits in installment...

  5. 20 CFR 1002.171 - How does the continuation of health plan benefits apply to a multiemployer plan that provides...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How does the continuation of health plan... system? 1002.171 Section 1002.171 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS... Service in the Uniformed Services Health Plan Coverage § 1002.171 How does the continuation of health plan...

  6. Public Drug Plan Coverage for Children Across Canada: A Portrait of Too Many Colours

    PubMed Central

    Ungar, Wendy J; Witkos, Maciej

    2005-01-01

    Background: As debate continues regarding pharmacare in Canada, little discussion has addressed appropriate drug plan coverage for vulnerable populations, such as children. The primary objective of this study was to determine the extent of medication coverage for children in publicly administered programs in each province across Canada. Methods: Data were collected on provincial, territorial and federal government drug plans, and 2003 formulary updates were obtained. A simulation model was constructed to demonstrate costs to a low-income family with an asthmatic child in each province. Programs were compared descriptively. The extent of interprovincial variation in 2003 formulary approvals was summarized statistically. Results: There was 39% variation between provinces with respect to 2003 formulary approvals (chi-square p < 0.0001) and 48% variation for 2003 paediatric-labelled products (chi-square p < 0.0001). Across Canada, only 8% of 2003 formulary approvals were indicated primarily for paediatric conditions. In the simulation model, costs were less than or equal to 3% of household income in provinces with plans for low-income families, catastrophic costs (Ontario) or for the population. Families who failed to qualify for low income plans or who resided in New Brunswick or Newfoundland faced costs up to 7% of household income. Interpretation: With regard to pharmaceutical benefits for children, provincial drug programs vary considerably in terms of whom they cover, what drugs are covered and how much subscribers must pay out of pocket. Unlike seniors and social assistance recipients, the provinces do not agree on the importance of providing comprehensive coverage for all children. For many Canadian children, significant financial barriers exist to medication access. PMID:19308106

  7. Health plan switching among members of the Federal Employees Health Benefits Program.

    PubMed

    Atherly, Adam; Florence, Curtis; Thorpe, Kenneth E

    2005-01-01

    This paper examines factors associated with switching health plans in the Federal Employees Health Benefits Program. Switching plans is not uncommon, with 12% of members switching plans annually. Individuals switch out of plans with premium increases and benefit decreases relative to other plans in the market. Switching is negatively associated with age due to increasing switching costs associated with age rather than decreasing premium sensitivity. Individuals in preferred provider organizations are less likely to switch, but are more responsive to premium increases than those in the managed care sector. Those who do switch plans are likely to switch to a different plan in the same sector.

  8. The Influence of Drug Testing and Benefit-Based Distribution of Opioid Substitution Therapy on Drug Abstinence.

    PubMed

    Gabrovec, Branko

    2015-01-01

    The objective of our research was to discover whether the new approach to urine drug testing has a positive effect on users' abstinence, users' treatment, and their cooperation, while remaining user-friendly, and whether this approach is more cost-effective. The centers are focused on providing high-quality treatment within a cost-efficient program. In this study, we focus on the influence of drug testing and benefit-based distribution of opioid substitution therapy (BBDOST) on drug abstinence. The purpose of this study was to find any possible positive effect of modified distribution of the therapy and illicit drug testing on the number of users who are abstinent from illicit drugs and users who are not abstinent from illicit drugs as well as the users' opinion on BBDOST and testing. We are also interested in a difference in abstinence rates between those on BBDOST and those not receiving BBDOST. In 2010, the method of drug testing at the center was changed (less frequent and random drug testing) to enable its users faster access to BBDOST (take-home therapy). It was found that the number of drug-abstinent program participants has increased from initial 44.5% (2010) to 54.1% (2014). According to the program participants, the new method allows them to achieve and maintain abstinence from drugs more easily. In addition, they are also satisfied with the modified way of drug testing. This opinion does not change with age, gender, and acquired benefits.

  9. What’s Wrong with the Survivor Benefit Plan?

    DTIC Science & Technology

    1986-04-01

    Found aspects of the program confusing. Most often mentioned were the benefit adjustment mechanism and the special tax advantage Features. Not...WHAT’S WRONG WITH THE SURVIVOR BENEFIT PLAN? AUTHOR(S) MAJOR RALPH A. BLA1ELOCK, USAF FACULTY ADVISOR MAJOR MACK FOSTER, ACSC/EDCM SPONSOR LT COLONEL...Include.ecurslty Ckwaaicationl WHAT’S WRONG WITH THE SURVIVOR BENEFIT , PERSONAL AUTHORST Blakelock, ph A., Major, USAF 13a. TYPE OF REPORT 13t. TIME

  10. [Challenges for clinical trials in oncology within the scope of early benefit assessment of drugs].

    PubMed

    Lange, Stefan

    2015-01-01

    Until May 31, 2015 the German Institute for Quality and Efficiency in Health Care (IQWiG) conducted 108 assessments for various diseases on the basis of 103 dossiers within the scope of the early benefit assessment of drugs pursuant to the Act on the Reform of the Market for Medicinal Products (AMNOG). 29 of these assessments (28 dossiers) referred to advanced stages of oncologic (including neoplastic-hematologic) diseases. In 21 of these 29 assessments (72%), IQWiG found an added benefit for at least one subpopulation or subgroup, compared to 33% with non-oncologic diseases. For oncologic diseases, the extent of benefit was classified as "major" in six assessments (21%), compared to 5% for non-oncologic disorders. In contrast, the conclusions of the oncologic studies were less certain: only one assessment provided proof (of an added benefit); for non-oncologic diseases, this was the case in eight assessments. A distinctive methodological feature of the available oncologic studies is that, as a rule, treatment switching was planned in the event of progression (normally on the basis of imaging or laboratory findings) and that shortly afterwards the follow-up of important endpoints (adverse events and patient-reported outcomes) was normally discontinued. In particular, the pre-specified option in the study protocol allowing the control group to switch treatment to the experimental intervention after progression ("protocol-permitted treatment switches") makes it extremely difficult to interpret the results beyond the outcome "progression" (or progression-free survival). This treatment switching is mostly justified by reference to ethical necessity. This, however, alleges that the experimental intervention (i. e., the new drug) is superior to the control intervention, which means that circular reasoning is unavoidable. But despite this, oncologic studies are better than their reputation. Hence, so far the results of the early benefit assessment of new drugs (regarding

  11. 42 CFR 422.104 - Special rules on supplemental benefits for MA MSA plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Special rules on supplemental benefits for MA MSA... and Beneficiary Protections § 422.104 Special rules on supplemental benefits for MA MSA plans. (a) An MA organization offering an MA MSA plan may not provide supplemental benefits that cover expenses...

  12. 42 CFR 422.104 - Special rules on supplemental benefits for MA MSA plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Special rules on supplemental benefits for MA MSA... and Beneficiary Protections § 422.104 Special rules on supplemental benefits for MA MSA plans. (a) An MA organization offering an MA MSA plan may not provide supplemental benefits that cover expenses...

  13. 42 CFR 422.104 - Special rules on supplemental benefits for MA MSA plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Special rules on supplemental benefits for MA MSA... and Beneficiary Protections § 422.104 Special rules on supplemental benefits for MA MSA plans. (a) An MA organization offering an MA MSA plan may not provide supplemental benefits that cover expenses...

  14. 76 FR 58020 - Prescription Drug User Fee Act IV Information Technology Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ...] Prescription Drug User Fee Act IV Information Technology Plan AGENCY: Food and Drug Administration, HHS. ACTION... information technology (IT) plan entitled ``PDUFA IV Information Technology Plan'' (updated plan) to achieve... Information Technology Plan.'' This plan will meet one of the performance goals agreed to under the 2007...

  15. 42 CFR 422.104 - Special rules on supplemental benefits for MA MSA plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Special rules on supplemental benefits for MA MSA... Beneficiary Protections § 422.104 Special rules on supplemental benefits for MA MSA plans. (a) An MA organization offering an MA MSA plan may not provide supplemental benefits that cover expenses that count...

  16. 42 CFR 422.104 - Special rules on supplemental benefits for MA MSA plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Special rules on supplemental benefits for MA MSA... Beneficiary Protections § 422.104 Special rules on supplemental benefits for MA MSA plans. (a) An MA organization offering an MA MSA plan may not provide supplemental benefits that cover expenses that count...

  17. Two Decades of Employee-Benefit Plans, 1950-1970: A Review.

    ERIC Educational Resources Information Center

    Kolodrubetz, Walter W.

    This article discusses the long-term growth of employee-benefit plans (which have grown tremendously since 1950) and assesses this trend in terms of real gains. The article states that contributions, by 1970, were nine times greater and benefit outlays 14 times greater than in 1950, and the number of persons covered by most types of benefits grew…

  18. The Inverse Benefit Law: How Drug Marketing Undermines Patient Safety and Public Health

    PubMed Central

    Light, Donald W.

    2011-01-01

    Recent highly publicized withdrawals of drugs from the market because of safety concerns raise the question of whether these events are random failures or part of a recurring pattern. The inverse benefit law, inspired by Hart's inverse care law, states that the ratio of benefits to harms among patients taking new drugs tends to vary inversely with how extensively the drugs are marketed. The law is manifested through 6 basic marketing strategies: reducing thresholds for diagnosing disease, relying on surrogate endpoints, exaggerating safety claims, exaggerating efficacy claims, creating new diseases, and encouraging unapproved uses. The inverse benefit law highlights the need for comparative effectiveness research and other reforms to improve evidence-based prescribing. PMID:21233426

  19. The inverse benefit law: how drug marketing undermines patient safety and public health.

    PubMed

    Brody, Howard; Light, Donald W

    2011-03-01

    Recent highly publicized withdrawals of drugs from the market because of safety concerns raise the question of whether these events are random failures or part of a recurring pattern. The inverse benefit law, inspired by Hart's inverse care law, states that the ratio of benefits to harms among patients taking new drugs tends to vary inversely with how extensively the drugs are marketed. The law is manifested through 6 basic marketing strategies: reducing thresholds for diagnosing disease, relying on surrogate endpoints, exaggerating safety claims, exaggerating efficacy claims, creating new diseases, and encouraging unapproved uses. The inverse benefit law highlights the need for comparative effectiveness research and other reforms to improve evidence-based prescribing.

  20. Benefits of advanced software techniques for mission planning systems

    NASA Technical Reports Server (NTRS)

    Gasquet, A.; Parrod, Y.; Desaintvincent, A.

    1994-01-01

    The increasing complexity of modern spacecraft, and the stringent requirement for maximizing their mission return, call for a new generation of Mission Planning Systems (MPS). In this paper, we discuss the requirements for the Space Mission Planning and the benefits which can be expected from Artificial Intelligence techniques through examples of applications developed by Matra Marconi Space.

  1. Benefits of advanced software techniques for mission planning systems

    NASA Astrophysics Data System (ADS)

    Gasquet, A.; Parrod, Y.; Desaintvincent, A.

    1994-10-01

    The increasing complexity of modern spacecraft, and the stringent requirement for maximizing their mission return, call for a new generation of Mission Planning Systems (MPS). In this paper, we discuss the requirements for the Space Mission Planning and the benefits which can be expected from Artificial Intelligence techniques through examples of applications developed by Matra Marconi Space.

  2. Amendments to Summary Plan Description regulations. Pension and Welfare Benefits Administration, Labor. Final rule.

    PubMed

    2000-11-21

    This document contains a final rule amending the regulations governing the content of the Summary Plan Description (SPD) required to be furnished to employee benefit plan participants and beneficiaries under the Employee Retirement Income Security Act of 1974, as amended (ERISA). These amendments implement information disclosure recommendations of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry, as set forth in their November 20, 1997, report, "Consumer Bill of Rights and Responsibilities." Specifically, the amendments clarify benefit, medical provider, and other information required to be disclosed in, or as part of, the SPD of a group health plan and repeal the limited exemption with respect to SPDs of welfare plans providing benefits through qualified health maintenance organizations (HMOs). In addition, this document contains several amendments updating and clarifying provisions relating to the content of SPDs that affect both pension and welfare benefit plans. This document also adopts in final form certain regulations that were effective on an interim basis implementing amendments to ERISA enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This final rule will affect employee pension and welfare benefit plans, including group health plans, as well as administrators, fiduciaries, participants and beneficiaries of such plans.

  3. 75 FR 54542 - Prohibited Transaction Exemption Procedures; Employee Benefit Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-08

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 29 CFR Part 2570 RIN 1210-AA98 Prohibited Transaction Exemption Procedures; Employee Benefit Plans Correction In proposed rule document 2010-21073 beginning on page 53172 in the issue of Monday, August 30, 2010, make the following correction...

  4. 42 CFR 433.145 - Assignment of rights to benefits-State plan requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Assignment of rights to benefits-State plan... Liability Assignment of Rights to Benefits § 433.145 Assignment of rights to benefits—State plan... beneficiary is required to: (1) Assign to the Medicaid agency his or her rights, or the rights of any other...

  5. 42 CFR 433.145 - Assignment of rights to benefits-State plan requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Assignment of rights to benefits-State plan... Liability Assignment of Rights to Benefits § 433.145 Assignment of rights to benefits—State plan... recipient is required to: (1) Assign to the Medicaid agency his or her rights, or the rights of any other...

  6. 42 CFR 433.145 - Assignment of rights to benefits-State plan requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Assignment of rights to benefits-State plan... Liability Assignment of Rights to Benefits § 433.145 Assignment of rights to benefits—State plan... beneficiary is required to: (1) Assign to the Medicaid agency his or her rights, or the rights of any other...

  7. 42 CFR 433.145 - Assignment of rights to benefits-State plan requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Assignment of rights to benefits-State plan... Liability Assignment of Rights to Benefits § 433.145 Assignment of rights to benefits—State plan... beneficiary is required to: (1) Assign to the Medicaid agency his or her rights, or the rights of any other...

  8. 42 CFR 433.145 - Assignment of rights to benefits-State plan requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Assignment of rights to benefits-State plan... Liability Assignment of Rights to Benefits § 433.145 Assignment of rights to benefits—State plan... recipient is required to: (1) Assign to the Medicaid agency his or her rights, or the rights of any other...

  9. Risk-benefit assessment of tocolytic drugs.

    PubMed

    Wischnik, A

    1991-01-01

    beta 2-Mimetics are the principal agents used for myometrial relaxation. As all the available drugs also have beta 1-stimulant effects, the various side effects (cardiovascular, pulmonary and metabolic) require a critical consideration of the clinical indications, thorough supervision and combined therapeutic concepts. With regard to clinical indications, 'prophylactic tocolysis' frequently turns out to be unnecessary, as does the treatment of physiological uterine contractions during pregnacy which have no effect on the cervix. The benefit of tocolysis must be seen not so much in a reduction of preterm labour but in enabling the obstetrician and neonatologist to optimise the handling of the premature baby, e.g. by allowing lung maturation or by enabling the patient to reach a centre for perinatal medicine before the birth. Labour-dependent fetal distress situations during birth at term can also be managed successfully. Supervision involves thorough control of both mother (especially of cardiovascular and metabolic parameters, electrolyte and water balance) and fetus (cardiotocography, fetometry) in order to decide individually when possible benefits are outweighed by maternal or fetal risks. Combination of beta 2-mimetic treatment with magnesium therapy reduces the beta-mimetic dosage required, has a cardioprotective action, and reduces the development of drug tolerance and the risk of lung oedema. This combination, therefore, should become routine in tocolytic therapy. If further protection against cardiovascular and risk of lung oedema is required, administration of beta 1-blockers is advisable.

  10. Strategic Benefit Planning in Colleges and Universities: Giving a Sense of Direction to the Benefit Program.

    ERIC Educational Resources Information Center

    DiBernardino, Frank J.; Mead, Paul D.

    1988-01-01

    Strategic benefit planning is a management process that establishes overall objectives that form the basis for decision making on all elements of indirect compensation. The Tax Reform Act of 1986 and implications to tax-sheltered annuities are discussed. An example of a statement of university policy on employee benefits is appended. (MLW)

  11. 26 CFR 1.436-1 - Limits on benefits and benefit accruals under single employer defined benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    .../applicability date provisions. (3) Special rules for certain plans—(i) New plans. The limitations described in... with the opportunity to make a new election under which the form of benefit previously elected is modified, subject to applicable qualification requirements. A participant who makes such a new election is...

  12. 26 CFR 1.436-1 - Limits on benefits and benefit accruals under single employer defined benefit plans.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    .../applicability date provisions. (3) Special rules for certain plans—(i) New plans. The limitations described in... with the opportunity to make a new election under which the form of benefit previously elected is modified, subject to applicable qualification requirements. A participant who makes such a new election is...

  13. 26 CFR 1.436-1 - Limits on benefits and benefit accruals under single employer defined benefit plans.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    .../applicability date provisions. (3) Special rules for certain plans—(i) New plans. The limitations described in... with the opportunity to make a new election under which the form of benefit previously elected is modified, subject to applicable qualification requirements. A participant who makes such a new election is...

  14. 26 CFR 1.410(b)-3 - Employees and former employees who benefit under a plan.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... under the section 401(a)(4) general test. (C) Defined contribution plans. A defined contribution plan is... the plan. Thus, for example, if the formula under a defined benefit plan takes into account only the... benefit previously accrued were disregarded. This could happen, for example, when the plan is applying the...

  15. Setting a national minimum standard for health benefits: how do state benefit mandates compare with benefits in large-group plans?

    PubMed

    Frey, Allison; Mika, Stephanie; Nuzum, Rachel; Schoen, Cathy

    2009-06-01

    Many proposed health insurance reforms would establish a federal minimum benefit standard--a baseline set of benefits to ensure that people have adequate coverage and financial protection when they purchase insurance. Currently, benefit mandates are set at the state level; these vary greatly across states and generally target specific areas rather than set an overall standard for what qualifies as health insurance. This issue brief considers what a broad federal minimum standard might look like by comparing existing state benefit mandates with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package, an example of minimum creditable coverage that reflects current standard practice among employer-sponsored health plans. With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require-indicating that a broad-based national benefit standard would include most existing state benefit mandates.

  16. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS...

  17. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS...

  18. Generic drug discount programs: are prescriptions being submitted for pharmacy benefit adjudication?

    PubMed

    Tungol, Alexandra; Starner, Catherine I; Gunderson, Brent W; Schafer, Jeremy A; Qiu, Yang; Gleason, Patrick P

    2012-01-01

      In 2006, pharmacies began offering select generic prescription drugs at discount prices (e.g., $4 for a 30-day supply) through nonmembership and membership programs. As part of the contract in membership generic drug discount programs, the member agrees to forgo submission of the claim to the insurance company. Claims not submitted for insurance adjudication may result in incomplete pharmacy benefit manager (PBM) and health plan data, which could negatively influence adherence reporting and clinical programs. To address potentially missing claims data, the Centers for Medicare Medicaid Services (CMS) encourages Medicare Part D sponsors to incentivize network pharmacies to submit claims directly to the plan for drugs dispensed outside of a member's Part D benefit, unless a member refuses. The extent of PBM and health plan claims capture loss due to generic drug discount programs is unknown. To identify changes in levothyroxine utilizers' prescription claims capture rate following the advent of generic drug discount membership and nonmembership programs. This retrospective concurrent cohort study used claims data from 3.5 million commercially insured members enrolled in health plans located in the central and southern United States with Prime Therapeutics pharmacy benefit coverage. Members were required to be 18 years or older and younger than 60 years as of January 1, 2006, and continuously enrolled from January 1, 2006, through December 31, 2010. Members utilizing generic levothyroxine for at least 120 days during January 1, 2006, through June 30, 2006 (baseline period) from the same pharmacy group with supply on July 1, 2006, were placed into 1 of 3 pharmacy groups: (1) nonmembership (Walmart, Sam's Club, Target, Kroger, City Market, and King Soopers pharmacies), (2) membership (Walgreens, CVS, Albertsons, and Savon pharmacies), or (3) the reference group of all other pharmacies. The index date was defined as July 1, 2006. The levothyroxine claim providing

  19. Using choice-based conjoint to determine the relative importance of dental benefit plan attributes.

    PubMed

    Cunningham, M A; Gaeth, G J; Juang, C; Chakraborty, G

    1999-05-01

    The purpose of this study was to use conjoint analysis to determine the importance of specific dental benefit plan features for University of Iowa (UI) staff and to build a model to predict enrollment. From a random sample of 2000 UI staff, 40 percent responded (N = 773). The survey instrument was developed using seven attributes (five dental benefit plan features and two facility characteristics) each offered at three levels (e.g., premium = $20, $15, $10/month). Pilot testing was used to find a realistic range of plan options. Twenty-seven hypothetical dental benefit plans were developed using fractional factorial combinations of the three levels for each of the seven attributes. For all of the hypothetical plans, dental care was to be provided in the UI predoctoral dental clinic. Plan profiles were arranged four per page by combining the existing plan with three hypothetical plans, for a total of nine pages. Respondents' task was to select one plan from each set of four. A regression-like statistical model (Multinomial Logit) was used to estimate importance of each attribute and each attribute level. Relative importance (and coefficients) for each of the seven attributes are as follows: maximum annual benefit (.98), orthodontic coverage (.72), routine restorative (.70), major restorative (.67), time to complete treatment (.61), clinic hours of operation (.47), premium (.18). For each attribute, relative importance of each of three levels will also be presented. These coefficients for each level are used to predict enrollment for plans with specific combinations of the dental benefit plan features.

  20. Employee Health Plan Details | Alaska Division of Retirement and Benefits

    Science.gov Websites

    Health Information Life Disability DCAP Forms/Publications Features Empower Retirement Account Info Home Retirement Benefits Employer Services AlaskaCare Easy Navigation Employee Health Gym Discount Health Plan FAQs Overview What Plan am I in? Information Enrollment Information FAQs Premiums Qualified

  1. Benefit or Burden? On the Intergenerational Inequity of Teacher Pension Plans

    ERIC Educational Resources Information Center

    Backes, Ben; Goldhaber, Dan; Grout, Cyrus; Koedel, Cory; Ni, Shawn; Podgursky, Michael; Xiang, P. Brett; Xu, Zeyu

    2016-01-01

    Most public school teachers in the United States are enrolled in defined benefit (DB) pension plans. Using administrative microdata from four states, combined with national pension funding data, we show these plans have accumulated substantial unfunded liabilities--effectively debt--owing to previous plan operations. On average across 49 state…

  2. 78 FR 45615 - Proposed Collection; Comment Request for the Annual Return/Report of Employee Benefit Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-29

    ... Annual Return/Report of Employee Benefit Plan AGENCY: Internal Revenue Service (IRS), Treasury. ACTION..., the IRS is soliciting comments concerning the Annual Return/Report of Employee Benefit Plan. [email protected] . SUPPLEMENTARY INFORMATION: Title: Annual Return/Report of Employee Benefit Plan. OMB...

  3. Getting closer to people: family planning provision by drug shops in Uganda

    PubMed Central

    Akol, Angela; Chin-Quee, Dawn; Wamala-Mucheri, Patricia; Namwebya, Jane Harriet; Mercer, Sarah Jilani; Stanback, John

    2014-01-01

    ABSTRACT Background: Private-sector drug shops are often the first point of health care in sub-Saharan Africa. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact. Methods: Between September 2010 and March 2011, we trained 139 drug shop operators (DSOs) in 4 districts of Uganda to safely administer intramuscular DMPA (depot medroxyprogesterone acetate) contraceptive injections. In 2012, we approached 54 of these DSOs and interviewed a convenience sample of 585 of their family planning clients to assess clients' contraceptive use and perspectives on the quality of care and satisfaction with services. Finally, we compared service statistics from April to June 2011 from drug shops, community health workers (CHWs), and government clinics in 3 districts to determine the drug shop market share of family planning services. Results: Most drug shop family planning clients interviewed were women with low socioeconomic status. The large majority (89%) were continuing family planning users. DMPA was the preferred contraceptive. Almost half of the drug shop clients had switched from other providers, primarily from government health clinics, mostly as a result of more convenient locations, shorter waiting times, and fewer stock-outs in drug shops. All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy. Three-quarters felt that drug shops offered affordable family planning services. Most of the DMPA clients (74%) were very satisfied with receiving their method from the drug shop and 98% intended to get the next injection from the drug shop. Between April and June 2011, clinics, CHWs, and drug shops in 3 districts delivered equivalent proportions of couple-years of protection, with drug shops leading marginally at 36

  4. Clinical benefit, price and approval characteristics of FDA-approved new drugs for treating advanced solid cancer, 2000-2015.

    PubMed

    Vivot, A; Jacot, J; Zeitoun, J-D; Ravaud, P; Crequit, P; Porcher, R

    2017-05-01

    Prices of anti-cancer drugs are skyrocking. We aimed to assess the clinical benefit of new drugs for treating advanced solid tumors at the time of their approval by the US Food and Drug Administration (FDA) and to search for a relation between price and clinical benefit of drugs. We included all new molecular entities and new biologics for treating advanced solid cancer that were approved by the FDA between 2000 and 2015. The clinical benefit of drugs was graded based on FDA medical review of pivotal clinical trials using the 2016-updated of the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). Characteristics of drugs and approvals were obtained from publicly available FDA documents and price was evaluated according to US Medicare, US Veterans Health Administration and United Kingdom market systems. The FDA approved 51 new drugs for advanced solid cancer from 2000 to 2015; we could evaluate the value of 37 drugs (73%). By the ESMO-MCBS, five drugs (14%) were grade one (the lowest), nine (24%) grade two, 10 (27%) grade three, 11 (30%) grade four and two (5%) grade five (the highest). Thus, 13 drugs (35%) showed a meaningful clinical benefit (scale levels 4 and 5). By the ASCO-VF which had a range of 3.4-67, the median drug value was 37 (interquartile range 20-52). We found no relationship between clinical benefit and drug price (P = 0.9). No characteristic of drugs and of approval was significantly associated with clinical benefit. Many recently FDA-approved new cancer drugs did not have high clinical benefit as measured by current scales. We found no relation between the price of drugs and benefit to society and patients. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Deferred Compensation Plan | Alaska Division of Retirement and Benefits

    Science.gov Websites

    Account Info Online General Info Empower Retirement Customer Service PIN Request Plan Booklet Investment Format Request Customer Service Request Status Refund Requests Resources Benefit Mailing Dates Booklets

  6. 41 CFR 60-741.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life insurance and other benefit plans. 60-741.25 Section 60-741.25 Public Contracts and Property Management... Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service...

  7. A Case Study: Introducing a New Benefit Plan on Campus

    ERIC Educational Resources Information Center

    Gustin, Karen; Bursic, Paul

    2004-01-01

    Many higher education institutions are strapped by benefit compensation costs for medical and pharmaceutical insurance, and there are few budget dollars left over for other health benefits, such as dental and eye care. Cornell University faced this dilemma and found voluntary dental and eye care plans to be an excellent solution. This article…

  8. The impact of flexible benefits plans on job satisfaction, organizational commitment and turnover intentions.

    PubMed

    Heshizer, B

    1994-01-01

    This study assesses the dimensionality of employee attitudes toward flexible benefits plans and the impact of these plans on measures of job satisfaction, commitment and turnover intent. The study points to the need for more work on the measurement of employee attitudes toward flexible benefits and on the nomological framework of flexible benefits as a construct in compensation research.

  9. 26 CFR 1.410(b)-3 - Employees and former employees who benefit under a plan.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... determining accrual rates under the section 401(a)(4) general test. (C) Defined contribution plans. A defined... basis to all employees in the plan. Thus, for example, if the formula under a defined benefit plan takes... determined under the plan if the benefit previously accrued were disregarded. This could happen, for example...

  10. Unique issues raised by drug benefit design.

    PubMed

    Berndt, Ernst R

    2004-01-01

    In this Perspective on the preceding paper by Joseph Newhouse, I point out a number of features of the pharmaceutical industry that differentiate it from other health care sectors. These differences help explain why it has proved to be so very difficult to construct policies that simultaneously contain health care costs, provide patients with high-quality care, and generate continued incentives for innovation. I then summarize Newhouse's preferred Medicare prescription drug benefit program and the issues it raises.

  11. 75 FR 33688 - Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Parts 4022 and 4044 Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: Pension...

  12. 75 FR 12121 - Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Parts 4022 and 4044 Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: Pension...

  13. Medicare Prescription Drug Plan Enrollees Report Less Positive Experiences Than Their Medicare Advantage Counterparts.

    PubMed

    Elliott, Marc N; Landon, Bruce E; Zaslavsky, Alan M; Edwards, Carol; Orr, Nathan; Beckett, Megan K; Mallett, Joshua; Cleary, Paul D

    2016-03-01

    Since 2006, Medicare beneficiaries have been able to obtain prescription drug coverage through standalone prescription drug plans or their Medicare Advantage (MA) health plan, options exercised in 2015 by 72 percent of beneficiaries. Using data from community-dwelling Medicare beneficiaries older than age sixty-four in 700 plans surveyed from 2007 to 2014, we compared beneficiaries' assessments of Medicare prescription drug coverage when provided by standalone plans or integrated into an MA plan. Beneficiaries in standalone plans consistently reported less positive experiences with prescription drug plans (ease of getting medications, getting coverage information, and getting cost information) than their MA counterparts. Because MA plans are responsible for overall health care costs, they might have more integrated systems and greater incentives than standalone prescription drug plans to provide enrollees medications and information effectively, including, since 2010, quality bonus payments to these MA plans under provisions of the Affordable Care Act. Project HOPE—The People-to-People Health Foundation, Inc.

  14. 76 FR 77900 - Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Parts 4022 and 4044 Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final...

  15. 76 FR 13883 - Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Parts 4022 and 4044 Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final...

  16. 78 FR 16401 - Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Parts 4022 and 4044 Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final...

  17. 78 FR 35754 - Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-14

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Parts 4022 and 4044 Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final...

  18. 77 FR 56770 - Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-14

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Parts 4022 and 4044 Allocation of Assets in Single-Employer Plans; Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: This final...

  19. Plan amendments--vesting of welfare benefits--settlor intent--ability to terminate health benefits for those on long-term disability.

    PubMed

    2010-01-01

    Halbach v. Great-West Life & Annuity Ins. Co., 561 F3d 872 (8th Cir. Mo. 2009): Because the vesting of benefits is subject to contractual arrangement under an employee benefit plan, summary judgment was improper where a genuine issue of material fact remained as to the settlor's intent to vest benefits.

  20. 20 CFR 1002.264 - Is the employee allowed to repay a previous distribution from a pension benefits plan upon being...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... distribution from a pension benefits plan upon being reemployed? 1002.264 Section 1002.264 Employees' Benefits... and Benefits Pension Plan Benefits § 1002.264 Is the employee allowed to repay a previous distribution from a pension benefits plan upon being reemployed? Yes, provided the plan is a defined benefit plan...

  1. A National Study of the Net Benefits of State Pension Plans for Educators

    ERIC Educational Resources Information Center

    Toutkoushian, Robert K.; Bathon, Justin M.; McCarthy, Martha M.

    2011-01-01

    Although benefits can be a sizable part of an educator's total compensation, there has been little scholarly inquiry into the state pension plans for educators. Despite the fact that all defined benefit plans rely on the same basic formula for calculating annual pensions, they vary across states in the multiplier used, the method for calculating…

  2. Planned home birth: benefits, risks, and opportunities

    PubMed Central

    Zielinski, Ruth; Ackerson, Kelly; Kane Low, Lisa

    2015-01-01

    While the number of women in developed countries who plan a home birth is low, the number has increased over the past decade in the US, and there is evidence that more women would choose this option if it were readily available. Rates of planned home birth range from 0.1% in Sweden to 20% in the Netherlands, where home birth has always been an integrated part of the maternity system. Benefits of planned home birth include lower rates of maternal morbidity, such as postpartum hemorrhage, and perineal lacerations, and lower rates of interventions such as episiotomy, instrumental vaginal birth, and cesarean birth. Women who have a planned home birth have high rates of satisfaction related to home being a more comfortable environment and feeling more in control of the experience. While maternal outcomes related to planned birth at home have been consistently positive within the literature, reported neonatal outcomes during planned home birth are more variable. While the majority of investigations of planned home birth compared with hospital birth have found no difference in intrapartum fetal deaths, neonatal deaths, low Apgar scores, or admission to the neonatal intensive care unit, there have been reports in the US, as well as a meta-analysis, that indicated more adverse neonatal outcomes associated with home birth. There are multiple challenges associated with research designs focused on planned home birth, in part because conducting randomized controlled trials is not feasible. This report will review current research studies published between 2004 and 2014 related to maternal and neonatal outcomes of planned home birth, and discuss strengths, limitations, and opportunities regarding planned home birth. PMID:25914559

  3. 29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... which is maintained pursuant to one or more collective bargaining agreements between employee..., unless the plan contains an explicit FMLA provision for maintaining coverage such as through pooled... by the group health plan, and benefits provided pursuant to the plan, must be maintained at the level...

  4. Getting closer to people: family planning provision by drug shops in Uganda.

    PubMed

    Akol, Angela; Chin-Quee, Dawn; Wamala-Mucheri, Patricia; Namwebya, Jane Harriet; Mercer, Sarah Jilani; Stanback, John

    2014-11-13

    Private-sector drug shops are often the first point of health care in sub-Saharan Africa. Training and supporting drug shop and pharmacy staff to provide a wide range of contraceptive methods and information is a promising high-impact practice for which more information is needed to fully document implementation experience and impact. Between September 2010 and March 2011, we trained 139 drug shop operators (DSOs) in 4 districts of Uganda to safely administer intramuscular DMPA (depot medroxyprogesterone acetate) contraceptive injections. In 2012, we approached 54 of these DSOs and interviewed a convenience sample of 585 of their family planning clients to assess clients' contraceptive use and perspectives on the quality of care and satisfaction with services. Finally, we compared service statistics from April to June 2011 from drug shops, community health workers (CHWs), and government clinics in 3 districts to determine the drug shop market share of family planning services. Most drug shop family planning clients interviewed were women with low socioeconomic status. The large majority (89%) were continuing family planning users. DMPA was the preferred contraceptive. Almost half of the drug shop clients had switched from other providers, primarily from government health clinics, mostly as a result of more convenient locations, shorter waiting times, and fewer stock-outs in drug shops. All clients reported that the DSOs treated them respectfully, and 93% trusted the drug shop operator to maintain privacy. Three-quarters felt that drug shops offered affordable family planning services. Most of the DMPA clients (74%) were very satisfied with receiving their method from the drug shop and 98% intended to get the next injection from the drug shop. Between April and June 2011, clinics, CHWs, and drug shops in 3 districts delivered equivalent proportions of couple-years of protection, with drug shops leading marginally at 36%, followed by clinics (33%) and CHWs (31

  5. Pharmacy Benefit Management Companies: Do They Create Value in the US Healthcare System?

    PubMed

    Lyles, Alan

    2017-05-01

    Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing. Whether these potential outcomes are realized within the relevant budget is a function of the healthcare system and the interaction of benefit design and clinical processes-not just individually vetted components. Efficiencies and values achieved in price discounts and cost sharing can be nullified if there is irrational prescribing (over-utilization, under-utilization and mis-utilization), variable patient adherence to medication regimens, ineffective formulary processes, or fraud, waste and abuse. Rising prescription drug costs and the increasing prevalence of 'high deductible health plans', which require much greater patient out-of-pocket costs, is creating a crisis for PBM efforts towards an affordable pharmacy benefit. Since PBM rebate and incentive contracts are opaque to the public, whether they add value by restraining higher drug prices or benefit from them is debatable.

  6. 42 CFR 423.908. - Phased-down State contribution to drug benefit costs assumed by Medicare.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Phased-down State contribution to drug benefit costs assumed by Medicare. 423.908. Section 423.908. Public Health CENTERS FOR MEDICARE & MEDICAID... Provisions § 423.908. Phased-down State contribution to drug benefit costs assumed by Medicare. This subpart...

  7. Teaching the Interrelationships among Costs, Expense, and Liability of a Defined Benefit Pension Plan

    ERIC Educational Resources Information Center

    Wilson, Arlette C.; Godwin, Norman H.

    2008-01-01

    The Financial Accounting Standards Board (FASB) recently issued Statement of Financial Accounting Standards No. 158 "Employers' Accounting for Defined Benefit Pension and Other Postretirement Plans" (SFAS #158). Their intent is to comprehensively reconsider the accounting for postretirement benefit plans in phases. The first phase was to provide…

  8. Federal Employees Health Benefits Program: Enrollment Options Following the Termination of a Plan or Plan Option. Final rule.

    PubMed

    2015-10-28

    The U.S. Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Employees Health Benefits (FEHB) Program regulations regarding enrollment options following the termination of a plan or plan option.

  9. Biometrical issues in the analysis of adverse events within the benefit assessment of drugs.

    PubMed

    Bender, Ralf; Beckmann, Lars; Lange, Stefan

    2016-07-01

    The analysis of adverse events plays an important role in the benefit assessment of drugs. Consequently, results on adverse events are an integral part of reimbursement dossiers submitted by pharmaceutical companies to health policy decision-makers. Methods applied in the analysis of adverse events commonly include simple standard methods for contingency tables. However, the results produced may be misleading if observations are censored at the time of discontinuation due to treatment switching or noncompliance, resulting in unequal follow-up periods. In this paper, we present examples to show that the application of inadequate methods for the analysis of adverse events in the reimbursement dossier can lead to a downgrading of the evidence on a drug's benefit in the subsequent assessment, as greater harm from the drug cannot be excluded with sufficient certainty. Legal regulations on the benefit assessment of drugs in Germany are presented, in particular, with regard to the analysis of adverse events. Differences in safety considerations between the drug approval process and the benefit assessment are discussed. We show that the naive application of simple proportions in reimbursement dossiers frequently leads to uninterpretable results if observations are censored and the average follow-up periods differ between treatment groups. Likewise, the application of incidence rates may be misleading in the case of recurrent events and unequal follow-up periods. To allow for an appropriate benefit assessment of drugs, adequate survival time methods accounting for time dependencies and duration of follow-up are required, not only for time-to-event efficacy endpoints but also for adverse events. © 2016 The Authors. Pharmaceutical Statistics published by John Wiley & Sons Ltd. © 2016 The Authors. Pharmaceutical Statistics published by John Wiley & Sons Ltd.

  10. Improving the decision-making process for nonprescription drugs: a framework for benefit-risk assessment.

    PubMed

    Brass, E P; Lofstedt, R; Renn, O

    2011-12-01

    Nonprescription drugs pose unique challenges to regulators. The fact that the barriers to access are lower for nonprescription drugs as compared with prescription drugs may permit additional consumers to obtain effective drugs. However, the use of these drugs by consumers in the absence of supervision by a health-care professional may result in unacceptable rates of misuse and suboptimal clinical outcomes. A value-tree method is proposed that defines important benefit and risk domains relevant to nonprescription drugs. This value tree can be used to comprehensively identify product-specific attributes in each domain and can also support formal benefit-risk assessment using a variety of tools. This is illustrated here, using a modification of the International Risk Governance Council (IRGC) framework, a flexible tool previously applied in a number of fields, which systematizes an approach to issue review, early alignment of stakeholders, evaluation, and risk mitigation/management. The proposed approach has the potential to provide structured, transparent tools for regulatory decision making for nonprescription drugs.

  11. 29 CFR 2509.78-1 - Interpretive bulletin relating to payments by certain employee welfare benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... employee welfare benefit plans. 2509.78-1 Section 2509.78-1 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR GENERAL INTERPRETIVE BULLETINS RELATING TO... payments by certain employee welfare benefit plans. The Department of Labor today announced its...

  12. Health plan utilization and costs of specialty drugs within 4 chronic conditions.

    PubMed

    Gleason, Patrick P; Alexander, G Caleb; Starner, Catherine I; Ritter, Stephen T; Van Houten, Holly K; Gunderson, Brent W; Shah, Nilay D

    2013-09-01

    Drugs are most typically defined as specialty because they are expensive; however, other criteria used to define a drug as specialty include biologic drugs, the need to inject or infuse the drug, the requirement for special handling, or drug availability only via a limited distribution network. Specialty drugs play an increasingly important role in the treatment of chronic conditions such as multiple sclerosis (MS), rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease (IBD), yet little is known regarding the comprehensive medical and pharmacy benefit utilization and cost trends for these conditions. To describe MS, RA, psoriasis, and IBD trends for condition prevalence, treatment with specialty drugs, specialty costs, nonspecialty costs, and total direct costs of care within the medical and pharmacy benefits. This was a descriptive analysis of a commercially insured population made up of 1 million members, using integrated medical and pharmacy administrative claims data from 2008 to 2010. Analyses were limited to continuously enrolled commercially insured individuals less than 65 years of age. Condition-specific cohorts for MS, RA, psoriasis, and IBD were defined using standardized criteria. Trends in condition prevalence, specialty drug use for the conditions, and direct total cost of care were analyzed. The direct costs were subcategorized into the following: medical benefit specialty drug costs, medical benefit all other costs, pharmacy benefit specialty drug costs, and pharmacy benefit all other costs. Trends and compound annual growth rates were calculated for the total cost of care and subcategory costs from 2008 through 2010. Condition prevalence ranged from a low of 1,720 per million members for MS to a high of 4,489 per million members for RA. Psoriasis and MS condition prevalence rates were unchanged over the 3 years; however, IBD prevalence increased 7.0%, and RA prevalence increased 9.7%. The rate of specialty drug use was lowest for IBD

  13. 78 FR 9928 - Food and Drug Administration Drug Shortages Task Force and Strategic Plan; Request for Comments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0124] Food and Drug Administration Drug Shortages Task Force and Strategic Plan; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice; request for comments. SUMMARY: To assist the Food...

  14. Benefit and risk information in prescription drug advertising: review of empirical studies and marketing implications.

    PubMed

    Kopp, S W; Bang, H K

    2000-01-01

    As pharmaceutical companies began to advertise prescription drugs directly to consumers as well as to physicians, understanding the impact of benefit and risk information in drug advertising on physicians and consumers has become more critical. This paper reviews previous empirical studies that examined the content of benefit and risk information in drug advertising and its potential effects on physicians' subsequent prescribing behaviors. It also reviews studies that investigated how consumers process information on a drug's efficacy and side effects. Based on the findings of these studies, implications are discussed for effective marketing information development as well as for government regulation.

  15. 20 CFR 1002.261 - Who is responsible for funding any plan obligation to provide the employee with pension benefits?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Who is responsible for funding any plan... and Benefits Pension Plan Benefits § 1002.261 Who is responsible for funding any plan obligation to... rules discussed below, the employer is liable to the pension benefit plan to fund any obligation of the...

  16. 75 FR 2161 - Proposed Extension of Information Collection; Comment Request; Employee Benefit Plan Claims...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration Proposed Extension of Information Collection; Comment Request; Employee Benefit Plan Claims Procedures Under ERISA AGENCY: Employee Benefits... Employee Benefits Security Administration (EBSA) is soliciting comments on a proposed extension of the...

  17. 77 FR 74515 - Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-14

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration Advisory Council on Employee Welfare... charter for the Advisory Council on Employee Welfare and Pension Benefit Plans is renewed. The Advisory Council on Employee Welfare and Pension Benefit Plans shall advise the Secretary of Labor on technical...

  18. 75 FR 80072 - Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Charter Renewal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration Advisory Council on Employee Welfare... charter for the Advisory Council on Employee Welfare and Pension Benefit Plans is renewed. The Advisory Council on Employee Welfare and Pension Benefit Plans shall advise the Secretary of Labor on technical...

  19. 76 FR 34590 - Bankruptcy Filing Date Treated as Plan Termination Date for Certain Purposes; Guaranteed Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Parts 4001, 4022, and 4044 RIN 1212-AA98 Bankruptcy Filing Date Treated as Plan Termination Date for Certain Purposes; Guaranteed Benefits; Allocation of Plan Assets; Pension Protection Act of 2006 AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final...

  20. 29 CFR 2509.94-3 - Interpretive bulletin relating to in-kind contributions to employee benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... employee benefit plans. 2509.94-3 Section 2509.94-3 Labor Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR GENERAL INTERPRETIVE BULLETINS RELATING TO...-kind contributions to employee benefit plans. (a) General. This bulletin sets forth the views of the...

  1. 5 CFR 890.204 - Withdrawal of approval of health benefits plans or carriers.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Withdrawal of approval of health benefits plans or carriers. 890.204 Section 890.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits...

  2. 5 CFR 890.204 - Withdrawal of approval of health benefits plans or carriers.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Withdrawal of approval of health benefits plans or carriers. 890.204 Section 890.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits...

  3. 5 CFR 890.204 - Withdrawal of approval of health benefits plans or carriers.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Withdrawal of approval of health benefits plans or carriers. 890.204 Section 890.204 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM Health Benefits...

  4. Benefits of Exercise for the Quality of Life of Drug-Dependent Patients.

    PubMed

    Giménez-Meseguer, Jorge; Tortosa-Martínez, Juan; de los Remedios Fernández-Valenciano, María

    2015-01-01

    This study combined quantitative and qualitative research methods to evaluate quality-of-life changes in drug-dependent patients after participation in a group-based exercise program. Quality of life (SF-36) and physical fitness (six-minute Walk Test, Timed Get Up and Go Test, and Chair Stand Test) were quantitatively determined in a group (n=37) of drug-dependent patients before and after a 12-week group exercise program (n=18) or routine care (n=19). Additionally, in-depth interviews were conducted at the end of the program with a subsample of 11 participants from the exercise group. Quantitative results showed improvements in fitness and different aspects of quality of life, such as physical function, mental health, vitality, social function, and general health perception. Qualitative results showed specific physical benefits (decreased injuries and muscle pain, decreased weight, and increased vitality with improvement in activities of daily living), psychological benefits (forgetting about everyday problems, improved mood, decreased stress and anxiety), social benefits, and a reduction in craving. The results of this study provide insight into the importance of exercise for the quality of life and recovery process of drug-dependent patients.

  5. Communicating quantitative risks and benefits in promotional prescription drug labeling or print advertising.

    PubMed

    West, Suzanne L; Squiers, Linda B; McCormack, Lauren; Southwell, Brian G; Brouwer, Emily S; Ashok, Mahima; Lux, Linda; Boudewyns, Vanessa; O'Donoghue, Amie; Sullivan, Helen W

    2013-05-01

    Under the Food, Drug, and Cosmetic Act, all promotional materials for prescription drugs must strike a fair balance in presentation of risks and benefits. How to best present this information is not clear. We sought to determine if the presentation of quantitative risk and benefit information in drug advertising and labeling influences consumers', patients', and clinicians' information processing, knowledge, and behavior by assessing available empirical evidence. We used PubMed for a literature search, limiting to articles published in English from 1990 forward. Two reviewers independently reviewed the titles and abstracts for inclusion, after which we reviewed the full texts to determine if they communicated risk/benefit information either: (i) numerically (e.g., percent) versus non-numerically (e.g., using text such as "increased risk") or (ii) numerically using different formats (e.g., "25% of patients", "one in four patients", or use of pictographs). We abstracted information from included articles into standardized evidence tables. The research team identified a total of 674 relevant publications, of which 52 met our inclusion criteria. Of these, 37 focused on drugs. Presenting numeric information appears to improve understanding of risks and benefits relative to non-numeric presentation; presenting both numeric and non-numeric information when possible may be best practice. No single specific format or graphical approach emerged as consistently superior. Numeracy and health literacy also deserve more empirical attention as moderators. Copyright © 2013 John Wiley & Sons, Ltd.

  6. 42 CFR 423.886 - Retiree drug subsidy amounts.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Retiree drug subsidy amounts. 423.886 Section 423... (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.886 Retiree drug subsidy amounts. (a) Amount of subsidy payment. (1...

  7. 42 CFR 423.886 - Retiree drug subsidy amounts.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Retiree drug subsidy amounts. 423.886 Section 423... (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.886 Retiree drug subsidy amounts. (a) Amount of subsidy payment. (1...

  8. 42 CFR 423.886 - Retiree drug subsidy amounts.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Retiree drug subsidy amounts. 423.886 Section 423... (CONTINUED) MEDICARE PROGRAM (CONTINUED) VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.886 Retiree drug subsidy amounts. (a) Amount of subsidy payment. (1...

  9. 33 CFR 385.35 - Achievement of the benefits of the Plan.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Ensuring Protection of the Natural System and Water Availability Consistent With the Goals and Purpose of the Plan § 385.35 Achievement of the benefits of the Plan. (a) Pre-CERP baseline water availability and quality. (1) Not later than June 14, 2004 the Corps of Engineers and the South Florida Water...

  10. 33 CFR 385.35 - Achievement of the benefits of the Plan.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Ensuring Protection of the Natural System and Water Availability Consistent With the Goals and Purpose of the Plan § 385.35 Achievement of the benefits of the Plan. (a) Pre-CERP baseline water availability and quality. (1) Not later than June 14, 2004 the Corps of Engineers and the South Florida Water...

  11. 33 CFR 385.35 - Achievement of the benefits of the Plan.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Ensuring Protection of the Natural System and Water Availability Consistent With the Goals and Purpose of the Plan § 385.35 Achievement of the benefits of the Plan. (a) Pre-CERP baseline water availability and quality. (1) Not later than June 14, 2004 the Corps of Engineers and the South Florida Water...

  12. 26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (b)(2)(ii)(A) merely because it eliminates employee contributions for all employees with plan year...) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies either of... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

  13. Medicare program; prohibition of midyear benefit enhancements for Medicare Advantage organizations. Final rule.

    PubMed

    2008-07-28

    This final rule prohibits Medicare Advantage (MA) organizations, including organizations offering MA plans to employer and union group health plan sponsors, from making midyear changes to nonprescription drug benefits, premiums, and cost-sharing submitted in their approved bids for a given contract year. This final rule also clarifies that MA organizations offering certain kinds of plans restricted to employer and union group health plan sponsors and not open to general enrollment may continue to offer benefit enhancements as they do currently, through means other than midyear benefit enhancements (MYBEs). Programs of all-inclusive care for elderly (PACE) are not subject to the provisions of this final rule and may continue to offer enhanced benefits as specified in our guidance for PACE plans.

  14. 78 FR 53704 - Employee Retirement Benefit Plan Returns Required on Magnetic Media

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... at (202) 622-7180 (not toll-free numbers). SUPPLEMENTARY INFORMATION: Background Electronic filing of... Actuarial Information,'' and the Schedule MB, ``Multiemployer Defined Benefit Plan and Certain Money... its successor). (ii) Multiemployer and certain money purchase plans. For multiemployer and certain...

  15. Medicinal benefits of marine invertebrates: sources for discovering natural drug candidates.

    PubMed

    De Zoysa, Mahanama

    2012-01-01

    Marine invertebrates are one of the major groups of organisms, which could be diversified under the major taxonomic groups of Porifera, Cnidaria, Mollusca, Arthropoda, Echinodermata, and many other minor phyla. To date, range of medicinal benefits and a significant number of marine natural products (MNPs) have been discovered from marine invertebrates. Seafood diet from edible marine invertebrates such as mollusks and crustaceans has been linked with various medicinal benefits to improve human health. Among marine invertebrates, spongers from phylum Porifera is the most dominant group responsible for discovering large number of MNPs, which have been used as template to develop therapeutic drugs. MNPs isolated from invertebrates have shown wide range of therapeutic properties including antimicrobial, antioxidant, antihypertensive, anticoagulant, anticancer, anti-inflammatory, wound healing and immune modulator, and other medicinal effects. Therefore, marine invertebrates are rich sources of chemical diversity and health benefits for developing drug candidates, cosmetics, nutritional supplements, and molecular probes that can be supported to increase the healthy life span of human. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. 42 CFR 423.886 - Retiree drug subsidy amounts.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Retiree drug subsidy amounts. 423.886 Section 423... (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Payments to Sponsors of Retiree Prescription Drug Plans § 423.886 Retiree drug subsidy amounts. (a) Amount of subsidy payment. (1) For each...

  17. The ESMO-Magnitude of Clinical Benefit Scale for novel oncology drugs: correspondence with three years of reimbursement decisions in Israel.

    PubMed

    Hammerman, Ariel; Greenberg-Dotan, Sari; Feldhamer, Ilan; Birnbaum, Yair; Cherny, Nathan I

    2018-02-01

    The European Society for Medical Oncology published in 2015 its Magnitude of Clinical Benefit Scale (ESMO-MCBS) for cancer medicines. Our objective was to evaluate the association between Israel's national reimbursement decisions regarding novel cancer drugs, prior to the availability of ESMO-MCBS, and the later published ESMO-MCBS scores. ESMO-MCBS scores were obtained retrospectively for the cancer drugs that were candidates for reimbursement in Israel in 2013-2015 and were categorized to 'highest benefit' (ESMO-MCBS 4-5 or A) 'medium benefit' (3 or B) and 'lowest benefit' (0-2 or C). The reimbursement decisions were accessed and compared with the categorized ESMO scores. ESMO-MCBS score was available for 19/22 drugs approved for reimbursement and 15/16 non-approved drugs. 58% of the approved drugs gained a 'highest benefit' score and 37% were 'medium benefit'. 87% of the non-approved drugs had 'lowest benefit' scores. Median score for approved drugs was 4 vs. 1 for the non-approved (p < 0.05). The Israeli decisions regarding reimbursement of novel cancer drugs, demonstrated concordance with ESMO-MCBS scores. Incorporation of ESMO-MCBS data in reimbursement deliberations could assist in framing the appropriate use of the limited resources to deliver effective and affordable cancer care.

  18. [The problem of post-marketing surveillance planning on drugs for infectious disease].

    PubMed

    Sato, J

    2001-12-01

    In principle, a new drug is approved via the assessments of safety and efficacy by the Ministry of Health, Labor and Welfare (MHLW). After approval, conduct of post-marketing surveillance is requested by law in order to assess the safety and efficacy of the drug in a large number of patients. Before initiating a surveillance, submission to MHLW of a document on the plan of survey is necessary in the purpose of inspection if it includes any ethical or regulatory problem or not. Through the inspections of the plans submitted during the period of April 1998 and March 2000, many problems have been pointed out. In this report, the author introduces some of the concrete problems noted in the plans on drugs for infectious diseases and shows some of the guidance made by the authority how to improve them. It is expected that such practical analyses of cases may be useful for future planning of post-marketing surveillance on drugs for infectious diseases.

  19. Effect of generic drug competition on the price of prescription drugs in Ontario.

    PubMed Central

    Lexchin, J

    1993-01-01

    OBJECTIVE: To analyse the potential effect of generic drug competition on prices in Ontario to assess the costs and benefits associated with Bill C-22 (An Act to amend the Patent Act). DESIGN: Comparison of the cost of the least and most expensive versions of all products sold by more than one manufacturer in 1991. The number of brand-name and generic drug companies marketing each of the products was recorded. RESULTS: Of 1599 products 437 (27.3%) were made by more than one company. Almost half (44.6%) of the 437 were sold by two companies. The more companies that sold a drug the greater the difference in price between the least and most expensive versions. Similarly, as the proportion of generic drug companies in competition increased, the greater the price difference. When competition was between generic drug companies only, the price spread was smaller than when it was between brand-name drug companies only. CONCLUSIONS: Generic drug competition can result in savings to the Ontario Drug Benefit Plan. A more in-depth analysis of the potential savings is necessary to fully assess the costs and benefits associated with Bill C-22. PMID:8439888

  20. A randomized controlled trial to assess the effect of a medication plan containing drug administration recommendations on patients' drug knowledge after 2 months.

    PubMed

    Send, A F J; Peters-Klimm, F; Bruckner, T; Haefeli, W E; Seidling, H M

    2017-02-01

    Patients' drug administration errors are often promoted by poor drug knowledge resulting from inadequate oral or written information. It has previously been shown that a medication plan enhanced with graphical and textual information on drug handling (enhanced medication plan) proved to immediately increase patients' drug knowledge. This study aimed to evaluate the effect of the enhanced medication plan on drug knowledge in outpatients after 2 months (intervention group) compared to patients with a simple medication plan with standard information (control group). We recruited patients using ≥5 drugs in four family practices in Germany. After inclusion, patients' knowledge on handling of their drugs was assessed using three questions from a standardized catalog. Thereafter, patients were randomized to the intervention or control group. After 2 months, drug knowledge was reassessed with three different questions from the same standardized catalog. Of 120 enrolled patients, 75% of participants in the control group (42/60 patients) and 78% of participants in the intervention group (46/60; P = 0·71) completed the study. Baseline drug knowledge was similar in both groups (43·7% vs. 40·6% correct answers). After 2 months, patients' drug knowledge showed an absolute increase of 23·2% in the intervention group (P < 0·01) and was unchanged in the control group (46·0%; P = 0·70). The enhanced medication plan outperformed the effect of a simple medication plan and persistently increased the fraction of correct answers of polypharmacy patients. This demonstrates that the enhanced medication plan may be a useful tool in promoting drug knowledge. © 2016 John Wiley & Sons Ltd.

  1. The definition and role of quality of life in Germany's early assessment of drug benefit: a qualitative approach.

    PubMed

    Lohrberg, David; Augustin, Matthias; Blome, Christine

    2016-02-01

    In 2011, Germany introduced a new form of drug benefit assessment, linking reimbursement prices to drug benefit and making quality of life (QoL) one of the main benefit criteria. Thus, QoL outcomes co-determine drug prices in Germany. QoL has, however, not been defined in the regulations. This study analyzed the definition and role of QoL in Germany's drug benefit assessment. It serves as a case study on the complexity of QoL as a parameter of health technology and drug assessments, which have become mandatory in almost all industrialized countries. In a qualitative analysis, the publicly available dossiers (summaries), dossier evaluations, protocols of the oral hearings, the final resolutions of the Federal Joint Committee (G-BA) and its rationale of all benefit assessments completed by 2013 (n = 66) were processed. Additionally, quantitative data on the decision outcomes were collected. Only two decisions drew on QoL outcomes as "main justifications" for additional benefit. It was due to a lack of valid and statistically significant QoL results, a deficient presentation of QoL data, or differing understandings of QoL, that QoL benefit was not demonstrated in more than two cases. While manufacturers applied wider definitions of QoL, the assessment institutions questioned evidence if it was not reported with the help of validated QoL questionnaires or deviated from their definition of QoL. The German experience with QoL as a drug benefit criterion highlights the importance of a clear QoL definition and according methodological regulations.

  2. Using a 401(h) account to fund retiree health benefits from your pension plan.

    PubMed

    Lee, David; Singerman, Eduardo

    2003-06-01

    If a health and welfare plan covering retirees faces financial shortfalls, administrators and trustees can fund retiree health benefit payments from a related pension plan that may be in better condition. This method is legal and ethical, but it requires sophisticated accounting techniques for creating an account that provides retiree members with promised benefits while meeting statutory and regulatory requirements.

  3. 29 CFR 2509.75-3 - Interpretive bulletin relating to investments by employee benefit plans in securities of...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Regulations Relating to Labor (Continued) EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF LABOR... Interpretive bulletin relating to investments by employee benefit plans in securities of registered investment.... That section provides that an investment by an employee benefit plan in securities issued by an...

  4. 77 FR 43601 - Risks and Benefits of Hydroxyethyl Starch Solutions; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-25

    ...] Risks and Benefits of Hydroxyethyl Starch Solutions; Public Workshop AGENCY: Food and Drug... public workshop entitled: ``Risks and Benefits of Hydroxyethyl Starch Solutions.'' The purpose of this... starch (HES) solutions. The public workshop has been planned in partnership with the Department of...

  5. 75 FR 41091 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: Pension Benefit Guaranty Corporation's regulation on Benefits...

  6. 75 FR 2437 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: Pension Benefit Guaranty Corporation's regulation on Benefits...

  7. 75 FR 6857 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-12

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: Pension Benefit Guaranty Corporation's regulation on Benefits...

  8. 75 FR 49407 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. SUMMARY: Pension Benefit Guaranty Corporation's regulation on Benefits...

  9. Provincial drug plan officials' views of the Canadian drug safety system.

    PubMed

    Lexchin, Joel; Wiktorowicz, Mary; Moscou, Kathy; Eggertson, Laura

    2013-06-01

    The Canadian constitution divides the responsibility for pharmaceuticals between the federal and provincial governments. While the provincial governments are responsible for establishing public formularies, the majority of the safety and efficacy information that the provinces use comes from the federal government. We interviewed drug plan officials from eight of the ten provinces and two of three territories regarding their views on the Canadian drug safety system. Here we report on the following categories: the federal drug approval system; the strengths and weaknesses of the federal system of postmarket pharmaceutical safety (i.e., pharmacosurveillance); resources available to support provincial formulary decision making; provincial roles in pharmacosurveillance; how the drug safety system could be improved; and the role of the Drug Safety and Effectiveness Network, a recently established virtual network designed to connect researchers throughout Canada who conduct postmarket drug research. Next, we place the Canadian system within an international context by comparing informational asymmetry between government institutions in the United States and the European Union and by looking at how institutions support each other's roles in sharing information and in jointly developing policy through the International Conference on Harmonization. Finally, we draw on international experiences and suggest potential solutions to the concerns that our key informants have identified.

  10. Awakening consumer stewardship of health benefits: prevalence and differentiation of new health plan models.

    PubMed

    Rosenthal, Meredith; Milstein, Arnold

    2004-08-01

    Despite widespread publicity of consumer-directed health plans, little is known about their prevalence and the extent to which their designs adequately reflect and support consumerism. We examined three types of consumer-directed health plans: health reimbursement accounts (HRAs), premium-tiered, and point-of-care tiered benefit plans. We sought to measure the extent to which these plans had diffused, as well as to provide a critical look at the ways in which these plans support consumerism. Consumerism in this context refers to efforts to enable informed consumer choice and consumers' involvement in managing their health. We also wished to determine whether mainstream health plans-health maintenance organization (HMO), point of service (POS), and preferred provider organization (PPO) models-were being influenced by consumerism. Our study uses national survey data collected by Mercer Human Resource Consulting from 680 national and regional commercial health benefit plans on HMO, PPO, POS, and consumer-directed products. We defined consumer-directed products as health benefit plans that provided (1) consumer incentives to select more economical health care options, including self-care and no care, and (2) information and support to inform such selections. We asked health plans that offered consumer-directed products about 2003 enrollment, basic design features, and the availability of decision support. We also asked mainstream health plans about their activities that supported consumerism (e.g., proactive outreach to inform or influence enrollee behavior, such as self-management or preventive care, reminders sent to patients with identified medical conditions.) We analyzed survey responses for all four product lines in order to identify those plans that offer health reimbursement accounts (HRAs), premium-tiered, or point-of-care tiered models as well as efforts of mainstream health plans to engage informed consumer decision making. The majority of enrollees in

  11. A practical approach to risk-benefit estimation in pediatric drug research.

    PubMed

    Koren, Gideon

    2015-02-01

    One of the most difficult challenges in pediatric drug research is in exposing children to risk, often without a balanced chance of benefits. While the concept of risk is similar in adult research, the adult patient can decide for himself/herself on an acceptable level of risk, whereas children have to accept the decisions of their guardians. This paper attempts to put the complexities of estimating risk in pediatric drug research into their practical perspective, and to familiarize the reader with the way such processes are conducted in different parts of the world. Although there are regional differences, all authorities typically quantify risks of pediatric research in general, and drug research in particular, in three levels: those experienced in day-to-day life; risks slightly above this 'baseline' risk; and risks substantially above 'baseline risk'. Proportionally, the diligence of the ethics process depends on these levels, as well as on the potential benefits (or lack of) to the child involved in the research. Importantly, risk is context dependent, and a particular intervention may be effective or safe in one setting but not in another, based on local experience, staffing levels, and similar variabilities.

  12. 48 CFR 52.215-18 - Reversion or Adjustment of Plans for Postretirement Benefits (PRB) Other Than Pensions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Plans for Postretirement Benefits (PRB) Other Than Pensions. 52.215-18 Section 52.215-18 Federal... Postretirement Benefits (PRB) Other Than Pensions. As prescribed in 15.408(j), insert the following clause: Reversion or Adjustment of Plans for Postretirement Benefits (PRB) Other Than Pensions (JUL 2005) (a) The...

  13. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  14. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS...

  15. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  16. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  17. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  18. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS...

  19. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS...

  20. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  1. "Telemarketing" hospital services: benefits, pitfalls and the planning process.

    PubMed

    Hafer, J C

    1984-01-01

    "Telemarketing" is an innovative concept used by many firms to increase the efficiency and effectiveness of product delivery efforts. It can be used by hospitals to benefit both patients and physicians. Further, it can be a tool that, if used properly, can improve the image of the hospital and assist in positioning the organization uniquely among its competitors. This paper discusses the exploratory nature, potential problems, and benefits of telemarketing hospital services and offers pre- and post-implementation considerations. This paper also provides an outline of a sample marketing plan that could serve as an initial model for hospitals that might consider this unique marketing approach.

  2. 75 FR 19542 - Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-15

    ... PENSION BENEFIT GUARANTY CORPORATION 29 CFR Part 4022 Benefits Payable in Terminated Single-Employer Plans; Interest Assumptions for Valuing and Paying Benefits AGENCY: Pension Benefit Guaranty Corporation. ACTION: Final rule. [[Page 19543

  3. Impact of the 1978 ADEA Amendments on Employee Benefit Plans.

    ERIC Educational Resources Information Center

    Mamorsky, Jeffrey D.

    1978-01-01

    The impact on employee benefit plans of the Age Discrimination in Employment Act amendments that raised the mandatory retirement age is addressed through a discussion and analysis of legislative history, court decisions, Department of Labor regulations, wage-hour rulings, and opinion letters. (Author/JMD)

  4. 26 CFR 1.401(a)(9)-6 - Required minimum distributions for defined benefit plans and annuity contracts.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Required minimum distributions for defined...-Sharing, Stock Bonus Plans, Etc. § 1.401(a)(9)-6 Required minimum distributions for defined benefit plans and annuity contracts. Q-1. How must distributions under a defined benefit plan be paid in order to...

  5. Rapid inverse planning for pressure-driven drug infusions in the brain.

    PubMed

    Rosenbluth, Kathryn H; Martin, Alastair J; Mittermeyer, Stephan; Eschermann, Jan; Dickinson, Peter J; Bankiewicz, Krystof S

    2013-01-01

    Infusing drugs directly into the brain is advantageous to oral or intravenous delivery for large molecules or drugs requiring high local concentrations with low off-target exposure. However, surgeons manually planning the cannula position for drug delivery in the brain face a challenging three-dimensional visualization task. This study presents an intuitive inverse-planning technique to identify the optimal placement that maximizes coverage of the target structure while minimizing the potential for leakage outside the target. The technique was retrospectively validated using intraoperative magnetic resonance imaging of infusions into the striatum of non-human primates and into a tumor in a canine model and applied prospectively to upcoming human clinical trials.

  6. The increased concentration of health plan markets can benefit consumers through lower hospital prices.

    PubMed

    Melnick, Glenn A; Shen, Yu-Chu; Wu, Vivian Yaling

    2011-09-01

    The long-term trend of consolidation among US health plans has raised providers' concerns that the concentration of health plan markets can depress their prices. Although our study confirmed that, it also revealed a more complex picture. First, we found that 64 percent of hospitals operate in markets where health plans are not very concentrated, and only 7 percent are in markets that are dominated by a few health plans. Second, we found that in most markets, hospital market concentration exceeds health plan concentration. Third, our study confirmed earlier studies showing that greater hospital market concentration leads to higher hospital prices. Fourth, we found that hospital prices in the most concentrated health plan markets are approximately 12 percent lower than in more competitive health plan markets. Overall, our results show that more concentrated health plan markets can counteract the price-increasing effects of concentrated hospital markets, and that-contrary to conventional wisdom-increased health plan concentration benefits consumers through lower hospital prices as long as health plan markets remain competitive. Our findings also suggest that consumers would benefit from policies that maintained competition in hospital markets or that would restore competition to hospital markets that are uncompetitive.

  7. The effectiveness of alternative planned durations of residential drug abuse treatment.

    PubMed Central

    McCusker, J; Vickers-Lahti, M; Stoddard, A; Hindin, R; Bigelow, C; Zorn, M; Garfield, F; Frost, R; Love, C; Lewis, B

    1995-01-01

    Randomized controlled trials were conducted at two residential drug abuse treatment facilities to compare programs that differed in planned duration. One trial compared a 6-month and a 12-month therapeutic community program (n = 184), and the second compared a 3-month and a 6-month relapse prevention program (n = 444). Retention rates over comparable time periods differed minimally by planned treatment duration, and the longer programs had lower completion rates. There was no effect in either trial of planned treatment duration on changes in psychosocial variables between admission and exit or on rates or patterns of drug use at follow-up between 2 and 6 months after exit. PMID:7573630

  8. Awakening Consumer Stewardship of Health Benefits: Prevalence and Differentiation of New Health Plan Models

    PubMed Central

    Rosenthal, Meredith; Milstein, Arnold

    2004-01-01

    Context Despite widespread publicity of consumer-directed health plans, little is known about their prevalence and the extent to which their designs adequately reflect and support consumerism. Objective We examined three types of consumer-directed health plans: health reimbursement accounts (HRAs), premium-tiered, and point-of-care tiered benefit plans. We sought to measure the extent to which these plans had diffused, as well as to provide a critical look at the ways in which these plans support consumerism. Consumerism in this context refers to efforts to enable informed consumer choice and consumers' involvement in managing their health. We also wished to determine whether mainstream health plans—health maintenance organization (HMO), point of service (POS), and preferred provider organization (PPO) models—were being influenced by consumerism. Data Sources/Study Setting Our study uses national survey data collected by Mercer Human Resource Consulting from 680 national and regional commercial health benefit plans on HMO, PPO, POS, and consumer-directed products. Study Design We defined consumer-directed products as health benefit plans that provided (1) consumer incentives to select more economical health care options, including self-care and no care, and (2) information and support to inform such selections. We asked health plans that offered consumer-directed products about 2003 enrollment, basic design features, and the availability of decision support. We also asked mainstream health plans about their activities that supported consumerism (e.g., proactive outreach to inform or influence enrollee behavior, such as self-management or preventive care, reminders sent to patients with identified medical conditions.) Data Collection/Extraction Methods We analyzed survey responses for all four product lines in order to identify those plans that offer health reimbursement accounts (HRAs), premium-tiered, or point-of-care tiered models as well as efforts of

  9. 29 CFR 2520.101-4 - Annual funding notice for multiemployer defined benefit pension plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... pension plans. 2520.101-4 Section 2520.101-4 Labor Regulations Relating to Labor (Continued) EMPLOYEE... pension plans. (a) In general. (1) Except as provided in paragraph (a)(2) of this section, pursuant to section 101(f) of the Act, the administrator of a defined benefit, multiemployer pension plan shall...

  10. Minnesota urban partnership agreement national evaluation : cost benefit analysis test plan.

    DOT National Transportation Integrated Search

    2009-11-17

    This report presents the cost benefit analysis test plan for the Minnesota Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Program. The Minnesota UPA projects focus on reducing congestion by emplo...

  11. Approaches to pharmacy benefit management and the impact of consumer cost sharing.

    PubMed

    Olson, Bridget M

    2003-01-01

    Numerous mechanisms have been introduced to deliver prescription drug benefits while controlling pharmaceutical costs. An understanding of the most prominent mechanisms of benefit management is an important step in determining the most effective approach to take in future years. The aims of this review were to illustrate the mechanisms by which managed care has attempted to efficiently and equitably deliver pharmacy benefits and to discuss the impact of such programs, including consumer cost sharing. A review of the literature was conducted using the PreMedline and MEDLINE databases from the years 1966 to 2002, reference lists from relevant articles, and online sources, including news releases, conference materials, and pharmacy benefit management reports. Numerous pharmacy benefit management tools and their impact on utilization, expenditures, and health outcomes are reviewed, including disease state management; utilization management (ie, quantity limitations and prior authorization); drug utilization review; formulary management (ie, open and closed); delivery systems (ie, retail and mail order); and mechanisms for implementing consumer cost sharing (ie, generic incentives, multitiered copayments, and co-insurance). Although there is some evidence to suggest that certain benefit management tools have been successful in reducing health plan expenditures, a more thorough investigation of their potential unintended consequences is needed. Implementing adequate levels of consumer cost sharing is necessary if employers and health plans are to continue offering prescription drug benefits. It is important to remember, however, that quality health care cannot be forfeited for the sake of short-term cost savings.

  12. [Assessing the added benefit of new ophthalmic drugs : Which additional insights can be extracted from the early benefit assessment?

    PubMed

    Appelrath, M; Glaeske, G

    2017-12-01

    Until now six ophthalmic agents have undergone the German early benefit assessment according to § 35a Social Security Code (SGB) V in a total of eleven indications. Only one agent (ocriplasmin) was recognized by the Federal Joint Committee as having an added benefit based on submitted study data for a subpopulation (indication of a considerable added benefit, limited for 5 years) and another agent, idebenone, received an added benefit due to its orphan drug designation (proof of a not quantifiable added benefit, limited for 2 years). All remaining agents (aflibercept, bromfenac, nepafenac and tafluprost/timolol) were not recognized as having an added benefit. The analysis showed that there was a lack of suitable evidence. Some reasons for the inappropriateness of the conducted trials for the usage in the early benefit assessment are the comparative therapy, the patient population included or the dosage regimens. For two agents (bromfenac and nepafenac) the pharmaceutical company did not even submit a value dossier. The examples from ophthalmology illustrate the methodological and procedural shortcomings of the assessment process and that results of an early benefit assessment should be interpreted with caution.

  13. Benefits of cetalkonium chloride cationic oil-in-water nanoemulsions for topical ophthalmic drug delivery.

    PubMed

    Daull, Philippe; Lallemand, Frédéric; Garrigue, Jean-Sébastien

    2014-04-01

    Topical ocular administration is the most convenient route of administration of drugs for the treatment of eye diseases. However, the bioavailability of drugs following eye instillations of eye drops is very low. Over the past 20 years, extensive efforts have been put into research to improve drug bioavailability without compromising treatment compliance and patients' quality of life. One of the most efficient ways to improve drug bioavailability is to increase the precorneal residence time of the eye drop formulations. As a result, new eye drops, with bioadhesive properties, have been developed based on the cationic oil-in-water (o/w) nanoemulsion technology. These low viscosity eye drop nanoemulsions have improved precorneal residence time through the electrostatic interactions between the positively charged oil nanodroplets and the negatively charged ocular surface epithelium. This review is the first to present the benefits of this new strategy used to improve ocular drug bioavailability. The roles of the cationic agent in the stabilization of a safe cationic o/w nanoemulsion have been discussed, as well as the unexpected benefits of the cationic o/w nanoemulsion for the protection and restoration of a healthy tear film and corneal epithelium.

  14. 42 CFR 417.164 - Effect of revocation of qualification on inclusion in employee's health benefit plans.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Effect of revocation of qualification on inclusion... inclusion in employee's health benefit plans. When an HMO's qualification is revoked under § 417.163(d), the following rules apply: (a) The HMO may not seek inclusion in employees health benefits plans under subpart E...

  15. 42 CFR 417.164 - Effect of revocation of qualification on inclusion in employee's health benefit plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Effect of revocation of qualification on inclusion... inclusion in employee's health benefit plans. When an HMO's qualification is revoked under § 417.163(d), the following rules apply: (a) The HMO may not seek inclusion in employees health benefits plans under subpart E...

  16. 42 CFR 417.164 - Effect of revocation of qualification on inclusion in employee's health benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Effect of revocation of qualification on inclusion... inclusion in employee's health benefit plans. When an HMO's qualification is revoked under § 417.163(d), the following rules apply: (a) The HMO may not seek inclusion in employees health benefits plans under subpart E...

  17. Benefits from remote sensing data utilization in urban planning processes and system recommendations

    NASA Technical Reports Server (NTRS)

    Mallon, H. J.; Howard, J. Y.

    1972-01-01

    The benefits of utilizing remote sensor data in the urban planning process of the Metropolitan Washington Council of Governments are investigated. An evaluation of sensor requirements, a description/ comparison of costs, benefits, levels of accuracy, ease of attainment, and frequency of update possible using sensor versus traditional data acquisition techniques are discussed.

  18. 78 FR 50112 - 168th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 168th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Teleconference Meeting Pursuant to the.... 1142, the 168th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans...

  19. 76 FR 55706 - 158th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-08

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 158th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Teleconference Meeting Pursuant to the.... 1142, the 158th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans...

  20. 77 FR 52061 - 163rd Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 163rd Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Teleconference Meeting Pursuant to the.... 1142, the 163rd open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans...

  1. 76 FR 6498 - 155th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-04

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 155th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Teleconference Meeting Pursuant to the.... 1142, the 155th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans...

  2. Ontario's plunging price-caps on generics: deeper dives may drown some drugs.

    PubMed

    Anis, Aslam; Harvard, Stephanie; Marra, Carlo

    2011-01-01

    In April 2010, the Ontario government announced another reduction in the maximum price of generic drugs permitted under the Ontario Drug Benefit (ODB) program, demanding that generic drugs now be sold for no more than 25% of the branded product's price. Other provinces are following Ontario in setting unprecedentedly low price-caps to reduce the cost of generic drugs. Generic product substitution legislation is vital to reducing costs to provincial drug plans, yet lower and lower price-caps may undo some of the benefits of substitution legislation if generics find it difficult to survive.

  3. 77 FR 59420 - 164th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-27

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 164th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority... 164th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as...

  4. 76 FR 65211 - 159th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 159th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority... 159th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as...

  5. 77 FR 11159 - 160th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 160th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority... 160th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as...

  6. 78 FR 62708 - 169th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 169th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority... 169th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as...

  7. 75 FR 27002 - 151st Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-13

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 151st Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority... 151st open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans will be held on...

  8. 77 FR 66186 - 164th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-02

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 164th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority... 164th open meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans (also known as...

  9. Medicare prescription drug coverage: Consumer information and preferences

    PubMed Central

    Winter, Joachim; Balza, Rowilma; Caro, Frank; Heiss, Florian; Jun, Byung-hill; Matzkin, Rosa; McFadden, Daniel

    2006-01-01

    We investigate prescription drug use, and information and enrollment intentions for the new Medicare Part D drug insurance program, using a sample of Medicare-eligible subjects surveyed before open enrollment began for this program. We find that, despite the complexity of competing plans offered by private insurers under Part D, a majority of the Medicare population had information on this program and a substantial majority planned to enroll. We find that virtually all elderly, even those with no current prescription drug use, can expect to benefit from enrollment in a Part D Standard plan at the low premiums available in the current market. However, there is a significant risk that many eligible seniors, particularly low-income elderly with poor health or cognitive impairment, will make poor enrollment and plan choices. PMID:16682629

  10. 75 FR 64947 - 154th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-20

    ... Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting; Notice #0;#0;Federal Register... Employee Benefits Security Administration 154th Meeting of the Advisory Council on Employee Welfare and... Advisory Council on Employee Welfare and Pension Benefit Plans will be held on November 3-4, 2010. The...

  11. Audit of Sandia Corporation`s pension plans and other prefunded benefits

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1994-04-06

    The audit disclosed that Sandia`s pension plans had $588.9 million in excess assets as of December 31, 1990, on a current value basis. If plan terminations and spin-offs occurred, at least $408.8 million of this amount could be returned to the Government without affecting the pension benefits that Sandia employees and retirees have earned. We recommended that Albuquerque take the necessary action to reduce the excess assets in the pension plans and recover the Government`s share. However, Albuquerque disagreed with the recommendation. Albuquerque justified leaving the excess assets in the pension plans to fund future plan amendments; to avoid futuremore » funding contributions; to avoid the costs and time-consuming administrative steps associated with taking action; and to prevent damaging effects on employee morale. We analyzed these points, and concluded that they should not prevent the Department from initiating action to return excess assets to the Government. Actuarial analysis of the pension plans showed that, even if certain plan adjustments were made, the plans were overfunded by $256 million as of December 31, 1991 (on an actuarial value basis).« less

  12. Methodological approach to determine minor, considerable, and major treatment effects in the early benefit assessment of new drugs

    PubMed Central

    Wieseler, Beate; Kaiser, Thomas; Thomas, Stefanie; Bender, Ralf; Windeler, Jürgen; Lange, Stefan

    2016-01-01

    At the beginning of 2011, the early benefit assessment of new drugs was introduced in Germany with the Act on the Reform of the Market for Medicinal Products (AMNOG). The Federal Joint Committee (G‐BA) generally commissions the Institute for Quality and Efficiency in Health Care (IQWiG) with this type of assessment, which examines whether a new drug shows an added benefit (a positive patient‐relevant treatment effect) over the current standard therapy. IQWiG is required to assess the extent of added benefit on the basis of a dossier submitted by the pharmaceutical company responsible. In this context, IQWiG was faced with the task of developing a transparent and plausible approach for operationalizing how to determine the extent of added benefit. In the case of an added benefit, the law specifies three main extent categories (minor, considerable, major). To restrict value judgements to a minimum in the first stage of the assessment process, an explicit and abstract operationalization was needed. The present paper is limited to the situation of binary data (analysis of 2 × 2 tables), using the relative risk as an effect measure. For the treatment effect to be classified as a minor, considerable, or major added benefit, the methodological approach stipulates that the (two‐sided) 95% confidence interval of the effect must exceed a specified distance to the zero effect. In summary, we assume that our approach provides a robust, transparent, and thus predictable foundation to determine minor, considerable, and major treatment effects on binary outcomes in the early benefit assessment of new drugs in Germany. After a decision on the added benefit of a new drug by G‐BA, the classification of added benefit is used to inform pricing negotiations between the umbrella organization of statutory health insurance and the pharmaceutical companies. PMID:26134089

  13. Federal employees health benefits program: discontinuance of health plan in an emergency. Final regulation.

    PubMed

    2007-01-17

    The Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Employees Health Benefits (FEHB) regulations regarding discontinuance of a health plan to include situations in which a health plan becomes incapacitated, either temporarily or permanently, as the result of a disaster.

  14. Pricing of multiple dosage prescription medications: an analysis of the Ontario Drug Benefit Formulary.

    PubMed

    Lexchin, Joel

    2009-07-01

    This paper investigates the pricing strategy (perfect flat pricing, perfect monotonic pricing, intermediate) used for multiple dosage medications listed in the Ontario Drug Benefit Formulary. All multiple dosage solid medications containing a single active ingredient newly listed in the Ontario Drug Benefit Formulary between 1996 and 2005 were identified. The relationship between price and dosage was calculated using a previously developed method. Seventy-three multiple dosage medications were introduced. Where medications were equivalent to existing ones in most cases companies followed the pricing strategy used by therapeutically equivalent drugs already in the formulary. Where there were no equivalent products companies did not adopt any particular pricing strategy. There was no difference in the way that companies priced scored tablets versus unscored tablets and capsules or in the way that they priced drugs that had objective measurements of efficacy/effectiveness, for example blood pressure, versus those that did not have these measurements. When Monotonic pricing is used it leads to higher expenditures whereas flat pricing results in lower expenditures and offers more predictability in expenditures. Provincial governments should consider requiring flat pricing in return for formulary listing.

  15. Use and reimbursement costs of smoking cessation medication under the Quebec public drug insurance plan.

    PubMed

    Tremblay, Michèle; Payette, Yves; Montreuil, Annie

    2009-01-01

    Since October 2000, the nicotine patch, nicotine gum and bupropion have been reimbursed under Quebec's public drug insurance plan. The objective of this study is to describe use of these medications between October 2000 and December 2004 by smokers covered by the public plan, as well as the costs of reimbursing these medications. Data from the Régie de l'assurance maladie du Québec were used to analyze prescriptions for smoking cessation medication issued to persons insured under the public drug insurance plan. Between October 1, 2000, and December 31, 2004, more than 300,000 Quebeckers covered by the public drug insurance plan were reimbursed for smoking cessation medications. This corresponds to a yearly average of 14% of all smokers insured under the public plan. The proportion of employment assistance recipients who used these medications was higher than the proportion of seniors or "other" insurance plan participants. Nicotine patches were the treatment of choice for most users. A total of $55 million was reimbursed by the public drug insurance plan for the nicotine patch, nicotine gum and bupropion over this four-year period. The reimbursement provisions put in place in Quebec in 2000 were successful in reaching financially disadvantaged smokers, at a cost that was comparable with other effective smoking cessation services.

  16. Reducing patient drug acquisition costs can lower diabetes health claims.

    PubMed

    Mahoney, John J

    2005-08-01

    Concerned about rising prevalence and costs of diabetes among its employees, Pitney Bowes Inc recently revamped its drug benefit design to synergize with ongoing efforts in its disease management and patient education programs. Specifically, based on a predictive model showing that low medication adherence was linked to subsequent increases in healthcare costs in patients with diabetes, the company shifted all diabetes drugs and devices from tier 2 or 3 formulary status to tier 1. The rationale was that reducing patient out-of-pocket costs would eliminate financial barriers to preventive care, and thereby increase adherence, reduce costly complications, and slow the overall rate of rising healthcare costs. This single change in pharmaceutical benefit design immediately made critical brand-name drugs available to most Pitney Bowes employees and their covered dependents for 10% coinsurance, the same coinsurance level as for generic drugs, versus the previous cost share of 25% to 50%. After 2 to 3 years, preliminary results in plan participants with diabetes indicate that medication possession rates have increased significantly, use of fixed-combination drugs has increased (possibly related to easier adherence), average total pharmacy costs have decreased by 7%, and emergency department visits have decreased by 26%. Hospital admission rates, although increasing slightly, remain below the demographically adjusted Medstat benchmark. Overall direct healthcare costs per plan participant with diabetes decreased by 6%. In addition, the rate of increase in overall per-plan-participant health costs at Pitney Bowes has slowed markedly, with net per-plan-participant costs in 2003 at about 4000 dollars per year versus 6500 dollars for the industry benchmark. This recent moderation in overall corporate health costs may be related to these strategic changes in drug benefit design for diabetes, asthma, and hypertension and also to ongoing enhancements in the company's disease

  17. Private expenditures on brand name prescription drugs after generic entry.

    PubMed

    Balaban, Dahlia Y; Dhalla, Irfan A; Law, Michael R; Bell, Chaim M

    2013-10-01

    Generic drugs offer a less expensive and therapeutically equivalent alternative to brand name drugs. Nevertheless, many Canadian private drug plans continue to pay for brand name drugs even after generics become available. The objective of this study was to quantify the excess spending resulting from this practice. We used the IMS Brogan PharmaStat database to study private-plan drug spending in Ontario from 2000 to 2009. We focused on three widely used drug classes: proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), and angiotensin-converting enzyme (ACE) inhibitors. For each specific molecule, we determined the difference between what private plans spent on the brand name version and what would have been spent if an available generic version of the same molecule had been purchased instead. We found that prescriptions paid for by private drug plans were often filled with brand name drugs after generics became available. This led to excess private spending of more than Can$107.8 million for these three drug classes over our study period: Can$54.4 million for PPIs, Can$32.4 million for SSRIs and Can$21.0 million for ACE inhibitors. Brand name drugs continue to be reimbursed by Canadian private drug plans at higher prices even after less expensive generic alternatives are available. By mandating generic substitution, substantial cost savings on benefit plans could be achieved.

  18. 20 CFR 404.470 - Nonpayment of disability benefits due to noncompliance with rules regarding treatment for drug...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Nonpayment of disability benefits due to noncompliance with rules regarding treatment for drug addiction or alcoholism. 404.470 Section 404.470 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Deductions; Reductions; and Nonpayment...

  19. Converting unused vacation days to retiree medical benefits: a proposed partial solution to an emerging national crisis.

    PubMed

    Saxon, Donald R

    2003-06-01

    Costs for retiree medical benefits are spiraling upward. One way to help fund this area of compensation, with little or no additional financial burden to either employers or employees, could be using an employee benefit plan whereby each year's unused vacation days and sick days are transferred into an employee's tax-free account in a voluntary employee benefit association (VEBA) trust. On retirement, the account is used to purchase a (pre-Medicare) retiree medical plan, prescription drug benefit, a Medicare supplemental policy and/or simply make Medicare premium payments.

  20. Mid-Term Assessment of the EU Drugs Strategy 2013-2020 and Final Evaluation of the Action Plan on Drugs 2013-2016: Final report.

    PubMed

    Emilie, Balbirnie; Matthew, Davies; Emma, Disley; Cristina Gonzalez, Monsalve; Stephen, Hartka; Stijn, Hoorens; Kristy, Kruithof; Martin, Sacher; Jirka, Taylor

    2018-01-01

    The aim of the EU Drugs Strategy 2013-2020 is to contribute to a reduction in drug demand and drug supply within the EU. The Strategy has so far been implemented by an Action Plan covering the period 2013-2016. This article sets out the findings of an evaluation that assesses the degree of implementation of the Strategy and the Action Plan in terms of outputs and, where possible, impacts. It looks at the extent to which the objectives of the Strategy have been achieved. The evaluation aims to provide evidence to support the European Commission's decision about whether to propose a new Action Plan for the period 2017-2020 and, if so, what changes would be needed compared to the current plan. Through applying a mixed-methods approach, the evaluation examined the effectiveness, efficiency, relevance and coherence of the actions undertaken on the basis of the EU Drugs Strategy and the Action Plan, as well as their EU added value. The evaluation makes 20 recommendations, addressed to the European Commission, Member States, the European Council and other stakeholders. The key recommendation for the Commission is that a new Action Plan should be implemented for the period 2017-2020. This should be an updated version of the current Action Plan, rather than taking a new approach or introducing more new actions.

  1. Balancing the benefits and costs of antibiotic drugs: the TREAT model.

    PubMed

    Leibovici, L; Paul, M; Andreassen, S

    2010-12-01

    TREAT is a computerized decision support system aimed at improving empirical antibiotic treatment of inpatients with suspected bacterial infections. It contains a model that balances, for each antibiotic choice (including 'no antibiotics'), expected benefit and expected costs. The main benefit afforded by appropriate, empirical, early antibiotic treatment in moderate to severe infections is a better chance of survival. Each antibiotic drug was consigned three cost components: cost of the drug and administration; cost of side effects; and costs of future resistance. 'No treatment' incurs no costs. The model worked well for decision support. Its analysis showed, yet again, that for moderate to severe infections, a model that does not include costs of resistance to future patients will always return maximum antibiotic treatment. Two major moral decisions are hidden in the model: how to take into account the limited life-expectancy and limited quality of life of old or very sick patients; and how to assign a value for a life-year of a future, unnamed patient vs. the present, individual patient. © 2010 The Authors. Clinical Microbiology and Infection © 2010 European Society of Clinical Microbiology and Infectious Diseases.

  2. San Francisco urban partnership agreement, national evaluation : cost benefit analysis test plan.

    DOT National Transportation Integrated Search

    2011-06-01

    This report presents the test plan for collecting and analyzing cost and benefit data for the San Francisco Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Program. The San Francisco UPA projects ...

  3. Alternative strategies for Medicare payment of outpatient prescription drugs--Part B and beyond.

    PubMed

    Danzon, Patricia M; Wilensky, Gail R; Means, Kathleen E

    2005-03-01

    Reimbursement options for pharmaceuticals reimbursed under Medicare Part B (physician-dispensed drugs) are changing and the new comprehensive Part D Medicare outpatient drug benefit brings further changes. The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) replaces traditional policy, of reimbursing Part B drugs at 95% of average wholesale price (AWP, a list price), with a percentage markup over the manufacturer's average selling price; in 2005 an indirect competitive procurement option will be introduced. In our view, although AWP-based reimbursement has been fraught with problems in the past, these could be fixed by constraining growth in AWP and periodically adjusting the discount off AWP. With these revisions, an AWP-based rule would preserve incentives for competitive discounting and deliver savings to Medicare. By contrast, basing Medicare reimbursement on a manufacturer's average selling price undermines incentives for discounting and, like any cost-based reimbursement rule, may result in higher prices to both public and private purchasers. Indirect competitive procurement for drugs alone, using specialty pharmacies, pharmacy benefit managers, or prescription drug plans, is unlikely to constrain costs to acceptable levels unless contractors retain flexibility to use standard benefit management tools. Folding Part B and Part D into comprehensive contracting with health plans for full health services is likely to offer the most efficient approach to managing the drug benefit.

  4. Effects of a consumer driven health plan on pharmaceutical spending and utilization.

    PubMed

    Parente, Stephen T; Feldman, Roger; Chen, Song

    2008-10-01

    To compare pharmaceutical spending and utilization in a consumer driven health plan (CDHP) with a three-tier pharmacy benefit design, and to examine whether the CDHP creates incentives to reduce pharmaceutical spending and utilization for chronically ill patients, generic or brand name drugs, and mail-order drugs. Retrospective insurance claims analysis from a large employer that introduced a CDHP in 2001 in addition to a point of service (POS) plan and a preferred provider organization (PPO), both of which used a three-tier pharmacy benefit. Difference-in-differences regression models were estimated for drug spending and utilization. Control variables included the employee's income, age, and gender, number of covered lives per contract, election of flexible spending account, health status, concurrent health shock, cohort, and time trend. Results. CDHP pharmaceutical expenditures were lower than those in the POS cohort in 1 year without differences in the use of brand name drugs. We find limited evidence of less drug consumption by CDHP enrollees with chronic illnesses, and some evidence of less generic drug use and more mail-order drug use among CDHP members. The CDHP is cost-neutral or cost-saving to both the employer and the employee compared with three-tier benefits with no differences in brand name drug use. © Health Research and Educational Trust.

  5. Low hanging fruit in infectious disease drug development.

    PubMed

    Kraus, Carl N

    2008-10-01

    Cost estimates for developing new molecular entities (NME) are reaching non-sustainable levels and coupled with increasing regulatory requirements and oversight have led many pharmaceutical sponsors to divest their anti-microbial development portfolios [Projan SJ: Why is big Pharma getting out of anti-bacterial drug discovery?Curr Opin Microbiol 2003, 6:427-430] [Spellberg B, Powers JH, Brass EP, Miller LG, Edwards JE, Jr: Trends in antimicrobial drug development: implications for the future.Clin Infect Dis 2004, 38:1279-1286]. Operational issues such as study planning and execution are significant contributors to the overall cost of drug development that can benefit from the leveraging of pre-randomization data in an evidence-based approach to protocol development, site selection and patient recruitment. For non-NME products there is even greater benefit from available data resources since these data may permit smaller and shorter study programs. There are now many available open source intelligence (OSINT) resources that are being integrated into drug development programs, permitting an evidence-based or 'operational epidemiology' approach to study planning and execution.

  6. Value-Based Insurance Design Benefit Offsets Reductions In Medication Adherence Associated With Switch To Deductible Plan.

    PubMed

    Reed, Mary E; Warton, E Margaret; Kim, Eileen; Solomon, Matthew D; Karter, Andrew J

    2017-03-01

    Enrollment in high-deductible health plans is increasing out-of-pocket spending. But innovative plans that pair deductibles with value-based insurance designs can help preserve low-cost access to high-value treatments for patients by aligning coverage with clinical value. Among adults in high-deductible health plans who were prescribed medications for chronic conditions, we examined what impact a value-based pharmacy benefit that offered free chronic disease medications had on medication adherence. Overall, we found that the value-based plan offset reductions in medication adherence associated with switching to a deductible plan. The value-based plan appeared particularly beneficial for patients who started with low levels of medication adherence. Patients with additional clinical complexity or vulnerable populations living in neighborhoods with lower socioeconomic status, however, did not show adherence improvements and might not be taking advantage of value-based insurance design provisions. Additional efforts may be needed to educate patients about their nuanced benefit plans to help overcome initial confusion about these complex plans. Project HOPE—The People-to-People Health Foundation, Inc.

  7. 42 CFR 422.106 - Coordination of benefits with employer or union group health plans and Medicaid.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... benefits under these circumstances is as follows: (1) All requirements of this part that apply to the MA..., labor organization, benefit fund trustee, or Medicaid plan benefits include the following: (1) Payment... contract with the State Medicaid agency. (c) Waiver or modification of contracts with MA organizations. (1...

  8. 26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... to satisfy this paragraph (b)(2)(ii)(A) merely because it eliminates employee contributions for all... requirements—(1) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

  9. 26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... to satisfy this paragraph (b)(2)(ii)(A) merely because it eliminates employee contributions for all... requirements—(1) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

  10. 26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... to satisfy this paragraph (b)(2)(ii)(A) merely because it eliminates employee contributions for all... requirements—(1) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

  11. 26 CFR 1.401(a)(4)-6 - Contributory defined benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... to satisfy this paragraph (b)(2)(ii)(A) merely because it eliminates employee contributions for all... requirements—(1) In general. A contributory DB plan satisfies this paragraph (b)(2)(ii)(B) if it satisfies... employee's base benefit percentage as required under paragraph (b)(2)(iii)(B)(1) of this section, it may be...

  12. Final rules relating to use of electronic communication and recordkeeping technologies by employee pension and welfare benefit plans. Notice of final rulemaking.

    PubMed

    2002-04-09

    This document contains final rules under Title I of the Employee Retirement Income Security Act of 1974, as amended (ERISA), concerning the disclosure of certain employee benefit plan information through electronic media, and the maintenance and retention of employee benefit plan records in electronic form. The rules establish a safe harbor pursuant to which all pension and welfare benefit plans covered by Title I of ERISA may use electronic media to satisfy disclosure obligations under Title I of ERISA. The rules also provide standards concerning the use of electronic media in the maintenance and retention of records required by sections 107 and 209 of ERISA. The rules affect employee pension and welfare benefit plans, including group health plans, plan sponsors, administrators and fiduciaries, and plan participants and beneficiaries.

  13. Evaluation of Risk Versus Benefit Information in Direct-To-Consumer (DTC) Prescription Drug Television Advertisements.

    PubMed

    Fahim, Germin; Toscani, Michael; Barone, Joseph A; Wang, Chris; Gandhi, Shivani

    2018-01-01

    The FDA's Presenting Risk Information draft guidance from May 2009 states that the time of risk versus benefit is a factor taken into consideration when evaluating audio and video direct-to-consumer (DTC) broadcasts. The objective of the study is to evaluate the proportion of risk narration on television (TV) advertisements in comparison to the actual proportion of serious adverse effects findings across select therapeutic areas. The study reviews prescription drug TV advertisements between the years 2010 and 2015 separated by therapeutic class. Indicators to assess risk versus benefit are as follows: total benefit time, total risk time, total ad time, percentage proportion of risk, and number of serious adverse effects (SAEs) listed in the package insert. The objective is establishing proportion of risk-to-benefit narration across therapeutic areas and the proportion of risk narration compared to the number of SAEs in the package insert. These outcomes will reflect whether TV advertisements abide by the "fair balance" rule and if the time spent on risk narrations is proportional to the number of SAEs across therapeutic areas. An analysis of risk versus benefit showed that there was a vast range of percentage differences in risk versus benefit narration across the products selected. The majority of the products narrated showed a 40% to 60% risk-to-benefit ratio. Six out of the 10 products evaluated communicated applicable black box warnings. There was variability among the SAE percentages presented between products. Lack of consistency exists between risks versus benefit proportions among different drug products.

  14. Oncogenic targets, magnitude of benefit, and market pricing of antineoplastic drugs.

    PubMed

    Amir, Eitan; Seruga, Bostjan; Martinez-Lopez, Joaquin; Kwong, Ryan; Pandiella, Atanasio; Tannock, Ian F; Ocaña, Alberto

    2011-06-20

    The relationship between market pricing of new anticancer drugs and the magnitude of clinical benefit caused by them has not been reported. Randomized clinical trials (RCTs) that evaluated approved new agents for solid tumors by the U.S. Food and Drug administration since the year 2000 were assessed. Hazard ratios (HRs) and 95% CIs were extracted for time-to-event end points described for each RCT. HRs were pooled for three groups: agents directed against a specific molecular target, for which the target population is selected by a biomarker (group A); less specific biologic targeted agents (group B); and chemotherapeutic agents (group C). Monthly market prices of these different drugs were compared. For overall survival (OS), the pooled HR was 0.69 (95% CI, 0.59 to 0.81) for group A (six drugs, six trials); it was 0.78 (95% CI, 0.74 to 0.83) for group B (seven drugs, 14 trials); and it was 0.84 (95% CI, 0.79 to 0.90) for group C (eight drugs, 12 trials). For progression-free survival (PFS), the pooled HR was 0.42 (95% CI, 0.36 to 0.49) for group A (six drugs, seven trials); it was 0.57 (95% CI, 0.51 to 0.64) for group B (seven drugs, 14 trials); and it was 0.75 (95% CI, 0.66 to 0.85) for group C (six drugs, 10 trials). Tests for heterogeneity between subgroups were highly significant for PFS (P < .001) and OS (P = .02). The median monthly prices for standard doses of drugs were $5375 for group A, $5644 for group B, and $6584 for group C (P = .87). New agents with specific molecular targets are clinically the most beneficial, but their monthly market prices are not significantly different from those of other anticancer agents.

  15. Methodological approach to determine minor, considerable, and major treatment effects in the early benefit assessment of new drugs.

    PubMed

    Skipka, Guido; Wieseler, Beate; Kaiser, Thomas; Thomas, Stefanie; Bender, Ralf; Windeler, Jürgen; Lange, Stefan

    2016-01-01

    At the beginning of 2011, the early benefit assessment of new drugs was introduced in Germany with the Act on the Reform of the Market for Medicinal Products (AMNOG). The Federal Joint Committee (G-BA) generally commissions the Institute for Quality and Efficiency in Health Care (IQWiG) with this type of assessment, which examines whether a new drug shows an added benefit (a positive patient-relevant treatment effect) over the current standard therapy. IQWiG is required to assess the extent of added benefit on the basis of a dossier submitted by the pharmaceutical company responsible. In this context, IQWiG was faced with the task of developing a transparent and plausible approach for operationalizing how to determine the extent of added benefit. In the case of an added benefit, the law specifies three main extent categories (minor, considerable, major). To restrict value judgements to a minimum in the first stage of the assessment process, an explicit and abstract operationalization was needed. The present paper is limited to the situation of binary data (analysis of 2 × 2 tables), using the relative risk as an effect measure. For the treatment effect to be classified as a minor, considerable, or major added benefit, the methodological approach stipulates that the (two-sided) 95% confidence interval of the effect must exceed a specified distance to the zero effect. In summary, we assume that our approach provides a robust, transparent, and thus predictable foundation to determine minor, considerable, and major treatment effects on binary outcomes in the early benefit assessment of new drugs in Germany. After a decision on the added benefit of a new drug by G-BA, the classification of added benefit is used to inform pricing negotiations between the umbrella organization of statutory health insurance and the pharmaceutical companies. © 2015 The Authors. Biometrical Journal Published by Wiley-VCH Verlag GmbH & Co. KGaA.

  16. 26 CFR 1.401-14 - Inclusion of medical benefits for retired employees in qualified pension or annuity plans.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 5 2014-04-01 2014-04-01 false Inclusion of medical benefits for retired employees in qualified pension or annuity plans. 1.401-14 Section 1.401-14 Internal Revenue INTERNAL REVENUE..., Profit-Sharing, Stock Bonus Plans, Etc. § 1.401-14 Inclusion of medical benefits for retired employees in...

  17. 26 CFR 1.401-14 - Inclusion of medical benefits for retired employees in qualified pension or annuity plans.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Inclusion of medical benefits for retired employees in qualified pension or annuity plans. 1.401-14 Section 1.401-14 Internal Revenue INTERNAL REVENUE..., Profit-Sharing, Stock Bonus Plans, Etc. § 1.401-14 Inclusion of medical benefits for retired employees in...

  18. 26 CFR 1.401-14 - Inclusion of medical benefits for retired employees in qualified pension or annuity plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Inclusion of medical benefits for retired employees in qualified pension or annuity plans. 1.401-14 Section 1.401-14 Internal Revenue INTERNAL REVENUE..., Profit-Sharing, Stock Bonus Plans, Etc. § 1.401-14 Inclusion of medical benefits for retired employees in...

  19. 26 CFR 1.401-14 - Inclusion of medical benefits for retired employees in qualified pension or annuity plans.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Inclusion of medical benefits for retired employees in qualified pension or annuity plans. 1.401-14 Section 1.401-14 Internal Revenue INTERNAL REVENUE..., Profit-Sharing, Stock Bonus Plans, Etc. § 1.401-14 Inclusion of medical benefits for retired employees in...

  20. Ontario’s plunging price-caps on generics: deeper dives may drown some drugs

    PubMed Central

    Anis, Aslam; Harvard, Stephanie; Marra, Carlo

    2011-01-01

    In April 2010, the Ontario government announced another reduction in the maximum price of generic drugs permitted under the Ontario Drug Benefit (ODB) program, demanding that generic drugs now be sold for no more than 25% of the branded product’s price. Other provinces are following Ontario in setting unprecedentedly low price-caps to reduce the cost of generic drugs. Generic product substitution legislation is vital to reducing costs to provincial drug plans, yet lower and lower price-caps may undo some of the benefits of substitution legislation if generics find it difficult to survive. PMID:22046229

  1. 20 CFR 1002.266 - What are the obligations of a multiemployer pension benefit plan under USERRA?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... period of service is responsible for making the employer contribution to the multiemployer plan, if the... multiemployer pension benefit plan is one to which more than one employer is required to contribute, and which... organizations and more than one employer. The Act uses ERISA's definition of a multiemployer plan. In addition...

  2. 42 CFR 422.106 - Coordination of benefits with employer or union group health plans and Medicaid.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... plans and Medicaid. (a) General rule. If an MA organization contracts with an employer, labor... enrollees in an MA plan, or contracts with a State Medicaid agency to provide Medicaid benefits to individuals who are eligible for both Medicare and Medicaid, and who are enrolled in an MA plan, the enrollees...

  3. Structure of the physical therapy benefit in a typical Blue Cross Blue Shield preferred provider organization plan available in the individual insurance market in 2011.

    PubMed

    Sandstrom, Robert W; Lehman, Jedd; Hahn, Lee; Ballard, Andrew

    2013-10-01

    The Affordable Care Act of 2010 establishes American Health Benefit Exchanges. The benefit design of insurance plans in state health insurance exchanges will be based on the structure of existing small-employer-sponsored plans. The purpose of this study was to describe the structure of the physical therapy benefit in a typical Blue Cross Blue Shield (BCBS) preferred provider organization (PPO) health insurance plan available in the individual insurance market in 2011. A cross-sectional survey design was used. The physical therapy benefit within 39 BCBS PPO plans in 2011 was studied for a standard consumer with a standard budget. First, whether physical therapy was a benefit in the plan was determined. If so, then the structure of the benefit was described in terms of whether the physical therapy benefit was a stand-alone benefit or part of a combined-discipline benefit and whether a visit or financial limit was placed on the physical therapy benefit. Physical therapy was included in all BCBS plans that were studied. Ninety-three percent of plans combined physical therapy with other disciplines. Two thirds of plans placed a limit on the number of visits covered. The results of the study are limited to 1 standard consumer, 1 association of insurance companies, 1 form of insurance (a PPO), and 1 PPO plan in each of the 39 states that were studied. Physical therapy is a covered benefit in a typical BCBS PPO health insurance plan. Physical therapy most often is combined with other therapy disciplines, and the number of covered visits is limited in two thirds of plans.

  4. On the socioeconomic benefits of family planning work.

    PubMed

    Yang, D

    1991-01-01

    The focus of this article is on 1) the intended socioeconomic benefit of Chinese family planning (FP) versus the benefit of the maternal production sector, 2) the estimated costs of FP work, 3) and the principal ways to lower FP costs. Marxian population theory, which is ascribed to in socialist China, states that population and socioeconomic development are interconnected and must adapt to each other and that an excessively large or small population will upset the balance and retard development. Malthusians believe that large populations reduce income, and Adam Smith believed that more people meant a larger market and more income. It is believed that FP will bring socioeconomic benefits to China. The socioeconomic benefit of material production is the linkage between labor consumption and the amount of labor usage with the fruits and benefits of labor. FP invests in human, material, and financial resources to reduce the birth rate and the absolute number of births. The investment is recouped in population. The increased national income generated from a small outlay to produce an ideal population would be used to improve material and cultural lives. FP brings economic benefits and accelerates social development (ecological balances women's emancipation and improvement in the physical and mental health of women and children, improvement in cultural learning and employment, cultivation of socialist morality and new practices, and stability). In computing FP cost, consideration is given to total cost and unit cost. Cost is dependent on the state budget allocation, which was 445.76 million yuan in 1982 and was doubled by 1989. World Bank figures for 1984 affixed the FP budget in China at 979.6 million US dollars, of which 80% was provided by China. Per person, this means 21 cents for central, provincial, prefecture, and country spending, 34 cents for rural collective set-ups, 25 cents for child awards, and various subsidies, 15 cents for sterilization, and 5 cents for

  5. Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit

    PubMed Central

    Kripke, Daniel F.

    2016-01-01

    This is a review of hypnotic drug risks and benefits, reassessing and updating advice presented to the Commissioner of the Food and Drug Administration (United States FDA). Almost every month, new information appears about the risks of hypnotics (sleeping pills). This review includes new information on the growing USA overdose epidemic, eight new epidemiologic studies of hypnotics’ mortality not available for previous compilations, and new emphasis on risks of short-term hypnotic prescription. The most important risks of hypnotics include excess mortality, especially overdose deaths, quiet deaths at night, infections, cancer, depression and suicide, automobile crashes, falls, and other accidents, and hypnotic-withdrawal insomnia. The short-term use of one-two prescriptions is associated with greater risk per dose than long-term use. Hypnotics are usually prescribed without approved indication, most often with specific contraindications, but even when indicated, there is little or no benefit. The recommended doses objectively increase sleep little if at all, daytime performance is often made worse, not better, and the lack of general health benefits is commonly misrepresented in advertising. Treatments such as the cognitive behavioral treatment of insomnia and bright light treatment of circadian rhythm disorders might offer safer and more effective alternative approaches to insomnia. PMID:27303633

  6. The effect of employee assistance plan benefits on the use of outpatient behavioral health care.

    PubMed

    Hodgkin, Dominic; Merrick, Elizabeth L; Hiatt, Deirdre; Horgan, Constance M; McGuire, Thomas G

    2010-12-01

    Nearly half of all US workers have access to an employee assistance plan (EAP). At the same time, most large US employers also purchase health benefits for their employees, and these benefits packages typically include behavioral health services. There is some potential overlap in services covered by the EAP and the health plan, and some employers choose to purchase the two jointly as an 'integrated product'. It is not clear whether EAP services substitute for outpatient behavioral health care services covered by the health plan. To evaluate how the number of EAP visits covered affects the use of regular outpatient behavioral health care (number of visits, and total spending), in an integrated product setting. Analysis of claims, eligibility and benefits data for 26,464 users of behavioral health care for the year 2005. For both EAP and regular behavioral health care, the individuals were enrolled with Managed Health Network (MHN), a large national specialty insurance plan. Multivariate regression analyses were performed to investigate the determinants of the number of regular outpatient visits, and spending for regular outpatient care. To address skewness in the dependent variables, the estimation used generalized linear models with a log link. A limited instrumental variable analysis was used to test for endogeneity of the number of EAP visits covered. Nearly half the enrollees in this sample were in employer plans that allowed 4-5 EAP visits per treatment episode, and 31% were allowed 3 EAP visits per year. Having an EAP visit allowance of 4-5 sessions per episode predicts fewer regular outpatient visits, compared with having an allowance of 3 sessions per year. More generous EAP allowances also reduce payments for outpatient care, with one exception. Greater availability of EAP benefits appears to reduce utilization of regular outpatient care, supporting the idea that the two types of care are to some extent perceived as substitutes. One limitation of this

  7. Comparisons of Food and Drug Administration and European Medicines Agency risk management implementation for recent pharmaceutical approvals: report of the International Society for Pharmacoeconomics and outcomes research risk benefit management working group.

    PubMed

    Lis, Yvonne; Roberts, Melissa H; Kamble, Shital; J Guo, Jeff; Raisch, Dennis W

    2012-12-01

    1) To compare the Food and Drug Administration's (FDA's) Risk Evaluation and Mitigation Strategies (REMS) and European Medicines Agency's (EMA's) Risk Management Plan (RMP) guidances and 2) to compare REMS and RMPs for specific chemical entities and biological products. FDA, EMA, and pharmaceutical company Web sites were consulted for details pertaining to REMS and RMPs. REMS requirements include medication guides, communication plans, elements to ensure safe use, implementation systems, and specified assessment intervals. RMP requirements are increased pharmacovigilance and risk minimization activities. We compared these requirements for drugs requiring both REMS and RMPs. We identified 95 drugs on FDA's REMS list as of March 2010. Of these, there were 29 drugs (11 biologics and 18 new chemical entities) with EMA RMPs. REMS and RMPs are similar in objectives, with comparable toolkits. Both allow flexibility in product-specific actions, recognizing adverse effects of potential concern. Of the 29 drugs reviewed, REMS requirements not included in RMPs were patient medication guides (100% of the drugs), provider communication plans (38%), and routine monitoring of REMS (66%). RMP requirements not included in REMS were specific adverse event reporting (45% of the drugs), prospective registry studies (34%), prospective epidemiology studies (24%), additional trial data (28%), and Summary of Product Characteristics contraindications (76%). Both REMS and RMPs provide positive guidance for identification, monitoring, and minimization of risk to patient safety. Currently, neither agency provides specific guidance on how risk should be related to benefit either qualitatively or quantitatively. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Drug-Free Schools & Communities: Program Planning Guidelines & Community Inventory.

    ERIC Educational Resources Information Center

    Montana State Board of Crime Control, Helena.

    This book is designed to provide Montana communities with the most current research-based information available concerning drug and alcohol prevention/education program planning. It also provides a concise overview of the programs being conducted in various Montana communities. It is intended for use as a resource manual, to provide readers with…

  9. Wrangling prescription drug benefits: a conversation with Express Scripts' Barrett Toan. Interview by Robert F. Atlas.

    PubMed

    Toan, Barrett

    2005-01-01

    Express Scripts, one of the three largest U.S. pharmacy benefit management (PBM) firms, has had one chief executive officer since its founding in the late 1980s. As Barrett Toan prepares to retire (he will remain as nonexecutive chairman), his company and other PBMs have moved onto center stage. The recent surge in drug spending has spawned great interest in PBMs' role, as well as controversy over PBMs' business practices. Implementation of the new Medicare prescription drug benefit depends heavily upon the capabilities that PBMs offer. Toan discusses these matters, plus expectations for the future of his industry-particularly opportunities associated with electronic prescribing.

  10. Colchicine in Pericardial Disease: from the Underlying Biology and Clinical Benefits to the Drug-Drug Interactions in Cardiovascular Medicine.

    PubMed

    Schenone, Aldo L; Menon, Venu

    2018-06-14

    This is an in-depth review on the mechanism of action, clinical utility, and drug-drug interactions of colchicine in the management of pericardial disease. Recent evidence about therapeutic targets on pericarditis has demonstrated that NALP3 inflammasome blockade is the cornerstone in the clinical benefits of colchicine. Such benefits extend from acute and recurrent pericarditis to transient constriction and post-pericardiotomy syndrome. Despite the increased utilization of colchicine in cardiovascular medicine, safety concerns remains unsolved regarding the long-term use of colchicine in the cardiac patient. Moreover, recent evidence has demonstrated that numerous cardiovascular medications, ranging from antihypertensive medication to antiarrhythmics, are known to interact with the CYP3A4 and/or P-gp system increasing the toxicity potential of colchicine. The use of adjunctive colchicine in the management of inflammatory pericardial diseases is standard of care in current practice. It is advised that a careful medication reconciliation with emphasis on pharmacokinetic is completed before prescribing colchicine in order to avoid harmful interaction by finding an alternative regimen or adjusting colchicine dosing.

  11. The use of Space Technology for the Benefit of Society in Context of Planning and Sustainable Development

    NASA Astrophysics Data System (ADS)

    Kuldeep, Kuldeep; Banu, Vijaya

    2016-07-01

    The introduction of the novel technology mostly leads to a number of advantages to the society. The space technology has shown such benefits in many fields including the areas of health and education, communication sectors, land and water resources management, weather forecasting and disaster management. It has vast potential for addressing a variety of societal problems of the developing countries especially in India in a effective manner. Large population which is spread over vast and remote areas of the nation, reaching out to them is a difficult task. This manuscript aims to explain the benefits originated from the application of space technology. The satellite imagery and its derived products can better be utilized for local level planning and sustainable development of a region. A case-study using Bhuvan Panchayat Portal developed by National Remote Sensing Centre, ISRO under the project "Space Based Information Support for De-Centralised Planning" towards Digital Empowerment of Society for Panchayat level Planning and Governance has been carried out, which list out the benefits that have accrued from the use of space technology for planning and development at grass root level in India. It covers, in particular, the benefits expected to be derived from the Indian Remote Sensing Satellite (IRS) Images and derived products. Certain conclusions about the benefits from space based inputs have been drawn that may be generally applicable to all developing countries. This paper also investigates the various possibilities and potentials of Remote Sensing technologies for societal applications.

  12. 26 CFR 1.401(l)-3 - Permitted disparity for defined benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... requirement of this paragraph (b). Thus, for example, if the form of a defined benefit plan's normal... the optional form (the “offset amount”). (D) Post-retirement cost-of-living adjustments—(1) In general... merely because it provides an automatic post-retirement cost-of-living adjustment that satisfies...

  13. 26 CFR 1.401(l)-3 - Permitted disparity for defined benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of this paragraph (b). Thus, for example, if the form of a defined benefit plan's normal retirement... the optional form (the “offset amount”). (D) Post-retirement cost-of-living adjustments—(1) In general... merely because it provides an automatic post-retirement cost-of-living adjustment that satisfies...

  14. The application of seismic risk-benefit analysis to land use planning in Taipei City.

    PubMed

    Hung, Hung-Chih; Chen, Liang-Chun

    2007-09-01

    In the developing countries of Asia local authorities rarely use risk analysis instruments as a decision-making support mechanism during planning and development procedures. The main purpose of this paper is to provide a methodology to enable planners to undertake such analyses. We illustrate a case study of seismic risk-benefit analysis for the city of Taipei, Taiwan, using available land use maps and surveys as well as a new tool developed by the National Science Council in Taiwan--the HAZ-Taiwan earthquake loss estimation system. We use three hypothetical earthquakes to estimate casualties and total and annualised direct economic losses, and to show their spatial distribution. We also characterise the distribution of vulnerability over the study area using cluster analysis. A risk-benefit ratio is calculated to express the levels of seismic risk attached to alternative land use plans. This paper suggests ways to perform earthquake risk evaluations and the authors intend to assist city planners to evaluate the appropriateness of their planning decisions.

  15. Plan to combat extensively drug-resistant tuberculosis: recommendations of the Federal Tuberculosis Task Force.

    PubMed

    2009-02-13

    An estimated one third of the world's population is infected with Mycobacterium tuberculosis, and nearly 9 million persons develop disease caused by M. tuberculosis each year. Although tuberculosis (TB) occurs predominantly in resource-limited countries, it also occurs in the United States. During 1985-1992, the United States was confronted with an unprecedented TB resurgence. This resurgence was accompanied by a rise in multidrug-resistant TB (MDR TB), which is defined as TB that is resistant to the two most effective first-line therapeutic drugs, isoniazid and rifampin. In addition, virtually untreatable strains of M. tuberculosis are emerging globally. Extensively drug-resistant (XDR) TB is defined as MDR TB that also is resistant to the most effective second-line therapeutic drugs used commonly to treat MDR TB: fluoroquinolones and at least one of three injectable second-line drugs used to treat TB (amikacin, kanamycin, or capreomycin). XDR TB has been identified in all regions of the world, including the United States. In the United States, the cost of hospitalization for one XDR TB patient is estimated to average $483,000, approximately twice the cost for MDR TB patients. Because of the limited responsiveness of XDR TB to available antibiotics, mortality rates among patients with XDR TB are similar to those of TB patients in the preantibiotic era. In January 1992, CDC convened a Federal TB Task Force to draft an action plan to improve prevention and control of drug-resistant TB in the United States (CDC. National action plan to combat multidrug-resistant tuberculosis. MMWR 1992;41([No. RR-11]). In November 2006, CDC reconvened the Task Force to draft an updated action plan to address the issue of MDR TB and XDR TB. Task Force members were divided into nine response areas and charged with articulating the most pressing problems, identifying barriers to improvement, and recommending specific action steps to improve prevention and control of XDR TB within their

  16. 78 FR 78366 - Draft Generic Drug User Fee Act Information Technology Plan; Availability for Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ...] Draft Generic Drug User Fee Act Information Technology Plan; Availability for Comment AGENCY: Food and... the availability for public comment of the draft information technology (IT) plan entitled ``GDUFA Information Technology Plan.'' This plan is intended to provide FDA's approach for enhancing business...

  17. 75 FR 68383 - Hearing on Reasonable Contracts or Arrangements for Welfare Benefit Plans Under Section 408(b)(2...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-05

    ..., e.g., group health plans, severance plans, vacation plans, apprenticeship and training plans, etc..., accident, disability, death or unemployment, or vacation benefits, apprenticeship or other training... written request to be heard; and (2) An outline of the topics to be discussed, indicating the time...

  18. Hazards and Benefits of Drug Interaction

    ERIC Educational Resources Information Center

    Labianca, Dominick A.

    1978-01-01

    Most cases of drug toxicity are direct consequences of drug misuse--either intentional or inadvertent. Discusses two types of drug interaction--synergistic and antagonistic. The former produces a combined effect greater than the sum of the effects of the individual drugs concerned; the latter is produced when the desired action of one drug is…

  19. Medicare prescription drug plan coverage of pharmacotherapies for opioid and alcohol dependence in WA.

    PubMed

    Kennedy, Jae; Dipzinski, Aaron; Roll, John; Coyne, Joseph; Blodgett, Elizabeth

    2011-04-01

    Pharmacotherapeutic treatments for drug addiction offer new options, but only if they are affordable for patients. The objective of this study is to assess the current availability and cost of five common antiaddiction medications in the largest federal medication insurance program in the US, Medicare Part D. In early 2010, we collected coverage and cost data from 41 Medicare Part D prescription drug plans (PDPs) and 45 Medicare Advantage Plans (MAPs) in Washington State. The great majority of Medicare plans (82-100%) covered common pharmacotherapeutic treatments for drug addiction. These Medicare plans typically placed patent protected medications on their highest formulary tiers, leading to relatively high patient co-payments during the initial Part D coverage period. For example, median monthly co-payments for buprenorphine (Suboxone®) were about $46 for PDPs, and about $56 for MAPs. While Medicare prescription plans usually cover pharmacotherapeutic treatments for drug addiction, high co-payments can limit access. For example, beneficiaries without supplemental coverage who use Vivitrol® would exceed their initial coverage cap in 7-8 months, reaching the "doughnut hole" in their Part D coverage and becoming responsible for the full cost of the medication (over $900 per month). The 2010 Patient Protection and Affordable Care Act will gradually eliminate this coverage gap, and loss of patent protection for other antiaddiction medications (Suboxone® and Campral®) should also drive down patient costs, improving access and compliance. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Fair Balance? An Analysis of the Functional Equivalence of Risk and Benefit Information in Prescription Drug Direct-to-Consumer Television Advertising

    ERIC Educational Resources Information Center

    Baird-Harris, Kay

    2009-01-01

    Prescription drug direct-to-consumer advertising (DTCA) has been a subject of controversy in recent years. Though government regulations require equivalent prominence of risks and benefits, there is concern about the ability of consumers with limited health literacy to fully comprehend the risks and benefits associated with drug use. Evaluating…

  1. Benefits and Challenges of Linking Green Infrastructure and Highway Planning in the United States

    NASA Astrophysics Data System (ADS)

    Marcucci, Daniel J.; Jordan, Lauren M.

    2013-01-01

    Landscape-level green infrastructure creates a network of natural and semi-natural areas that protects and enhances ecosystem services, regenerative capacities, and ecological dynamism over long timeframes. It can also enhance quality of life and certain economic activity. Highways create a network for moving goods and services efficiently, enabling commerce, and improving mobility. A fundamentally profound conflict exists between transportation planning and green infrastructure planning because they both seek to create connected, functioning networks across the same landscapes and regions, but transportation networks, especially in the form of highways, fragment and disconnect green infrastructure networks. A key opportunity has emerged in the United States during the last ten years with the promotion of measures to link transportation and environmental concerns. In this article we examined the potential benefits and challenges of linking landscape-level green infrastructure planning and implementation with integrated transportation planning and highway project development in the United States policy context. This was done by establishing a conceptual model that identified logical flow lines from planning to implementation as well as the potential interconnectors between green infrastructure and highway infrastructure. We analyzed the relationship of these activities through literature review, policy analysis, and a case study of a suburban Maryland, USA landscape. We found that regionally developed and adopted green infrastructure plans can be instrumental in creating more responsive regional transportation plans and streamlining the project environmental review process while enabling better outcomes by enabling more targeted mitigation. In order for benefits to occur, however, landscape-scale green infrastructure assessments and plans must be in place before integrated transportation planning and highway project development occurs. It is in the transportation

  2. Benefits and challenges of linking green infrastructure and highway planning in the United States.

    PubMed

    Marcucci, Daniel J; Jordan, Lauren M

    2013-01-01

    Landscape-level green infrastructure creates a network of natural and semi-natural areas that protects and enhances ecosystem services, regenerative capacities, and ecological dynamism over long timeframes. It can also enhance quality of life and certain economic activity. Highways create a network for moving goods and services efficiently, enabling commerce, and improving mobility. A fundamentally profound conflict exists between transportation planning and green infrastructure planning because they both seek to create connected, functioning networks across the same landscapes and regions, but transportation networks, especially in the form of highways, fragment and disconnect green infrastructure networks. A key opportunity has emerged in the United States during the last ten years with the promotion of measures to link transportation and environmental concerns. In this article we examined the potential benefits and challenges of linking landscape-level green infrastructure planning and implementation with integrated transportation planning and highway project development in the United States policy context. This was done by establishing a conceptual model that identified logical flow lines from planning to implementation as well as the potential interconnectors between green infrastructure and highway infrastructure. We analyzed the relationship of these activities through literature review, policy analysis, and a case study of a suburban Maryland, USA landscape. We found that regionally developed and adopted green infrastructure plans can be instrumental in creating more responsive regional transportation plans and streamlining the project environmental review process while enabling better outcomes by enabling more targeted mitigation. In order for benefits to occur, however, landscape-scale green infrastructure assessments and plans must be in place before integrated transportation planning and highway project development occurs. It is in the transportation

  3. 29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A... contributions on behalf of an employee using FMLA leave as though the employee had been continuously employed...

  4. 29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A... contributions on behalf of an employee using FMLA leave as though the employee had been continuously employed...

  5. 29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A... contributions on behalf of an employee using FMLA leave as though the employee had been continuously employed...

  6. 29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Employee Leave Entitlements Under the Family and Medical Leave Act § 825.211 Maintenance of benefits under multi-employer health plans. (a) A... contributions on behalf of an employee using FMLA leave as though the employee had been continuously employed...

  7. Planning influenza vaccination programs: a cost benefit model

    PubMed Central

    2012-01-01

    Background Although annual influenza vaccination could decrease the significant economic and humanistic burden of influenza in the United States, immunization rates are below recommended levels, and concerns remain whether immunization programs can be cost beneficial. The research objective was to compare cost benefit of various immunization strategies from employer, employee, and societal perspectives. Methods An actuarial model was developed based on the published literature to estimate the costs and benefits of influenza immunization programs. Useful features of the model included customization by population age and risk-level, potential pandemic risk, and projection year. Various immunization strategies were modelled for an average U.S. population of 15,000 persons vaccinated in pharmacies or doctor’s office during the 2011/12 season. The primary outcome measure reported net cost savings per vaccinated (PV) from the perspective of various stakeholders. Results Given a typical U.S. population, an influenza immunization program will be cost beneficial for employers when more than 37% of individuals receive vaccine in non-traditional settings such as pharmacies. The baseline scenario, where 50% of persons would be vaccinated in non-traditional settings, estimated net savings of $6 PV. Programs that limited to pharmacy setting ($31 PV) or targeted persons with high-risk comorbidities ($83 PV) or seniors ($107 PV) were found to increase cost benefit. Sensitivity analysis confirmed the scenario-based findings. Conclusions Both universal and targeted vaccination programs can be cost beneficial. Proper planning with cost models can help employers and policy makers develop strategies to improve the impact of immunization programs. PMID:22835081

  8. Managing psychotropic drug costs: will formularies work?

    PubMed

    Huskamp, Haiden A

    2003-01-01

    Payers of pharmaceutical benefits are increasingly turning to drug formularies in an attempt to control rising pharmacy costs, including those for psychotropic drugs. In this paper I examine several issues that policymakers should consider when addressing formulary design for psychotropic drugs: heterogeneity within mental health disorders and limited information about treatment effectiveness for individual patients; the potential for plans to try to use formularies to avoid adverse selection and implications for psychotropic coverage; the interaction of Medicaid formulary policy and manufacturers' incentives for psychotropic innovation; and incentives created by mental health institutions that decrease formularies' potential effectiveness in controlling psychotropic drug costs.

  9. Availability of evidence of benefits on overall survival and quality of life of cancer drugs approved by European Medicines Agency: retrospective cohort study of drug approvals 2009-13.

    PubMed

    Davis, Courtney; Naci, Huseyin; Gurpinar, Evrim; Poplavska, Elita; Pinto, Ashlyn; Aggarwal, Ajay

    2017-10-04

    Objective  To determine the availability of data on overall survival and quality of life benefits of cancer drugs approved in Europe. Design  Retrospective cohort study. Setting  Publicly accessible regulatory and scientific reports on cancer approvals by the European Medicines Agency (EMA) from 2009 to 2013. Main outcome measures  Pivotal and postmarketing trials of cancer drugs according to their design features (randomisation, crossover, blinding), comparators, and endpoints. Availability and magnitude of benefit on overall survival or quality of life determined at time of approval and after market entry. Validated European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) used to assess the clinical value of the reported gains in published studies of cancer drugs. Results  From 2009 to 2013, the EMA approved the use of 48 cancer drugs for 68 indications. Of these, eight indications (12%) were approved on the basis of a single arm study. At the time of market approval, there was significant prolongation of survival in 24 of the 68 (35%). The magnitude of the benefit on overall survival ranged from 1.0 to 5.8 months (median 2.7 months). At the time of market approval, there was an improvement in quality of life in seven of 68 indications (10%). Out of 44 indications for which there was no evidence of a survival gain at the time of market authorisation, in the subsequent postmarketing period there was evidence for extension of life in three (7%) and reported benefit on quality of life in five (11%). Of the 68 cancer indications with EMA approval, and with a median of 5.4 years' follow-up (minimum 3.3 years, maximum 8.1 years), only 35 (51%) had shown a significant improvement in survival or quality of life, while 33 (49%) remained uncertain. Of 23 indications associated with a survival benefit that could be scored with the ESMO-MCBS tool, the benefit was judged to be clinically meaningful in less than half (11/23, 48%). Conclusions

  10. Physicians' views of formularies: implications for Medicare drug benefit design.

    PubMed

    Landon, Bruce E; Reschovsky, James D; Blumenthal, David

    2004-01-01

    As Congress considers introducing a drug benefit for Medicare, it will more than likely adopt a program that uses a formulary. We examined data from the Community Tracking Study Physicians Survey, a large, nationally representative study of physicians, to learn about physicians' views of formularies. Our results suggest that several aspects of formularies are associated with physicians' positive views about them. Policymakers should consider imposing limits on the number of competing Medicare formularies operating in a particular area, promoting the adoption and use of information technology, and incorporating financial incentives for physicians to adhere to formularies.

  11. Perceived Exercise Self-Efficacy, Benefits and Barriers, and Commitment to a Plan for Exercise among Jordanians with Chronic Illnesses.

    PubMed

    Darawad, Muhammad W; Khalil, Amani A; Hamdan-Mansour, Ayman M; Nofal, Basema M

    2016-11-01

    To explore Jordanian chronic illnesses patients' perceived exercise self-efficacy, benefits and barriers, and commitment to exercise planning, and to assess the relationship between those variables. Descriptive cross-sectional design. Data were collected from a convenience sample of 402 outpatient Jordanians with chronic illnesses, using Exercise Self-Efficacy Scale, Exercise Benefits and Barriers Scale, and Commitment to a Plan for Exercise Scale. The average BMI was 28.3, and exercise period 3.2 hours/ week. Participants reported moderate perceived self-efficacy (M= 47.5%, SD= 11.7), commitment to exercise planning (M=2.0/3, SD=0.3), exercise barriers (M=2.4/4, SD=0.3), and benefits (M=2.3/4, SD=0.3). Commitment to exercise planning had a significant correlation with barriers (r=0.11) and benefits (r=0.10). Self-efficacy was not found to correlate with other variables. Even though participants reported higher perceived self-efficacy and commitment to exercise plan than that reported in literature, they were found to be overweight and inactive, which indicates the importance of such study. Exercise education programs are needed taking into considerations patients' individual differences. However, the broad grouping of diseases may not produce a homogenous sample, for which disease categories are recommended in future studies. Patients with chronic illness need more encouragement to engage themselves in exercise practices. Exercise educational program for patients with chronic illnesses should consider patients' reported exercise benefits and barriers. © 2014 Association of Rehabilitation Nurses.

  12. Riding the rollercoaster: the ups and downs in out-of-pocket spending under the standard Medicare drug benefit.

    PubMed

    Stuart, Bruce; Briesacher, Becky A; Shea, Dennis G; Cooper, Barbara; Baysac, Fatima S; Limcangco, M Rhona

    2005-01-01

    This study projects how much Medicare beneficiaries who sign up for the standard Part D drug benefit in 2006 will pay in quarterly out-of-pocket payments through 2008. In the first year we estimate that about 38 percent of enrollees will hit the benefit's no-coverage zone, known as the "doughnut hole," and that 14 percent will exceed the catastrophic threshold. Because drug spending is highly persistent over time, beneficiaries who experience the biggest gaps in coverage are likely to do so year after year, with potentially serious financial consequences.

  13. [Analysis of Late AMNOG Benefit Assessments].

    PubMed

    Rieder, Veronika; Hammerschmidt, Thomas

    2018-04-26

    Since 2011, new drugs are assessed at the time of launch in Germany (AMNOG). Based on this early benefit assessment (EBA), drug prices are negotiated. At this time, the evidence base might be weak. A later benefit assessment (LBA) is not done on a regular basis except for selected drugs. Our objective was to analyze the impact of LBAs of drugs for the same indication. Analysis of all completed LBAs between 2011 and 2016. 228 benefit assessments have been performed since 2011. 26 drugs were assessed twice for the same indication. Oncology and diabetes were the most common therapeutic areas in LBA and more pronounced than in EBA. 15 LBAs were due to the EBAs having a time limitation because of insufficient evidence base partially based on conditional approval. Time between EBA and LBA was 2.6 years. All 15 drugs had added benefit in the EBA, 4 got a better, 5 a worse assessment in the LBA. Seven drugs without added benefit in the EBA were assessed at the request of the manufacturer because of new data after 1.7 years. Three drugs could show added benefit in the LBA. Finally, 4 orphan drugs were reassessed according to the AMNOG regulation after achieving annual sales of 50 million euros. One got a better, 2 got a worse benefit assessment. Average improvement of benefit was +1.5 on a scale between - 3 (worst negative benefit) and +9 (highest positive benefit). Average deterioration of added benefit was - 1.4. Negotiated prices were significantly correlated with the change in the benefit assessment. LBA on a broader evidence base did not result in a significantly changed outcome. A general LBA for all drugs does not appear to be necessary because of the limited effect on the benefit assessment and the price when considering cost and administrative burden of the AMNOG benefit assessment. The selective approach of LBA for specific drugs is sufficient in cases in which the evidence base was limited at launch. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Benefits of family planning: an assessment of women's knowledge in rural Western Kenya.

    PubMed

    Mutombo, Namuunda; Bakibinga, Pauline; Mukiira, Carol; Kamande, Eva

    2014-03-18

    The last two decades have seen an increase in literature reporting an increase in knowledge and use of contraceptives among individuals and couples in Kenya, as in the rest of Africa, but there is a dearth of information regarding knowledge about benefits of family planning (FP) in Kenya. To assess the factors associated with knowledge about the benefits of FP for women and children, among women in rural Western Kenya. Data are drawn from the Packard Western Kenya Project Baseline Survey, which collected data from rural women (aged 15-49 years). Ordinal regression was used on 923 women to determine levels of knowledge and associated factors regarding benefits of FP. Women in rural Western Kenya have low levels of knowledge about benefits of FP and are more knowledgeable about benefits for the mother rather than for the child. Only age, spousal communication and type of contraceptive method used are significant. Women's level of knowledge about benefits of FP is quite low and may be one of the reasons why fertility is still high in Western Kenya. Therefore, FP programmes need to focus on increasing women's knowledge about the benefits of FP in this region.

  15. Do Prescription Drug Ads Tell Consumers Enough About Benefits and Side Effects? Results From the Health Information National Trends Survey, Fourth Administration.

    PubMed

    Sullivan, Helen W; Campbell, Miriam

    2015-01-01

    Direct-to-consumer prescription drug advertising (DTCA) is a major source of consumer information about prescription drugs. The present study updates 2002 U.S. Food and Drug Administration phone survey questions that found that 44% and 61% of consumers thought that DTCA did not include enough information about benefits and risks, respectively. The present study was administered by mail using a nationally representative sample, and provides a more in-depth understanding of how these beliefs relate to demographic and health characteristics. Data collected from 3,959 respondents to the National Cancer Institute's 2011 Health Information National Trends Survey find results similar to the 2002 survey: 46% and 52% of respondents thought that DCTA did not include enough information about benefits and risks, respectively. Respondents fell into four groups: 23% agreed that DTCA tells enough about drug benefits and risks, 41% disagreed, 18% expressed no opinion, and 18% had discordant beliefs. DTCA attitudes were negatively associated with education, income, and whether respondents purchase prescription drugs; attitudes were positively associated with whether respondents understand prescription drug information. This study confirms that a plurality of Americans believe that DTCA does not include enough information about benefits and risks, suggesting that the educational effect of DTCA could be improved.

  16. 41 CFR 60-300.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... VETERANS, AND ARMED FORCES SERVICE MEDAL VETERANS Discrimination Prohibited § 60-300.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

  17. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Health insurance, life... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance, life insurance and other benefit plans. (a) An insurer, hospital, or medical service company, health...

  18. 26 CFR 1.401-14 - Inclusion of medical benefits for retired employees in qualified pension or annuity plans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Inclusion of medical benefits for retired...-Sharing, Stock Bonus Plans, Etc. § 1.401-14 Inclusion of medical benefits for retired employees in... employer providing such medical benefits by reason of permanent disability. For purposes of the preceding...

  19. 78 FR 78367 - Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ...] Draft Prescription Drug User Fee Act V Information Technology Plan; Availability for Comment AGENCY... announcing the availability for public comment of the draft information technology (IT) plan entitled ``PDUFA V Information Technology Plan.'' This plan is intended to provide FDA's approach for enhancing...

  20. The Media and Controlled Substances; Anti-Drug Legislation. Lesson Plans.

    ERIC Educational Resources Information Center

    Laverdure, Sharon

    1991-01-01

    Provides two lesson plans for classroom use. Focuses on media influence on the use of alcohol and tobacco and on regulatory laws and their effect on drug use. Identifies connections that can be made to textbooks and magazine articles, as well as suggestions for opening, developing, and concluding each lesson. (DK)

  1. 42 CFR 423.272 - Review and negotiation of bid and approval of plans submitted by potential Part D sponsors.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-PD plans with the following exceptions: (1) Exemption from negotiations. These plans are exempt from... prescription drug coverage and actuarial determinations. (1) Application of revenue requirements standard. CMS... in benefits offered under the plan. (c) Limited risk plans. (1) Application of limited risk plans...

  2. 42 CFR 423.272 - Review and negotiation of bid and approval of plans submitted by potential Part D sponsors.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-PD plans with the following exceptions: (1) Exemption from negotiations. These plans are exempt from... prescription drug coverage and actuarial determinations. (1) Application of revenue requirements standard. CMS... in benefits offered under the plan. (c) Limited risk plans. (1) Application of limited risk plans...

  3. A cost-benefit analysis of the Mexican Social Security Administration's family planning program.

    PubMed

    Nortman, D L; Halvas, J; Rabago, A

    1986-01-01

    A cost-benefit analysis of the family planning program of the Mexican Social Security System (IMSS) was undertaken to test the hypothesis that IMSS's family planning services yield a net savings to IMSS by reducing the load on its maternal and infant care service. The cost data are believed to be of exceptionally high quality because they were empirically ascertained by a retrospective and prospective survey of unit time and personnel costs per specified detailed type of service in 37 IMSS hospitals and 16 clinics in 13 of Mexico's 32 states. Based on the average cost per case, the analysis disclosed that for every peso (constant 1983 currency) that IMSS spent on family planning services to its urban population during 1972-1984 inclusive, the agency saved nine pesos. The article concludes by raising the speculative question as to the proportion of the births averted by the IMSS family planning program that would have been averted in the absence of IMSS's family planning services.

  4. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Health insurance, life insurance and other benefit plans. 60-250.25 Section 60-250.25 Public Contracts and Property Management... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance...

  5. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 1 2013-07-01 2013-07-01 false Health insurance, life insurance and other benefit plans. 60-250.25 Section 60-250.25 Public Contracts and Property Management... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance...

  6. 41 CFR 60-250.25 - Health insurance, life insurance and other benefit plans.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 1 2012-07-01 2009-07-01 true Health insurance, life insurance and other benefit plans. 60-250.25 Section 60-250.25 Public Contracts and Property Management... SEPARATED VETERANS, AND OTHER PROTECTED VETERANS Discrimination Prohibited § 60-250.25 Health insurance...

  7. Determinants of Medicare plan choices: are beneficiaries more influenced by premiums or benefits?

    PubMed

    Jacobs, Paul D; Buntin, Melinda B

    2015-07-01

    To evaluate the sensitivity of Medicare beneficiaries to premiums and benefits when selecting healthcare plans after the introduction of Part D. We matched respondents in the 2008 Medicare Current Beneficiary Survey to the Medicare Advantage (MA) plans available to them using the Bid Pricing Tool and previously unavailable data on beneficiaries' plan choices. We estimated a 2-stage nested logit model of Medicare plan choice decision making, including the decision to choose traditional fee-for-service (FFS) Medicare or an MA plan, and for those choosing MA, which specific plan they chose. Beneficiaries living in areas with higher average monthly rebates available from MA plans were more likely to choose MA rather than FFS. When choosing MA plans, beneficiaries are roughly 2 to 3 times more responsive to dollars spent to reduce cost sharing than reductions in their premium. We calculated an elasticity of plan choice with respect to the monthly MA premium of -0.20. Beneficiaries with lower incomes are more sensitive to plan premiums and cost sharing than higher-income beneficiaries. MA plans appear to have a limited incentive to aggressively price their products, and seem to compete primarily over reduced beneficiary cost sharing. Given the limitations of the current plan choice environment, policies designed to encourage the selection of lower-cost plans may require increasing premium differences between plans and providing the tools to enable beneficiaries to easily assess those differences.

  8. Is law enforcement of drug-impaired driving cost-efficient? An explorative study of a methodology for cost-benefit analysis.

    PubMed

    Veisten, Knut; Houwing, Sjoerd; Mathijssen, M P M René; Akhtar, Juned

    2013-03-01

    Road users driving under the influence of psychoactive substances may be at much higher relative risk (RR) in road traffic than the average driver. Legislation banning blood alcohol concentrations above certain threshold levels combined with roadside breath-testing of alcohol have been in lieu for decades in many countries, but new legislation and testing of drivers for drug use have recently been implemented in some countries. In this article we present a methodology for cost-benefit analysis (CBA) of increased law enforcement of roadside drug screening. This is an analysis of the profitability for society, where costs of control are weighed against the reduction in injuries expected from fewer drugged drivers on the roads. We specify assumptions regarding costs and the effect of the specificity of the drug screening device, and quantify a deterrence effect related to sensitivity of the device yielding the benefit estimates. Three European countries with different current enforcement levels were studied, yielding benefit-cost ratios in the approximate range of 0.5-5 for a tripling of current levels of enforcement, with costs of about 4000 EUR per convicted and in the range of 1.5 and 13 million EUR per prevented fatality. The applied methodology for CBA has involved a simplistic behavioural response to enforcement increase and control efficiency. Although this methodology should be developed further, it is clearly indicated that the cost-efficiency of increased law enforcement of drug driving offences is dependent on the baseline situation of drug-use in traffic and on the current level of enforcement, as well as the RR and prevalence of drugs in road traffic. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Health Plans Respond to Parity: Managing Behavioral Health Care in the Federal Employees Health Benefits Program

    PubMed Central

    Ridgely, M Susan; Burnam, M Audrey; Barry, Colleen L; Goldman, Howard H; Hennessy, Kevin D

    2006-01-01

    The government often uses the Federal Employees Health Benefits (FEHB) Program as a model for both public and private health policy choices. In 2001, the U.S. Office of Personnel Management (OPM) implemented full parity, requiring that FEHB carriers offer mental health and substance abuse benefits equal to general medical benefits. OPM instructed carriers to alter their benefit design but permitted them to determine whether they would manage care and what structures or processes they would use. This article reports on the experience of 156 carriers and the government-wide BlueCross and BlueShield Service Benefit Plan. Carriers dropped cost-restraining benefit limits. A smaller percentage also changed the management of the benefit, but these changes affected the care of many enrollees, making the overall parity effect noteworthy. PMID:16529573

  10. Health plans respond to parity: managing behavioral health care in the Federal Employees Health Benefits Program.

    PubMed

    Ridgely, M Susan; Burnam, M Audrey; Barry, Colleen L; Goldman, Howard H; Hennessy, Kevin D

    2006-01-01

    The government often uses the Federal Employees Health Benefits (FEHB) Program as a model for both public and private health policy choices. In 2001, the U.S. Office of Personnel Management (OPM) implemented full parity, requiring that FEHB carriers offer mental health and substance abuse benefits equal to general medical benefits. OPM instructed carriers to alter their benefit design but permitted them to determine whether they would manage care and what structures or processes they would use. This article reports on the experience of 156 carriers and the government-wide BlueCross and BlueShield Service Benefit Plan. Carriers dropped cost-restraining benefit limits. A smaller percentage also changed the management of the benefit, but these changes affected the care of many enrollees, making the overall parity effect noteworthy.

  11. Ask the experts: the challenges and benefits of flow chemistry to optimize drug development.

    PubMed

    Anderson, Neal; Gernaey, Krist V; Jamison, Timothy F; Kircher, Manfred; Wiles, Charlotte; Leadbeater, Nicholas E; Sandford, Graham; Richardson, Paul

    2012-09-01

    Against a backdrop of a struggling economic and regulatory climate, pharmaceutical companies have recently been forced to develop new ways to provide more efficient technology to meet the demands of a competitive drug industry. This issue, coupled with an increase in patent legislation and a rising generics market, makes these themes common issues in the growth of drug development. As a consequence, the importance of process chemistry and scale-up has never been more under the spotlight. Future Medicinal Chemistry wishes to share the thoughts and opinions of a variety of experts from this field, discussing issues concerning the use of flow chemistry to optimize drug development, the potential regulatory and environmental challenges faced with this, and whether the academic and industrial sectors could benefit from a more harmonized system relevant to process chemistry.

  12. 29 CFR Appendix A to Part 4050 - Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Examples of Designated Benefit Determinations for Missing... PLAN TERMINATIONS MISSING PARTICIPANTS Pt. 4050, App. A Appendix A to Part 4050—Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans With Deemed Distribution Dates on...

  13. 29 CFR Appendix A to Part 4050 - Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Examples of Designated Benefit Determinations for Missing... PLAN TERMINATIONS MISSING PARTICIPANTS Pt. 4050, App. A Appendix A to Part 4050—Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans With Deemed Distribution Dates on...

  14. 29 CFR Appendix A to Part 4050 - Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Examples of Designated Benefit Determinations for Missing... PLAN TERMINATIONS MISSING PARTICIPANTS Pt. 4050, App. A Appendix A to Part 4050—Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans With Deemed Distribution Dates on...

  15. 29 CFR Appendix A to Part 4050 - Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Examples of Designated Benefit Determinations for Missing... PLAN TERMINATIONS MISSING PARTICIPANTS Pt. 4050, App. A Appendix A to Part 4050—Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans With Deemed Distribution Dates on...

  16. Accelerated approval of oncology products: the food and drug administration experience.

    PubMed

    Johnson, John R; Ning, Yang-Min; Farrell, Ann; Justice, Robert; Keegan, Patricia; Pazdur, Richard

    2011-04-20

    We reviewed the regulatory history of the accelerated approval process and the US Food and Drug Administration (FDA) experience with accelerated approval of oncology products from its initiation in December 11, 1992, to July 1, 2010. The accelerated approval regulations allowed accelerated approval of products to treat serious or life-threatening diseases based on surrogate endpoints that are reasonably likely to predict clinical benefit. Failure to complete postapproval trials to confirm clinical benefit with due diligence could result in removal of the accelerated approval indication from the market. From December 11, 1992, to July 1, 2010, the FDA granted accelerated approval to 35 oncology products for 47 new indications. Clinical benefit was confirmed in postapproval trials for 26 of the 47 new indications, resulting in conversion to regular approval. The median time between accelerated approval and regular approval of oncology products was 3.9 years (range = 0.8-12.6 years) and the mean time was 4.7 years, representing a substantial time savings in terms of earlier availability of drugs to cancer patients. Three new indications did not show clinical benefit when confirmatory postapproval trials were completed and were subsequently removed from the market or had restricted distribution plans implemented. Confirmatory trials were not completed for 14 new indications. The five longest intervals from receipt of accelerated approval to July 1, 2010, without completion of trials to confirm clinical benefit were 10.5, 6.4, 5.5, 5.5, and 4.7 years. The five longest intervals between accelerated approval and successful conversion to regular approval were 12.6, 9.7, 8.1, 7.5, and 7.4 years. Trials to confirm clinical benefit should be part of the drug development plan and should be in progress at the time of an application seeking accelerated approval to prevent an ineffective drug from remaining on the market for an unacceptable time.

  17. Are prescription drug insurance choices consistent with expected utility theory?

    PubMed

    Bundorf, M Kate; Mata, Rui; Schoenbaum, Michael; Bhattacharya, Jay

    2013-09-01

    To determine the extent to which people make choices inconsistent with expected utility theory when choosing among prescription drug insurance plans and whether tabular or graphical presentation format influences the consistency of their choices. Members of an Internet-enabled panel chose between two Medicare prescription drug plans. The "low variance" plan required higher out-of-pocket payments for the drugs respondents usually took but lower out-of-pocket payments for the drugs they might need if they developed a new health condition than the "high variance" plan. The probability of a change in health varied within subjects and the presentation format (text vs. graphical) and the affective salience of the clinical condition (abstract vs. risk related to specific clinical condition) varied between subjects. Respondents were classified based on whether they consistently chose either the low or high variance plan. Logistic regression models were estimated to examine the relationship between decision outcomes and task characteristics. The majority of respondents consistently chose either the low or high variance plan, consistent with expected utility theory. Half of respondents consistently chose the low variance plan. Respondents were less likely to make discrepant choices when information was presented in graphical format. Many people, although not all, make choices consistent with expected utility theory when they have information on differences among plans in the variance of out-of-pocket spending. Medicare beneficiaries would benefit from information on the extent to which prescription drug plans provide risk protection. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  18. Guidelines for conducting pharmaceutical budget impact analyses for submission to public drug plans in Canada.

    PubMed

    Marshall, Deborah A; Douglas, Patrick R; Drummond, Michael F; Torrance, George W; Macleod, Stuart; Manti, Orlando; Cheruvu, Lokanadha; Corvari, Ron

    2008-01-01

    Until now, there has been no standardized method of performing and presenting budget impact analyses (BIAs) in Canada. Nevertheless, most drug plan managers have been requiring this economic data to inform drug reimbursement decisions. This paper describes the process used to develop the Canadian BIA Guidelines; describes the Guidelines themselves, including the model template; and compares this guidance with other guidance on BIAs. The intended audience includes those who develop, submit or use BIA models, and drug plan managers who evaluate BIA submissions. The Patented Medicine Prices Review Board (PMPRB) initiated the development of the Canadian BIA Guidelines on behalf of the National Prescription Drug Utilisation Information System (NPDUIS). The findings and recommendations from a needs assessment with respect to BIA submissions were reviewed to inform guideline development. In addition, a literature review was performed to identify existing BIA guidance. The detailed guidance was developed on this basis, and with the input of the NPDUIS Advisory Committee, including drug plan managers from multiple provinces in Canada and a representative from the Canadian Agency for Drugs and Technologies in Health. A Microsoft Excel-based interactive model template was designed to support BIA model development. Input regarding the guidelines and model template was sought from each NPDUIS Advisory Committee member to ensure compatibility with existing drug plan needs. Decisions were made by consensus through multiple rounds of review and discussion. Finally, BIA guidance in Canadian provinces and other countries were compared on the basis of multiple criteria. The BIA guidelines consist of three major sections: Analytic Framework, Inputs and Data Sources, and Reporting Format. The Analytic Framework section contains a discussion of nine general issues surrounding BIAs (model design, analytic perspective, time horizon, target population, costing, scenarios to be compared

  19. 21 CFR 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.84 Section 312.84... Severely-debilitating Illnesses § 312.84 Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. (a) FDA's application of the...

  20. 21 CFR 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.84 Section 312.84... Severely-debilitating Illnesses § 312.84 Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. (a) FDA's application of the...

  1. 21 CFR 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.84 Section 312.84... Severely-debilitating Illnesses § 312.84 Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. (a) FDA's application of the...

  2. 21 CFR 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.84 Section 312.84... Severely-debilitating Illnesses § 312.84 Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. (a) FDA's application of the...

  3. Drug-Drug Interactions, Effectiveness, and Safety of Hormonal Contraceptives in Women Living with HIV.

    PubMed

    Scarsi, Kimberly K; Darin, Kristin M; Chappell, Catherine A; Nitz, Stephanie M; Lamorde, Mohammed

    2016-11-01

    Family planning options, including hormonal contraceptives, are essential for improving reproductive health among the more than 17 million women living with HIV worldwide. For these women, prevention of unintended pregnancy decreases maternal and child mortality, as well as reduces the risk of perinatal HIV transmission. Similarly, treatment of HIV with antiretroviral therapy (ART) is essential for reducing morbidity and mortality among HIV-positive individuals, as well as preventing HIV transmission between sexual partners or from mother to child. Importantly, despite the benefits of hormonal contraceptives, barriers to effective family planning methods exist for HIV-positive women. Specifically, drug-drug interactions can occur between some antiretroviral medications and some hormonal contraceptives, which may influence both contraceptive efficacy and tolerability. In addition, safety concerns have been raised about the impact of hormonal contraceptives on HIV disease progression, tolerability, and the risk of female-to-male HIV transmission. This review article summarizes the potential for drug-drug interactions, tolerability, and contraceptive effectiveness when hormonal contraceptives are combined with ART. In addition, the evidence surrounding the influence of hormonal contraceptives on HIV transmission and HIV disease progression in women living with HIV are summarized.

  4. Benefits planning--what you must know: interview with Daniel Fortuno, AIDS Benefits Counselors. Interview by John S. James.

    PubMed

    Fortuno, D

    1996-09-20

    Daniel Fortuno, a counselor with AIDS Benefits Counselors (ABC), summarizes key insurance and benefits information for persons living with AIDS (PWAs), particularly those who reside in California. Fortuno explains the managed care concept and basic health insurance terms, such as pre-existing conditions, health maintenance organizations (HMOs), preferred provider organizations (PPOs), contestability, and the Consolidated Omnibus Budget Reconciliation Act (COBRA). Fortuno explains a California law that became effective in July 1993 that greatly restricts the ability of health insurance companies to refuse insurance due to preexisting conditions to small groups of persons. This law, AB 1672, makes health insurance available to the sick with little overall rises in prices. Federal insurance laws and regulations that impact PWAs and HIV-positive individuals are outlined. In the interview, Fortuno also discusses Medicaid/Medi-Cal (California's Medicaid), Social Security programs, State disability, and the AIDS Drug Assistance Program. Fortuno offers suggestions for obtaining good private insurance and evaluates the pros and cons of HMOs, PPOs, and indemnity insurance.

  5. Puzzling out the new Medicare. How plan sponsors can understand and use Medicare+Choice to benefit their members and themselves.

    PubMed

    Parahus, S

    1999-01-01

    This article will discuss issues confronting plan sponsors in light of new Medicare+Choice options, and ways of responding to those issues. It will include a section with highlights of the "new" Medicare, including a brief description of new terminology and general descriptions of the different types of "coordinated care plans" and other options, e.g., POS, PPO, HMO, FFS, PSO and MSA. Its principal focus, however, will be on ways that plan sponsors can respond to--and capitalize on--the changes in Medicare and offer retirees a broader array of benefits while at the same time increasing their control over plan costs. The article will introduce the idea of plan sponsors constructing a retiree "flexible benefits" program comprising Medicare+Choice options.

  6. Incentive formularies and changes in prescription drug spending.

    PubMed

    Landon, Bruce E; Rosenthal, Meredith B; Normand, Sharon-Lise T; Spettell, Claire; Lessler, Adam; Underwood, Howard R; Newhouse, Joseph P

    2007-06-01

    To examine the impact of incentive formularies on prescription drug spending shifts in formulary compliance, use of generic medications, and mail-order fulfillment in the year after introduction of a new pharmacy benefit strategy. Pre-post comparison study with matched concurrent control group (difference-indifferences analysis). Study subjects were continuously enrolled patients from a single large health plan in the northeastern United States. Health plan administrative data were used to determine the total, health plan, and out-of-pocket spending in the year before and the year after the introduction of 12 different benefit changes, including 1 in which copayments decreased. Overall, changing from a single-tier or 2-tier formulary to a 3-tier formulary was associated with a decrease in total drug spending of about 5% to 15%. Plan spending decreased more dramatically, about 20%, whereas out-of-pocket spending that resulted from higher copayments increased between 20% and >100%. Changing to an incentive formulary with higher copayments was accompanied by a small but inconsistent decrease in use of nonformulary selections and a concomitant increase in both generic and formulary preferred utilization. Mail-order fulfillment doubled, albeit from a low baseline level. Switching to incentive formulary arrangements with higher levels of copayments generally led to overall lower drug costs and vice versa. These effects varied with the degree of change, level of baseline spending, and magnitude of the copayments. Whether these effects are beneficial overall depends on potential health effects and spillover effects on medical spending.

  7. The UIC ICBG (University of Illinois at Chicago International Cooperative Biodiversity Group) Memorandum of Agreement: a model of benefit-sharing arrangement in natural products drug discovery and development.

    PubMed

    Soejarto, D D; Gyllenhaal, C; Fong, H H S; Xuan, L T; Hiep, N T; Hung, N V; Bich, T Q; Southavong, B; Sydara, K; Pezzuto, J M

    2004-02-01

    The Convention on Biodiversity mandates a new approach to the discovery of natural product drugs, one that incorporates concepts of national ownership of genetic resources, intellectual property rights in traditional knowledge, and sharing of economic benefits with countries that are the source of new natural products. The International Cooperative Biodiversity Group (ICBG) program was established to support experimentation in implementation of the Convention through development and execution of international agreements for bioprospecting. The agreement of one such ICBG program, between the University of Illinois at Chicago and institutions in Vietnam and Laos, is presented here. The core elements contained in the single, five-way Memorandum of Agreement are the arrangements for intellectual property rights, treatment of informed consent, and plans for benefit-sharing (including the sharing of short- and long-term royalty benefits, capacity building, and community reciprocity). Program participants were able to develop a practical and flexible agreement that satisfies the wishes of all institutions that are parties to it.

  8. Cost Sharing, Family Health Care Burden, and the Use of Specialty Drugs for Rheumatoid Arthritis

    PubMed Central

    Karaca-Mandic, Pinar; Joyce, Geoffrey F; Goldman, Dana P; Laouri, Marianne

    2010-01-01

    Objectives To examine the impact of benefit generosity and household health care financial burden on the demand for specialty drugs in the treatment of rheumatoid arthritis (RA). Data Sources/Study Setting Enrollment, claims, and benefit design information for 35 large private employers during 2000–2005. Study Design We estimated multivariate models of the effects of benefit generosity and household financial burden on initiation and continuation of biologic therapies. Data Extraction Methods We defined initiation of biologic therapy as first-time use of etanercept, adalimumab, or infliximab, and we constructed an index of plan generosity based on coverage of biologic therapies in each plan. We estimated the household's burden by summing up the annual out-of-pocket (OOP) expenses of other family members. Principal Findings Benefit generosity affected both the likelihood of initiating a biologic and continuing drug therapy, although the effects were stronger for initiation. Initiation of a biologic was lower in households where other family members incurred high OOP expenses. Conclusions The use of biologic therapy for RA is sensitive to benefit generosity and household financial burden. The increasing use of coinsurance rates for specialty drugs (as under Medicare Part D) raises concern about adverse health consequences. PMID:20831715

  9. Advancing Medication Safety: Establishing a National Action Plan for Adverse Drug Event Prevention.

    PubMed

    Harris, Yael; Hu, Dale J; Lee, Christine; Mistry, Mishale; York, Andrew; Johnson, Tisha K

    2015-08-01

    Adverse drug events (ADEs) are important contributors to preventable morbidity and mortality, comprising one third of all hospital adverse events. In response to growing evidence detailing the high prevalence of ADEs, particularly among vulnerable older adults, Congress requested that the Secretary of the Department of Health and Human Services (HHS) convene a Federal Interagency Steering Committee to establish a National Action Plan to focus on ADE prevention. In August 2014, the Office of Disease Prevention and Health Promotion released the final version of the National Action Plan for Adverse Drug Event Prevention. The Action Plan directly supports the goals of the HHS Strategic Plan and the Patient Protection and Affordable Care Act by providing guidance on tracking and preventing ADEs, as well as describing evidence-based tools and resources to enhance medication safety. ADE ACTION PLAN CONTENT: The Federal Interagency Steering Committee focused the Action Plan on ADEs that are clinically significant, account for the greatest number of measurable harms as identified by using existing surveillance tools, and are largely preventable. As such, the decision was made to target three medication classes: anticoagulants, diabetes agents (insulin and oral hypoglycemic agents), and opioids. The Action Plan is organized around four key areas: surveillance; evidence-based prevention; payment, policy incentives, and oversight; and research opportunities to advance medication safety. One measure of the ADE Action Plan's success will be the wider dissemination of information and educational resources to providers and patients (or consumers) regarding the risks associated with medications. Future Action Plan iterations are likely to consider other high-priority medication classes and update the recommendations.

  10. 29 CFR Appendix A to Part 4050 - Examples of Designated Benefit Determinations for Missing Participants Under § 4050.5 in Plans...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the deemed distribution date, and has a normal retirement benefit of $1,000 per month payable at age... Participants Under § 4050.5 in Plans With Deemed Distribution Dates on and After August 17, 1998 A Appendix A... Benefit Determinations for Missing Participants Under § 4050.5 in Plans With Deemed Distribution Dates on...

  11. Integrated corridor management initiative : demonstration phase evaluation – San Diego benefit-cost analysis test plan.

    DOT National Transportation Integrated Search

    2012-08-01

    This report presents the test plan for conducting the Benefit-Cost Analysis (BCA) for the United States Department of Transportation (U.S. DOT) evaluation of the San Diego Integrated Corridor Management (ICM) Initiative Demonstration. The ICM project...

  12. University Benefits Survey: Part I (All Benefits Excluding Pensions).

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    Information on all benefits, excluding pensions, provided by 16 Ontario universities is presented. The following general questions concerning benefits are covered: administration and insurance plans, communication of benefit programs to employees, proposed changes in benefits, provision of life and dismemberment insurance, and maternity leave…

  13. Design, implementation, and first-year outcomes of a value-based drug formulary.

    PubMed

    Sullivan, Sean D; Yeung, Kai; Vogeler, Carol; Ramsey, Scott D; Wong, Edward; Murphy, Chad O; Danielson, Dan; Veenstra, David L; Garrison, Louis P; Burke, Wylie; Watkins, John B

    2015-04-01

    Value-based insurance design attempts to align drug copayment tier with value rather than cost. Previous implementations of value-based insurance design have lowered copayments for drugs indicated for select "high value" conditions and have found modest improvements in medication adherence. However, these implementations have generally not resulted in cost savings to the health plan, suggesting a need for increased copayments for "low value" drugs. Further, previous implementations have assigned equal copayment reductions to all drugs within a therapeutic area without assessing the value of individual drugs. Aligning the individual drug's copayment to its specific value may yield greater clinical and economic benefits. In 2010, Premera Blue Cross, a large not-for-profit health plan in the Pacific Northwest, implemented a value-based drug formulary (VBF) that explicitly uses cost-effectiveness analyses after safety and efficacy reviews to estimate the value of each individual drug. Concurrently, Premera increased copayments for existing tiers. To describe and evaluate the design, implementation, and first-year outcomes of the VBF. We compared observed pharmacy cost per member per month in the year following the VBF implementation with 2 comparator groups: (1) observed pharmacy costs in the year prior to implementation, and (2) expected costs if no changes were made to the pharmacy benefits. Expected costs were generated by applying autoregressive integrated moving averages to pharmacy costs over the previous 36 months. We used an interrupted time series analysis to assess drug use and adherence among individuals with diabetes, hypertension, or dyslipidemia compared with a group of members in plans that did not implement a VBF.  Pharmacy costs decreased by 3% compared with the 12 months prior and 11% compared with expected costs. There was no significant decline in medication use or adherence to treatments for patients with diabetes, hypertension, or dyslipidemia

  14. Out-of-pocket drug costs and drug utilization patterns of postmenopausal Medicare beneficiaries with osteoporosis.

    PubMed

    Conwell, Leslie Jackson; Esposito, Dominick; Garavaglia, Susan; Meadows, Eric S; Colby, Margaret; Herrera, Vivian; Goldfarb, Seth; Ball, Daniel; Marciniak, Martin

    2011-08-01

    The Medicare Part D coverage gap has been associated with lower adherence and drug utilization and higher discontinuation. Because osteoporosis has a relatively high prevalence among Medicare-eligible postmenopausal women, we examined changes in utilization of osteoporosis medications during this coverage gap. The purpose of this study was to investigate changes in out-of-pocket (OOP) drug costs and utilization associated with the Medicare Part D coverage gap among postmenopausal beneficiaries with osteoporosis. This retrospective analysis of 2007 pharmacy claims focuses on postmenopausal female Medicare beneficiaries enrolled in full-, partial-, or no-gap exposure standard or Medicare Advantage prescription drug plans (PDPs), retiree drug subsidy (RDS) plans, or the low-income subsidy program. We compared beneficiaries with osteoporosis who were taking teriparatide (Eli Lilly and Company, Indianapolis, Indiana) (n = 5657) with matched samples of beneficiaries who were taking nonteriparatide osteoporosis medications (NTO; n = 16,971) or who had other chronic conditions (OCC; n = 16,971). We measured average monthly prescription drug fills and OOP costs, medication discontinuation, and skipping. More than half the sample reached the coverage gap; OOP costs then rose for teriparatide users enrolled in partial- or full-gap exposure plans (increase of 121% and 186%; $300 and $349) but fell for those in no-gap exposure PDPs or RDS plans (decrease of 49% and 30%; $131 and $40). OOP costs for beneficiaries in partial- or full-gap exposure PDPs increased >120% (increase of $144 and $176) in the NTO group and nearly doubled for the OCC group (increase of $124 and $151); these OOP costs were substantially lower than those for teriparatide users. Both teriparatide users and NTO group members discontinued or skipped medications more often than persons in the OCC group, regardless of plan or benefit design. Medication discontinuation and OOP costs among beneficiaries with

  15. The Effect of Pharmacy Benefit Design on Patient-Physician Communication About Costs

    PubMed Central

    Shrank, William H; Fox, Sarah A; Kirk, Adele; Ettner, Susan L; Cantrell, Clairessa H; Glassman, Peter; Asch, Steven M

    2006-01-01

    BACKGROUND Incentive-based formularies have been widely instituted to control the rising costs of prescription drugs. To work properly, such formularies depend on patients to be aware of financial incentives and communicate their cost preferences with prescribing physicians. The impact of financial incentives on patient awareness of and communication about those costs is unknown. OBJECTIVE To evaluate the relationship between enrollment in incentive-based pharmacy benefit plans and awareness of out-of-pocket costs and rates of communication about out-of-pocket costs. DESIGN A matched telephone survey of patients and their primary care physicians. SETTING Los Angeles County. PARTICIPANTS One thousand nine hundred and seventeen patients aged 53 to 82 (73% response rate). MEASUREMENTS Patient-reported pharmacy benefit design, knowledge of out-of-pocket costs, and discussion of out-of-pocket costs with physicians. RESULTS Sixty-two percent of patients who had prescription drug coverage and were aware of their pharmacy benefit design reported being enrolled in incentive-based plans. The majority of these (54%) were “never” or only “sometimes” aware of their out-of-pocket cost requirements at the time of the physician visit. After controlling for numerous physician and patient level variables, we found that patients enrolled in pharmacy benefit designs requiring no copayments were more likely to report they “never” discuss out-of-pocket costs with physicians compared with patients enrolled in incentive-based pharmacy benefit designs (81% vs 67%, P =.001) and patients with no prescription druginsurance (57%, P <.001). CONCLUSIONS Incentive-based pharmacy benefit plans and lack of insurance are associated with increased rates of discussions about out-of-pocket costs. Nonetheless, most incentive-based enrollees are unaware of out-of-pocket costswhen prescriptions are written and never discuss out-of-pocket costs with their physicians, likely mitigating the

  16. Marine Planning Benefits the Environment

    EPA Science Inventory

    Coastal and Marine Spatial Planning (CMSP) and Ecosystem-Based Management (EBM) are management approaches that allow sustainable coastal and ocean planning. The basic unit of management under CMSP is a large region, with the United States coastlines and Great Lakes divided into ...

  17. University Benefits Survey. Part I (All Benefits Excluding Pensions).

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    Results of a 1984 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: questions on general benefits, such as insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, and maternity leave policy;…

  18. A stochastic multicriteria model for evidence-based decision making in drug benefit-risk analysis.

    PubMed

    Tervonen, Tommi; van Valkenhoef, Gert; Buskens, Erik; Hillege, Hans L; Postmus, Douwe

    2011-05-30

    Drug benefit-risk (BR) analysis is based on firm clinical evidence regarding various safety and efficacy outcomes. In this paper, we propose a new and more formal approach for constructing a supporting multi-criteria model that fully takes into account the evidence on efficacy and adverse drug reactions. Our approach is based on the stochastic multi-criteria acceptability analysis methodology, which allows us to compute the typical value judgments that support a decision, to quantify decision uncertainty, and to compute a comprehensive BR profile. We construct a multi-criteria model for the therapeutic group of second-generation antidepressants. We assess fluoxetine and venlafaxine together with placebo according to incidence of treatment response and three common adverse drug reactions by using data from a published study. Our model shows that there are clear trade-offs among the treatment alternatives. Copyright © 2011 John Wiley & Sons, Ltd.

  19. Bird on the wire: Landscape planning considering costs and benefits for bird populations coexisting with power lines.

    PubMed

    D'Amico, Marcello; Catry, Inês; Martins, Ricardo C; Ascensão, Fernando; Barrientos, Rafael; Moreira, Francisco

    2018-02-24

    Power-line grids are increasingly expanding worldwide, as well as their negative impacts on avifauna, namely the direct mortality through collision and electrocution, the reduction of breeding performance, and the barrier effect. On the other hand, some bird species can apparently benefit from the presence of power lines, for example perching for hunting purposes or nesting on electricity towers. In this perspective essay, we reviewed the scientific literature on both costs and benefits for avifauna coexisting with power lines. Overall, we detected a generalized lack of studies focusing on these costs or benefits at a population level. We suggest that a switch in research approach to a larger spatio-temporal scale would greatly improve our knowledge about the actual effects of power lines on bird populations. This research approach would facilitate suitable landscape planning encompassing both mitigation of costs and promotion of benefits for bird populations coexisting with power lines. For example, the strategic route planning of electricity infrastructures would limit collision risk or barrier effects for threatened bird populations. Concurrently, this strategic route planning would promote the range expansion of threatened populations of other bird species, by providing nesting structures in treeless but potentially suitable landscapes. We suggest establishing a collaborative dialogue among the scientific community, governments, and electricity companies, with the aim to produce a win-win scenario in which both biodiversity conservation and infrastructure development are integrated in a common strategy.

  20. Predicting Drug Safety and Communicating Risk: Benefits of a Bayesian Approach.

    PubMed

    Lazic, Stanley E; Edmunds, Nicholas; Pollard, Christopher E

    2018-03-01

    Drug toxicity is a major source of attrition in drug discovery and development. Pharmaceutical companies routinely use preclinical data to predict clinical outcomes and continue to invest in new assays to improve predictions. However, there are many open questions about how to make the best use of available data, combine diverse data, quantify risk, and communicate risk and uncertainty to enable good decisions. The costs of suboptimal decisions are clear: resources are wasted and patients may be put at risk. We argue that Bayesian methods provide answers to all of these problems and use hERG-mediated QT prolongation as a case study. Benefits of Bayesian machine learning models include intuitive probabilistic statements of risk that incorporate all sources of uncertainty, the option to include diverse data and external information, and visualizations that have a clear link between the output from a statistical model and what this means for risk. Furthermore, Bayesian methods are easy to use with modern software, making their adoption for safety screening straightforward. We include R and Python code to encourage the adoption of these methods.

  1. Defined contribution health benefits.

    PubMed

    Fronstin, P

    2001-03-01

    This Issue Brief discusses the emerging issue of "defined contribution" (DC) health benefits. The term "defined contribution" is used to describe a wide variety of approaches to the provision of health benefits, all of which have in common a shift in the responsibility for payment and selection of health care services from employers to employees. DC health benefits often are mentioned in the context of enabling employers to control their outlay for health benefits by avoiding increases in health care costs. DC health benefits may also shift responsibility for choosing a health plan and the associated risks of choosing a plan from employers to employees. There are three primary reasons why some employers currently are considering some sort of DC approach. First, they are once again looking for ways to keep their health care cost increases in line with overall inflation. Second, some employers are concerned that the public "backlash" against managed care will result in new legislation, regulations, and litigation that will further increase their health care costs if they do not distance themselves from health care decisions. Third, employers have modified not only most employee benefit plans, but labor market practices in general, by giving workers more choice, control, and flexibility. DC-type health benefits have existed as cafeteria plans since the 1980s. A cafeteria plan gives each employee the opportunity to determine the allocation of his or her total compensation (within employer-defined limits) among various employee benefits (primarily retirement or health). Most types of DC health benefits currently being discussed could be provided within the existing employment-based health insurance system, with or without the use of cafeteria plans. They could also allow employees to purchase health insurance directly from insurers, or they could drive new technologies and new forms of risk pooling through which health care services are provided and financed. DC health

  2. 75 FR 45166 - Advisory Council on Employee Welfare and Pension Benefit Plans; Nominations for Vacancies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-02

    ... fields of insurance, corporate trust, actuarial counseling, investment counseling, investment management..., 2010. The groups or fields they represent are as follows: (1) Employee organizations (representing an... and Pension Benefit Plans, to represent any of the groups or fields specified in the preceding...

  3. Future delivery of the Drug Interventions Programme: do the benefits justify the costs?

    PubMed

    Osborne, Andrew

    2013-10-01

    The Drug Interventions Programme is an initiative employed by the Home Office in 2003 to integrate the Criminal Justice System with drug treatment services with the ultimate goal of reducing acquisitive crime. Drug Action Teams employ this scheme on a local level by providing a broad range of services for misusers in the community. Although much attention has been placed on societal gains, there is an added benefit in improving the health outcomes of those referred. Opioid replacement therapy decreases illicit heroin use, reduces mortality and maintains contact with misusers allowing for psychosocial intervention. The Drug Interventions Programme provides direct access to such treatment in an otherwise high-risk and disengaged population. Anecdotal evidence of the programme is positive; with improved mental and physical health in offenders and a reduction in hospital admissions. However, monitoring health outcomes in offenders is challenging as long-term follow-up is difficult, poor compliance is an issue and coercive referrals may introduce a reporting bias. Drug Action Team services are cost-effective due a lower consumption of health and social care and reduced offending levels. The Drug Interventions Programme has been successful in maintaining offenders in treatment and the Home Office claim its role in reducing crime is cost-saving. Future delivery of the initiative is at risk due to spending reductions, competing interests and a focus towards payment by results. Opposition to future implementation of the Drug Interventions Programme must be met with evidence for its effectiveness in order to ensure its continued investment. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  4. How drug life-cycle management patent strategies may impact formulary management.

    PubMed

    Berger, Jan; Dunn, Jeffrey D; Johnson, Margaret M; Karst, Kurt R; Shear, W Chad

    2016-10-01

    Drug manufacturers may employ various life-cycle management patent strategies, which may impact managed care decision making regarding formulary planning and management strategies when single-source, branded oral pharmaceutical products move to generic status. Passage of the Hatch-Waxman Act enabled more rapid access to generic medications through the abbreviated new drug application process. Patent expirations of small-molecule medications and approvals of generic versions have led to substantial cost savings for health plans, government programs, insurers, pharmacy benefits managers, and their customers. However, considering that the cost of developing a single medication is estimated at $2.6 billion (2013 dollars), pharmaceutical patent protection enables companies to recoup investments, creating an incentive for innovation. Under current law, patent protection holds for 20 years from time of patent filing, although much of this time is spent in product development and regulatory review, leaving an effective remaining patent life of 7 to 10 years at the time of approval. To extend the product life cycle, drug manufacturers may develop variations of originator products and file for patents on isomers, metabolites, prodrugs, new drug formulations (eg, extended-release versions), and fixed-dose combinations. These additional patents and the complexities surrounding the timing of generic availability create challenges for managed care stakeholders attempting to gauge when generics may enter the market. An understanding of pharmaceutical patents and how intellectual property protection may be extended would benefit managed care stakeholders and help inform decisions regarding benefit management.

  5. Use and Perceived Benefits of Mobile Devices by Physicians in Preventing Adverse Drug Events in the Nursing Home

    PubMed Central

    Handler, Steven M.; Boyce, Richard D.; Ligons, Frank; Perera, Subashan; Nace, David A.; Hochheiser, Harry

    2015-01-01

    Objective Although mobile devices equipped with drug reference software may help prevent adverse drug events (ADEs) in the nursing home (NH) by providing medication information at the point-of-care, little is known about their use and perceived benefits. The goal of this study was to conduct a survey of a nationally representative sample of NH physicians to quantify the use and perceived benefits of mobile devices in preventing ADEs in the NH setting. Design/Setting/Participants We surveyed physicians who attended the 2010 the AMDA Annual Symposium about their use of mobile devices and beliefs about the effectiveness of drug reference software in preventing ADEs. Results The overall net valid response rate was 70% (558/800) with 42% (236/558) using mobile devices to assist with prescribing in the NH. Physicians with ≤15 years clinical experience were 67% more likely to be mobile device users, compared to those with >15 years of clinical experience (odds ratio=1.68; 95% confidence interval=1.17-2.41; p=0.005). For those who used a mobile device to assist with prescribing, almost all (98%) reported performing an average of one or more drug look-ups per day, performed an average of 1-2 lookups per day for potential drug-drug interactions (DDIs), and most (88%) believed that drug reference software had helped to prevent at least one potential ADE in the preceding four-week period. Conclusions The proportion of NH physicians who use mobile devices with drug reference software, while significant, is lower than in other clinical environments. Our results suggest that NH physicians who use mobile devices equipped with drug reference software believe they are helpful for reducing ADEs. Further research is needed to better characterize the facilitators and barriers to adoption of the technology in the NH and its precise impact on NH ADEs. PMID:24094901

  6. Legislations and policies to expand mental health and substance abuse benefits in health insurance plans: a community guide systematic economic review.

    PubMed

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A; Goetzel, Ron Z; Finnie, Ramona; Thota, Anilkrishna B

    2015-03-01

    Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. This review is unable to determine the overall economic value of policies that expanded MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when long-term MH/SA patient-level data becomes available to researchers. A

  7. 76 FR 44047 - Advisory Council on Employee Welfare and Pension Benefit Plans; Nominations for Vacancies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-22

    ... fields of insurance, corporate trust, actuarial counseling, investment counseling, investment management... November 14, 2011. The groups or fields they represent are as follows: (1) Employee organizations; (2... Benefit Plans, to represent any of the groups or fields specified in the preceding paragraph, may submit...

  8. 26 CFR 1.401(a)-15 - Requirement that plan benefits are not decreased on account of certain Social Security increases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... which section 401(a)(15) applies provides an annual benefit at the normal retirement age, 65, in the form of a stated benefit formula amount less a specified percentage of the primary insurance amount payable under title II of the Social Security Act. The plan provides no early retirement benefits. In the...

  9. Ontario Universities Benefits Survey, 1988-89. Part I: Benefits Excluding Pensions.

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    Institutional responses to a survey of Ontario universities concerning employee fringe benefits are reported. Each institution's treatment of these benefits issues is summarized or presented in chart form: general benefits questions (administration of insurance plans, communication of benefits information to employees, proposed benefit changes,…

  10. The Drug Question: The Constitution and Public Policy. Teacher's Guide.

    ERIC Educational Resources Information Center

    Constitutional Rights Foundation, Los Angeles, CA.

    This teacher's guide complements the student text's presentation of lesson plans on the subject of illegal drug use. The booklet begins with an explanation of the benefits of law-related education (LRE) for democratic education. The guide then outlines suggestions for handling controversy; directing discussion; organizing cooperative and small…

  11. Ontario Universities Benefits Survey, 1990-91: Part I, Benefits Excluding Pensions.

    ERIC Educational Resources Information Center

    Council of Ontario Universities, Toronto.

    The report details, in tabular form, non-pension benefits offered by each of 17 Ontario universities. These include: supplementary health insurance; long term disability; sick leave entitlement; sick leave-benefits continuance; long term disability-benefits continuance; life insurance; survivor benefit; dental plan; post-retirement benefits;…

  12. 42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HMO or of transfer from HMO to non-HMO coverage, or exclusions, or limitations based on health status... this selection, lose their eligibility for free-standing dental, optical, or prescription drug benefits... option.) - (ii) The non-HMO option provides free-standing coverage for optical services (such as...

  13. University Benefits Survey. Part I (All Benefits Excluding Pensions).

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    Results of a 1985 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: whether the university self-administers insurance plans, communication of information on benefits, proposed changes in benefits, provision of accidental death and dismemberment insurance,…

  14. University Benefits Survey. Part I (All Benefits Excluding Pensions).

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    Results of a 1986 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: whether the university self- administers insurance plans, communication of benefits, proposed changes in benefits, provision of accidental death and dismemberment insurance, maternity leave…

  15. University Benefits Survey, Part I (All Benefits Excluding Pensions).

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    The results of a survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: whether the university self-administers insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, maternity leave policy, Ontario…

  16. University Benefits Survey. Part 1 (All Benefits Excluding Pensions).

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    Results of a 1983 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: whether the university self-administers insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, maternity leave policy,…

  17. Strategic planning: the basics and benefits.

    PubMed

    Hansen, R D

    1999-01-01

    Strategic planning can help a medical practice take an honest look at itself in light of the changes taking place in its environment and within the practice itself. The objective is for the group to design a plan, or road map, to its envisioned future. For medical practices, strategic planning is a four part process: 1) gaining buy-in for the process itself from the leadership and physicians; 2) gathering pertinent data about the group's environment through external resources, and about the group itself through interviews and surveys of physicians; 3) conducting a facilitated off-site retreat of key physicians and leaders in order to review data, discuss issues and develop a one to two year action plan; and, 4) carrying out the action plan developed at the retreat and measuring its outcomes. A follow-up mini-retreat about six months after the first retreat is highly recommended, as is instituting a process of sharing of the results and outcomes of the plan with all members of the organization.

  18. Your Medicare Benefits

    MedlinePlus

    ... health plans include all Medicare Advantage Plans, Medicare Cost Plans, and Demonstration/Pilot Programs. PACE plans can be offered by public or private entities and provide Part D and other benefits in addition to Part A and Part B ...

  19. The impact of two pharmaceutical risk-sharing agreements on pricing, promotion, and net health benefits.

    PubMed

    Zaric, Gregory S; Xie, Bin

    2009-01-01

    Health insurers are increasingly making use of risk-sharing agreements with drug manufacturers to manage uncertainties regarding the costs and effectiveness of new drugs. Several risk-sharing models exist including those based on sales volume, achievement of clinical thresholds, and achievement of cost-effectiveness thresholds. The objective of this article is to compare two risk-sharing arrangements and to investigate conditions under which each is preferable from the perspective of the payer and the manufacturer. We develop two two-period models to compare two risk-sharing arrangements between a payer and a drug manufacturer in which there is uncertainty about the effectiveness of the new drug. In the first risk-sharing agreement, the drug is listed on a formulary in the first period but delisted in the second period if the net monetary benefit in the first period is negative. In the second risk-sharing agreement, the manufacturer pays a rebate in each period if the net monetary benefit in that period is negative. We show that the relative performance of the two arrangements depends on several factors and that neither arrangement is always preferred. Additionally, we are able to identify situations in which a payer and a manufacturer would prefer the same plan and other situations in which the two parties would disagree on which plan was most desirable. Because neither risk-sharing arrangement is always preferred, payers and manufacturers must carefully consider the characteristics of their individual situation when entering into such contracts.

  20. Estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada.

    PubMed

    Morgan, Steven G; Li, Winny; Yau, Brandon; Persaud, Nav

    2017-02-27

    Canada's universal health care system does not include universal coverage of prescription drugs. We sought to estimate the effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. We used administrative and market research data to estimate the 2015 shares of the volume and cost of prescriptions filled in the community setting that were for 117 drugs on a model list of essential medicines for Canada. We compared prices of these essential medicines in Canada with prices in the United States, Sweden and New Zealand. We estimated the cost of adding universal public drug coverage of these essential medicines based on anticipated effects on medication use and pricing. The 117 essential medicines on the model list accounted for 44% of all prescriptions and 30% of total prescription drug expenditures in 2015. Average prices of generic essential medicines were 47% lower in the US, 60% lower in Sweden and 84% lower in New Zealand; brand-name drugs were priced 43% lower in the US. Estimated savings from universal public coverage of these essential medicines was $4.27 billion per year (range $2.72 billion to $5.83 billion; 28% reduction) for patients and private drug plan sponsors, at an incremental government cost of $1.23 billion per year (range $373 million to $1.98 billion; 11% reduction). Our analysis showed that adding universal public coverage of essential medicines to the existing public drug plans in Canada could address most of Canadians' pharmaceutical needs and save billions of dollars annually. Doing so may be a pragmatic step forward while more comprehensive pharmacare reforms are planned. © 2017 Canadian Medical Association or its licensors.

  1. 26 CFR 1.415(a)-1 - General rules with respect to limitations on benefits and contributions under qualified plans.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and disability benefits); (vii) Section 1.415(b)-1(g)(3) (regarding adjustments to applicable... survivor and disability benefits under governmental plans); (viii) Section 1.415(c)-1(b)(2)(ii) and (3)(iii...)(5) (providing an alternative rule for inclusion of compensation after a severance from employment...

  2. Drug Abuse Assessment, Program Planning and Resource Development in the Black Community.

    ERIC Educational Resources Information Center

    Gunn, Karen S.

    This paper presents a needs assessment project developed to establish drug-related services in a small black community. A literature review reveals the influence of social issues relevant to the population on research methodology, program planning, and social action. The convergent analysis approach used in the needs assessment is explained and…

  3. Prescription drugs: issues of cost, coverage, and quality.

    PubMed

    Copeland, C

    1999-04-01

    only the most efficacious drugs are covered. Anecdotal evidence suggests that copayments for prescriptions are going to increase. Some health plans are including prescription drug costs in their capitated payments to physicians. Furthermore, prescription drug plans are expected to use formularies more aggressively. In 1996, an average 5.47 outpatient prescriptions were written for those ages 55-64, compared with more than eight for those age 65 and older. Inevitably, this translated to significantly more spending for prescription drugs by the elderly. In 1994-1995, the average elderly individual (age 65 or older) spent $558 on prescription drugs, while the average 55-64-year-old spent $355. While prescription drugs are showing sharp price increases, they are also becoming more important in the treatment of many diseases. Consequently, both employers and policymakers must carefully balance the design and cost of a drug benefit so that continual innovation is preserved and the benefit can remain affordable and effective.

  4. Risk Management Plans: are they a tool for improving drug safety?

    PubMed

    Frau, Serena; Font Pous, Maria; Luppino, Maria Rosa; Conforti, Anita

    2010-08-01

    In 2005, new European legislation authorised Regulatory Agencies to require drug companies to submit a risk management plan (RMP) comprising detailed commitments for post-marketing pharmacovigilance. The aim of the study is to describe the characteristics of RMP for 15 drugs approved by the European Medicines Agency (EMA) and their impact on post-marketing safety issues. Of the 90 new Chemical Entities approved through a centralised procedure by the EMA during 2006 and 2007, 15 of them were selected and their safety aspects and relative RMPs analysed. All post-marketing communications released for safety reasons related to these drugs were also considered. A total of 157 safety specifications were established for the drugs assessed. Risk minimisation activities were foreseen for 5 drugs as training activities. Post-marketing safety issues emerged for 12 of them, leading to 39 type II variations in Summary of Product Characteristics (SPC). Nearly half of such variations, 19 (49%), concerned safety aspects not envisaged by the RMPs. Besides this, 9 Safety Communications were published for 6 out of 15 drugs assessed. The present study reveals several critical points on the way RMPs have been implemented. Several activities proposed by the RMPs do not appear to be adequate in dealing with the potential risks of drugs. Poor communication of risk to practitioners and to the public, and above all limited transparency for the total assessment of risk, seem to transform RMPs into a tool to reassure the public when inadequately evaluated drugs are granted premature marketing authorisation.

  5. Weighing up the benefits and harms of a new anti-cancer drug: a survey of Australian oncologists.

    PubMed

    Chim, L; Salkeld, G; Stockler, M R; Mileshkin, L

    2015-08-01

    Little is known about the relative importance that oncologists attribute to the benefits and harms of anti-cancer drugs when considering treatment options with their patients. To quantify the trade-offs made between overall survival, progression-free survival and adverse effects. A web-based survey elicited importance weights for the benefits and harms of bevacizumab or everolimus. Combining the importance weights with trial-based probabilities produced a score and ranking for each treatment option. A total of 40 responses was received for the bevacizumab scenario and 32 for the everolimus scenario. All respondents regarded overall survival and progression-free survival as the most important attributes - more important than avoiding the potential harms regardless of drugs. Among the potential harms, respondents allocated the highest mean importance weight to gastrointestinal (GI) perforation and rated absolute improvement in overall survival as 1.6 times and 2.3 times as important as avoiding GI perforation in the two versions of the bevacizumab scenario respectively. For the everolimus scenario, stomatitis and pneumonitis were allocated the highest mean importance weights with absolute improvement in overall survival rated as 2.2 times as important as avoiding stomatitis/pneumonitis. All 40 respondents (100%) favoured treatment option with bevacizumab to no bevacizumab based on respondents' determined weights for treatment attributes. The converse was found for everolimus with 22 (69%) of respondents preferring the 'no everolimus' option. Oncologists' preferences over the benefits and harms of treatment do, when combined with evidence of effect, influence treatment decisions for anti-cancer drugs. © 2015 Royal Australasian College of Physicians.

  6. 29 CFR 4281.41 - Benefit suspensions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Benefit suspensions. 4281.41 Section 4281.41 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION INSOLVENCY, REORGANIZATION... WITHDRAWAL Benefit Suspensions § 4281.41 Benefit suspensions. If the plan sponsor determines that the plan is...

  7. 29 CFR 4281.41 - Benefit suspensions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Benefit suspensions. 4281.41 Section 4281.41 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION INSOLVENCY, REORGANIZATION... WITHDRAWAL Benefit Suspensions § 4281.41 Benefit suspensions. If the plan sponsor determines that the plan is...

  8. 29 CFR 4281.41 - Benefit suspensions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Benefit suspensions. 4281.41 Section 4281.41 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION INSOLVENCY, REORGANIZATION... WITHDRAWAL Benefit Suspensions § 4281.41 Benefit suspensions. If the plan sponsor determines that the plan is...

  9. 29 CFR 4281.41 - Benefit suspensions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Benefit suspensions. 4281.41 Section 4281.41 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION INSOLVENCY, REORGANIZATION... WITHDRAWAL Benefit Suspensions § 4281.41 Benefit suspensions. If the plan sponsor determines that the plan is...

  10. 29 CFR 4281.41 - Benefit suspensions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Benefit suspensions. 4281.41 Section 4281.41 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION INSOLVENCY, REORGANIZATION... WITHDRAWAL Benefit Suspensions § 4281.41 Benefit suspensions. If the plan sponsor determines that the plan is...

  11. Questions and answers on employee benefit issues.

    PubMed

    1994-06-01

    This Issue Brief addresses 19 topics in the areas of pensions, health insurance, and other benefits. In addition to the topics listed below, the report includes data on the prevalence of benefits, tax incentives associated with benefits, lump-sum distributions, number of private pension plans, pension coverage rates, 401(k) plans, employer spending on group health insurance, self-insured health plans, employer initiatives to reduce health care costs, and employers' response to the retiree health benefits accounting rule, and flexible benefits plans. In 1992, U.S. employers (public and private) spent $629 billion for noncash benefits, representing nearly 18 percent of total compensation, excluding paid time off. In 1992, 71 percent of the 50.1 million individuals aged 55 and over received retirement benefits, including distributions from private and public pensions, annuities, individual retirement accounts, Keoghs, 401(k)s, and Social Security. Among the 76 percent of all private pension plan participants who participated in a single plan, 30 percent named a defined benefit plan as their pension plan type, 58 percent named a defined contribution plan as their pension plan type, and 12 percent did not know their plan type. Private and public pension funds held more than $4.6 trillion in assets at the end of 1993. The 1993 year-end assets are more than triple the asset level of 1983 (nominal terms). According to the Congressional Budget Office, U.S. expenditures on health care were expected to have reached $898 billion in 1993, up from $751.8 billion in 1991, an increase of 19.4 percent in nominal terms.

  12. Strategic benefits of master facility plans.

    PubMed

    Shannon, K

    1996-02-01

    In recent years, many healthcare executives have stopped developing master facility plans due to some basic misconceptions about them, namely that master facility plans are too rigid or require major capital commitment. By getting past these misconceptions, healthcare executives can help their organizations develop and implement master facility plans that serve as flexible, reliable blueprints in guiding the organizations toward achieving their strategic, operational, and financial goals.

  13. Remote controlled capsules in human drug absorption (HDA) studies.

    PubMed

    Wilding, Ian R; Prior, David V

    2003-01-01

    The biopharmaceutical complexity of today's new drug candidates provides significant challenges for pharmaceutical scientists in terms of both candidate selection and optimizing subsequent development strategy. In addition, life cycle management of marketed drugs has become an important income stream for pharmaceutical companies, but the selection of least risk/highest benefit strategies is far from simple. The proactive adoption of human drug absorption (HDA) studies using remote controlled capsules offers the pharmaceutical scientist significant guidance for planning a route through the maze of product development. This review examines the position of HDA studies in drug development, using a variety of case histories and an insightful update on remote controlled capsules to achieve site-specific delivery.

  14. Cost-effective river rehabilitation planning: optimizing for morphological benefits at large spatial scales.

    PubMed

    Langhans, Simone D; Hermoso, Virgilio; Linke, Simon; Bunn, Stuart E; Possingham, Hugh P

    2014-01-01

    River rehabilitation aims to protect biodiversity or restore key ecosystem services but the success rate is often low. This is seldom because of insufficient funding for rehabilitation works but because trade-offs between costs and ecological benefits of management actions are rarely incorporated in the planning, and because monitoring is often inadequate for managers to learn by doing. In this study, we demonstrate a new approach to plan cost-effective river rehabilitation at large scales. The framework is based on the use of cost functions (relationship between costs of rehabilitation and the expected ecological benefit) to optimize the spatial allocation of rehabilitation actions needed to achieve given rehabilitation goals (in our case established by the Swiss water act). To demonstrate the approach with a simple example, we link costs of the three types of management actions that are most commonly used in Switzerland (culvert removal, widening of one riverside buffer and widening of both riversides) to the improvement in riparian zone quality. We then use Marxan, a widely applied conservation planning software, to identify priority areas to implement these rehabilitation measures in two neighbouring Swiss cantons (Aargau, AG and Zürich, ZH). The best rehabilitation plans identified for the two cantons met all the targets (i.e. restoring different types of morphological deficits with different actions) rehabilitating 80,786 m (AG) and 106,036 m (ZH) of the river network at a total cost of 106.1 Million CHF (AG) and 129.3 Million CH (ZH). The best rehabilitation plan for the canton of AG consisted of more and better connected sub-catchments that were generally less expensive, compared to its neighbouring canton. The framework developed in this study can be used to inform river managers how and where best to spend their rehabilitation budget for a given set of actions, ensures the cost-effective achievement of desired rehabilitation outcomes, and helps

  15. Analysis of the Risks and Benefits of New Chemical Entities Approved by the US Food and Drug Administration (FDA) and Subsequently Withdrawn From the US Market.

    PubMed

    Patriarca, Peter A; Van Auken, R Michael; Kebschull, Scott A

    2018-01-01

    Benefit-risk evaluations of drugs have been conducted since the introduction of modern regulatory systems more than 50 years ago. Such judgments are typically made on the basis of qualitative or semiquantitative approaches, often without the aid of quantitative assessment methods, the latter having often been applied asymmetrically to place emphasis on benefit more so than harm. In an effort to preliminarily evaluate the utility of lives lost or saved, or quality-adjusted life-years (QALY) lost and gained as a means of quantitatively assessing the potential benefits and risks of a new chemical entity, we focused our attention on the unique scenario in which a drug was initially approved based on one set of data, but later withdrawn from the market based on a second set of data. In this analysis, a dimensionless risk to benefit ratio was calculated in each instance, based on the risk and benefit quantified in similar units. The results indicated that FDA decisions to approve the drug corresponded to risk to benefit ratios less than or equal to 0.136, and that decisions to withdraw the drug from the US market corresponded to risk to benefit ratios greater than or equal to 0.092. The probability of FDA approval was then estimated using logistic regression analysis. The results of this analysis indicated that there was a 50% probability of FDA approval if the risk to benefit ratio was 0.121, and that the probability approaches 100% for values much less than 0.121, and the probability approaches 0% for values much greater than 0.121. The large uncertainty in these estimates due to the small sample size and overlapping data may be addressed in the future by applying the methodology to other drugs.

  16. Use and perceived benefits of mobile devices by physicians in preventing adverse drug events in the nursing home.

    PubMed

    Handler, Steven M; Boyce, Richard D; Ligons, Frank M; Perera, Subashan; Nace, David A; Hochheiser, Harry

    2013-12-01

    Although mobile devices equipped with drug reference software may help prevent adverse drug events (ADEs) in the nursing home (NH) by providing medication information at the point of care, little is known about their use and perceived benefits. The goal of this study was to conduct a survey of a nationally representative sample of NH physicians to quantify the use and perceived benefits of mobile devices in preventing ADEs in the NH setting. We surveyed physicians who attended the 2010 American Medical Directors Association Annual Symposium about their use of mobile devices, and beliefs about the effectiveness of drug reference software in preventing ADEs. The overall net valid response rate was 70% (558/800) with 42% (236/558) using mobile devices to assist with prescribing in the NH. Physicians with 15 or fewer years of clinical experience were 67% more likely to be mobile device users, compared with those with more than 15 years of clinical experience (odds ratio = 1.68; 95% confidence interval = 1.17-2.41; P = .005). For those who used a mobile device to assist with prescribing, almost all (98%) reported performing an average of 1 or more drug look-ups per day, performed an average of 1 to 2 lookups per day for potential drug-drug interactions (DDIs), and most (88%) believed that drug reference software had helped to prevent at least 1 potential ADE in the preceding 4-week period. The proportion of NH physicians who use mobile devices with drug reference software, although significant, is lower than in other clinical environments. Our results suggest that NH physicians who use mobile devices equipped with drug reference software believe they are helpful for reducing ADEs. Further research is needed to better characterize the facilitators and barriers to adoption of the technology in the NH and its precise impact on NH ADEs. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  17. Transforming Barriers into Bridges: The Benefits of a Student-Driven Accessibility Planning Committee. Practice Brief

    ERIC Educational Resources Information Center

    Cragg, Stephanie J.; Carter, Irene; Nikolova, Kristina

    2013-01-01

    The School of Social Work and Disability Studies Accessibility Planning Committee (APC) is a student-driven initiative that has been in existence for over 10 years. This practice brief looked at the committee through interviews with faculty and student members. The investigation aimed to determine whether the benefits of having a student-driven…

  18. Retiree health benefits-vesting of welfare benefits-early retirement-duty to bargain-termination of benefits-estoppel.

    PubMed

    2010-01-01

    Poore v. Simpson Paper Co., 2009 U.S. App. LEXIS 11170 (9th Cir. Or. May 21, 2009). To be able to sue under ERISA, retirement health plan participants need not show that their benefits are vested the same way pension benefits are vested; the rights to the benefits need not be fixed or unalterable, rather, the employee must have an entitlement to the benefits.

  19. [Cost-benefit analysis of the implementation of automated drug-dispensing systems in Critical Care and Emergency Units].

    PubMed

    Poveda Andrés, J L; García Gómez, C; Hernández Sansalvador, M; Valladolid Walsh, A

    2003-01-01

    To determine monetary impact when traditional drug floor stocks are replaced by Automated Drug Dispensing Systems (ADDS) in the Medical Intensive Care Unit, Surgical Intensive Care Unit and the Emergency Room. We analysed four different flows considered to be determinant when implementing ADDS in a hospital environment: capital investment, staff costs, inventory costs and costs related to drug use policies. Costs were estimated by calculation of the current net value. Its analysis shows that those expenses derived from initial investment are compensated by the three remaining flows, with costs related to drug use policies showing the most substantial savings. Five years after initial investment, global cash-flows have been estimated at 300.525 euros. Replacement of traditional floor stocks by ADDS in the Medical Intensive Care Unit, Surgery Intensive Care Unit and the Emergency Room produces a positive benefit/cost ratio (1.95).

  20. Angiotensin receptor blockers on the formularies of Medicare drug plans.

    PubMed

    Gellad, Walid F; Huskamp, Haiden A; Phillips, Kathryn A; Haas, Jennifer S

    2007-08-01

    The presence of angiotensin receptor blockers (ARBs) on the formularies of Medicare Part D prescription drug plans (PDPs) is vitally important to the health of seniors who cannot tolerate angiotensin-converting enzyme (ACE) inhibitors. To determine whether ARBs are present on the formularies of PDPs and how the prescription cost-sharing for ARBs under Part D compares to cost-sharing before Part D. Cross-sectional analyses of March 2006 Medicare Part D formularies (n = 1,446) and of ARB utilization and cost-sharing for adults over the age of 64 included in the nationally representative Medical Expenditure Panel Survey. (1) Presence of ARBs on Part D formularies. (2) Average out-of-pocket costs for 30-day supply of ARBs before and after Part D (both in 2006 dollars). All PDP formularies included at least 1 ARB. Most plans covered 2 ARBs (41%) and 35% covered all 7. The average monthly copay for the most commonly used ARB, valsartan, is $28 under part D, $14 before Part D for individuals with prescription coverage, and $53 before Part D for individuals without coverage. Whereas ARBs are present on all Part D formularies, many seniors will pay more for these drugs under Part D. Any savings in copayments under Part D may be erased by the monthly premium and by more expensive cost-sharing when seniors reach the 'donut hole'.

  1. Effect of educational intervention on knowledge, perceived benefits, barriers and self-efficacy regarding AIDS preventive behaviors among drug addicts

    PubMed Central

    Bastami, Fatemeh; Mostafavi, Firoozeh; Hassanzadeh, Akbar

    2015-01-01

    Background and Objectives: Addicts account for approximately 68.15% of AIDS cases in Iran and injection drug users are considered as a major factor in the spread of AIDS in Iran. The purpose of this study was to determine the effect of an educational intervention on the perceived self-efficacy, benefits, and barriers concerning AIDS preventive behaviors among drug addicts in Khorramabad, Iran. Methods: This is a quasi-experimental study carried out in 2013 on 88 addicts kept in rehabilitations center in Khorramabad. The data collection instruments included a questionnaire on self-efficacy, perceived benefits, perceived barriers, knowledge and preventive behaviors regarding HIV. Data were analyzed by paired t-test, independent t-test, Chi-square and analysis of covariance. Results: Paired t-test showed that the mean scores for perceived benefits and barriers, knowledge and preventive behaviors significantly increased in the intervention group after the intervention than before the intervention. But the increase in self-efficacy score was not statistically significant. Conclusions: The results of this study showed that training and education based on the health belief model led to an increase in knowledge, self-efficacy, perceived benefits, performance and reduction in perceived barriers in addicts. It is recommended that future studies should include strategies for enhancing self-efficacy and perceived benefits as well as strategies for reducing barriers to the adoption of preventive behaviors. PMID:27462632

  2. Does variation among provincial drug formulary antimicrobial listings in Canada influence prescribing rates?

    PubMed

    Glass-Kaastra, Shiona K; Finley, Rita; Hutchinson, Jim; Patrick, David M; Weiss, Karl; Conly, John

    2014-01-01

    The financial accessibility of antimicrobial drugs to the outpatient community in Canada is governed at the provincial level through formularies. Each province may choose to list particular drugs or impose restriction criteria on products in order to guide prescribing and/or curtail costs. Although changes to formularies have been shown to change patterns in the use of individual products and alter costs, no comparison has been made among the provincial antimicrobial formularies with regards to flexibility/stringency, or an assessment of how these formularies impact overall antimicrobial use in the provinces. To summarize provincial antimicrobial formularies and assess whether their relative flexibility/stringency had a statistical impact upon provincial prescription volume during a one year period. Provincial drug plan formularies were accessed and summarized for all prescribed antimicrobials in Canada during 2010. The number of general and restricted benefits for each plan was compiled by antimicrobial classification. Population-adjusted prescription rates for all individual antimicrobials and by antimicrobial class were obtained from the Canadian Integrated Program for Antimicrobial Resistance Surveillance. Correlations between the number of general benefits, restricted benefits, and total benefits with the prescription rate in the provinces were assessed by Spearman rank correlation coefficients. Formularies varied considerably among the Canadian provinces. Quebec had the most flexible formulary, offering the greatest number of general benefits and fewest restrictions. In contrast, Saskatchewan's formulary displayed the lowest number of general benefits and most restrictions. Correlation analyses detected a single significant result; macrolide prescription rates decreased as the number of general macrolide benefits increased. All other rates of provincial antimicrobial prescribing and measures of flexibility/stringency revealed no significant correlations

  3. Ontario Universities Benefits Survey, 1989-90. Part I: Benefits Excluding Pensions.

    ERIC Educational Resources Information Center

    Council of Ontario Universities, Toronto.

    The report compares benefits offered to employees of 17 universities in Ontario, Canada. The report, which is entirely in tabular form, presentation of universities' responses to general benefits questions, such as the administration of insurance plans, communication of benefits to employees, proposed changes in benefits, provision of accidental…

  4. The value and benefits of the International Conference on Harmonisation to drug regulatory authorities: advancing harmonization for better public health.

    PubMed

    Molzon, J A; Giaquinto, A; Lindstrom, L; Tominaga, T; Ward, M; Doerr, P; Hunt, L; Rago, L

    2011-04-01

    The International Conference on Harmonisation (ICH) is an unparalleled undertaking, which has brought together drug regulatory authorities and pharmaceutical trade associations from Europe, Japan, and the United States, to discuss the scientific and technical aspects of medical product registration. Launched in 1990, the value and benefits of ICH to regulators are being realized. ICH has harmonized submission requirements and created a harmonized submission format that is relieving both companies and regulatory authorities of the burdens of assembling and reviewing separate submissions for each region. As more countries embrace ICH guidelines, we anticipate additional benefits, including the promotion of good review practices and, ultimately, a common regulatory language that will facilitate further interactions among global drug regulatory authorities.

  5. 29 CFR 4041A.43 - Benefit forms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Benefit forms. 4041A.43 Section 4041A.43 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS TERMINATION OF MULTIEMPLOYER PLANS Closeout of Sufficient Plans § 4041A.43 Benefit forms. (a) General rule. Except as provided...

  6. 29 CFR 4041A.43 - Benefit forms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Benefit forms. 4041A.43 Section 4041A.43 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS TERMINATION OF MULTIEMPLOYER PLANS Closeout of Sufficient Plans § 4041A.43 Benefit forms. (a) General rule. Except as provided...

  7. 29 CFR 4041A.43 - Benefit forms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Benefit forms. 4041A.43 Section 4041A.43 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS TERMINATION OF MULTIEMPLOYER PLANS Closeout of Sufficient Plans § 4041A.43 Benefit forms. (a) General rule. Except as provided...

  8. 29 CFR 4041A.43 - Benefit forms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Benefit forms. 4041A.43 Section 4041A.43 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS TERMINATION OF MULTIEMPLOYER PLANS Closeout of Sufficient Plans § 4041A.43 Benefit forms. (a) General rule. Except as provided...

  9. 29 CFR 4041A.43 - Benefit forms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Benefit forms. 4041A.43 Section 4041A.43 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION PLAN TERMINATIONS TERMINATION OF MULTIEMPLOYER PLANS Closeout of Sufficient Plans § 4041A.43 Benefit forms. (a) General rule. Except as provided...

  10. 42 CFR 417.155 - How the HMO option must be included in the health benefits plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... in its health benefits plan. (3) In all cases, the HMO has the right to include, with the basic... OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS...-standing” health benefits—(1) Basic requirement. At the request of a qualified HMO, the employing entity or...

  11. 78 FR 24235 - 166th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-24

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 166th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority contained in Section 512 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1142, the 166th open meeting of the Advisory Council on...

  12. 76 FR 36578 - 156th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-22

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 156th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority contained in Section 512 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1142, the 156th open meeting of the Advisory Council on...

  13. 77 FR 44676 - 162nd Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-30

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 162nd Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority contained in Section 512 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1142, the 162nd open meeting of the Advisory Council on...

  14. 75 FR 57063 - 153rd Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-17

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 153rd Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority contained in Section 512 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1142, the 153rd open meeting of the Advisory Council on...

  15. 76 FR 48903 - 157th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 157th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority contained in Section 512 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1142, the 157th open meeting of the Advisory Council on...

  16. 75 FR 47636 - 152nd Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 152nd Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority contained in Section 512 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1142, the 152nd open meeting of the Advisory Council on...

  17. 77 FR 28406 - 161st Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-14

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 161st Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority contained in Section 512 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1142, the 161st open meeting of the Advisory Council on...

  18. 78 FR 44600 - 167th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ... DEPARTMENT OF LABOR Employee Benefits Security Administration 167th Meeting of the Advisory Council on Employee Welfare and Pension Benefit Plans; Notice of Meeting Pursuant to the authority contained in Section 512 of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1142, the 167th open meeting of the Advisory Council on...

  19. Managing prescription drug costs: a case study.

    PubMed

    DuBois, R W; Feinberg, P E

    1994-06-01

    Pharmacy costs in most private insurance companies and public concerns have risen over the past several years. To address the problem of increased expenditures in its government employee pharmacy program, the State of New York sought bids from outside vendors to help it control pharmaceutical costs. The following is a case study of the tools the state employed in that effort. Over time, both prescription drug coverage and mental health and substance abuse benefits were carved out of the medical plan and are now provided under free-standing programs. In order to participate, an independent pharmacy must accept a discount of 10% off the average wholesale price of brand name drugs and 25% off the average generic price of generic drugs.

  20. Consumer participation in the planning and delivery of drug treatment services: the current arrangements.

    PubMed

    Bryant, Joanne; Saxton, Melissa; Madden, Annie; Bath, Nicky; Robinson, Suzanne

    2008-03-01

    Consumer participation in decision-making about service planning is common in certain health services in Australia but is thought to be largely underdeveloped in drug treatment services. This paper (1) describes the current practices within Australian drug treatment services that aim to include consumers in service planning and provision; and (2) determines how much consumers know about the existing opportunities for involvement. Sixty-four randomly selected service providers (representing 64 separate services) completed interviews about the current arrangements for consumer participation within their services (response rate = 82%). A total of 179 consumers completed interviews assessing their knowledge of the consumer participation activities available at the service they attended. Consumer participation activities were not uncommon in drug treatment services, although the existing activities were concerned largely with providing information to or receiving information from consumers. Activities that included consumers in higher forms of involvement, such as those in which consumers took part in decision-making, were largely uncommon. Consumers had a considerable lack of knowledge about the participation activities available to them, revealing a lack of communication between providers and consumers. While service providers were making efforts to engage consumers in service planning and provision (despite the general lack of State or Commonwealth policy directives and extra funding to do so), these appear ineffectual because of poor communication between providers and consumers. As a starting point, a critical part of any meaningful consumer participation initiative must include systems to ensure that consumers know about available opportunities.

  1. Do Patients of Subspecialist Physicians Benefit from Written Asthma Action Plans?

    PubMed Central

    Mellins, Robert B.; Dimango, Emily; Serebrisky, Denise; Zhang, Yuan; Bye, Michael R.; Dovey, Mark E.; Nachman, Sami; Hutchinson, Vincent; Evans, David

    2015-01-01

    Rationale: Asthma clinical guidelines suggest written asthma action plans are essential for improving self-management and outcomes. Objectives: To assess the efficacy of written instructions in the form of a written asthma action plan provided by subspecialist physicians as part of usual asthma care during office visits. Methods: A total of 407 children and adults with persistent asthma receiving first-time care in pulmonary and allergy practices at 4 urban medical centers were randomized to receive either written instructions (n = 204) or no written instructions other than prescriptions (n = 203) from physicians. Measurements and Main Results: Using written asthma action plan forms as a vehicle for providing self-management instructions did not have a significant effect on any of the primary outcomes: (1) asthma symptom frequency, (2) emergency visits, or (3) asthma quality of life from baseline to 12-month follow-up. Both groups showed similar and significant reductions in asthma symptom frequency (daytime symptoms [P < 0.0001], nocturnal symptoms [P < 0.0001], β-agonist use [P < 0.0001]). There was also a significant reduction in emergency visits for the intervention (P < 0.0001) and control (P < 0.0006) groups. There was significant improvement in asthma quality-of-life scores for adults (P < 0.0001) and pediatric caregivers (P < 0.0001). Conclusions: Our results suggest that using a written asthma action plan form as a vehicle for providing asthma management instructions to patients with persistent asthma who are receiving subspecialty care for the first time confers no added benefit beyond subspecialty-based medical care and education for asthma. Clinical trial registered with www.clinicaltrials.gov (NCT 00149461). PMID:25867075

  2. Patient, physician, pharmacy, and pharmacy benefit design factors related to generic medication use.

    PubMed

    Shrank, William H; Stedman, Margaret; Ettner, Susan L; DeLapp, Dee; Dirstine, June; Brookhart, M Alan; Fischer, Michael A; Avorn, Jerry; Asch, Steven M

    2007-09-01

    Increased use of generic medications conserves insurer and patient financial resources and may increase patient adherence. The objective of the study is to evaluate whether physician, patient, pharmacy benefit design, or pharmacy characteristics influence the likelihood that patients will use generic drugs Observational analysis of 2001-2003 pharmacy claims from a large health plan in the Western United States. We evaluated claims for 5,399 patients who filled a new prescription in at least 1 of 5 classes of chronic medications with generic alternatives. We identified patients initiated on generic drugs and those started on branded medications who switched to generic drugs in the subsequent year. We used generalized estimating equations to perform separate analyses assessing the relationship between independent variables and the probability that patients were initiated on or switched to generic drugs. Of the 5,399 new prescriptions filled, 1,262 (23.4%) were generics. Of those initiated on branded medications, 606 (14.9%) switched to a generic drug in the same class in the subsequent year. After regression adjustment, patients residing in high-income zip codes were more likely to initiate treatment with a generic than patients in low-income regions (RR = 1.29; 95% C.I. 1.04-1.60); medical subspecialists (RR = 0.82; 0.69-0.95) and obstetrician/gynecologists (RR = 0.81; 0.69-0.98) were less likely than generalist physicians to initiate generics. Pharmacy benefit design and pharmacy type were not associated with initiation of generic medications. However, patients were over 2.5 times more likely to switch from branded to generic medications if they were enrolled in 3-tier pharmacy plans (95% C.I. 1.12-6.09), and patients who used mail-order pharmacies were 60% more likely to switch to a generic (95% C.I. 1.18-2.30) after initiating treatment with a branded drug. Physician and patient factors have an important influence on generic drug initiation, with the patients who

  3. Economic Effects of Legislations and Policies to Expand Mental Health and Substance Abuse Benefits in Health Insurance Plans: A Community Guide Systematic Review

    PubMed Central

    Jacob, Verughese; Qu, Shuli; Chattopadhyay, Sajal; Sipe, Theresa Ann; Knopf, John A.; Goetzel, Ron Z.; Finnie, Ramona; Thota, Anilkrishna B.

    2015-01-01

    Background Health insurance plans have historically limited the benefits for mental health and substance abuse (MH/SA) services compared to benefits for physical health services. In recent years, legislative and policy initiatives in the U.S. have been taken to expand MH/SA health insurance benefits and achieve parity with physical health benefits. The relevance of these legislations for international audiences is also explored, particularly for the European context. Aims of the Study This paper reviews the evidence of costs and economic benefits of legislative or policy interventions to expand MH/SA health insurance benefits in the U.S. The objectives are to assess the economic value of the interventions by comparing societal cost to societal benefits, and to determine impact on costs to insurance plans resulting from expansion of these benefits. Methods The search for economic evidence covered literature published from January 1950 to March 2011 and included evaluations of federal and state laws or rules that expanded MH/SA benefits as well as voluntary actions by large employers. Two economists screened and abstracted the economic evidence of MH/SA benefits legislation based on standard economic and actuarial concepts and methods. Results The economic review included 12 studies: eleven provided evidence on cost impact to health plans, and one estimated the effect on suicides. There was insufficient evidence to determine if the intervention was cost-effective or cost-saving. However, the evidence indicates that MH/SA benefits expansion did not lead to any substantial increase in costs to insurance plans, measured as a percentage of insurance premiums. Discussion and Limitations This review is unable to determine the overall economic value of policies that expand MH/SA insurance benefits due to lack of cost-effectiveness and cost-benefit studies, predominantly due to the lack of evaluations of morbidity and mortality outcomes. This may be remedied in time when

  4. Does bargaining affect Medicare prescription drug plan reimbursements to independent pharmacies?

    PubMed

    Tang, Yuexin; Xie, Yang; Urmie, Julie M; Doucette, William R

    2011-01-01

    To examine how pharmacy bargaining activities affect reimbursement rates in Medicare Part D prescription drug plan (PDP) contracts, controlling for pharmacy quality attributes, market structures, and area socioeconomic status. Cross-sectional study. Six Medicare regions throughout the United States between October and December 2009. Random sample of 1,650 independent pharmacies; 321 returned surveys containing sufficient responses for analysis. Pharmacies were surveyed regarding PDP reimbursement rates, costs, and cash prices of two popular prescription drugs (atorvastatin calcium [Lipitor-Pfizer] and lisinopril, 1-month supply of a common strength), as well as pharmacy bargaining activities and quality attributes. Data also were used from the National Council for Prescription Drug Programs pharmacy database, the 2000 U. S. Census, and the 2006 Economic Census on local market structures and area socio-economic status. PDP reimbursement rates. For the brand-name drug atorvastatin calcium, the PDP reimbursement was positively related to a pharmacy's request for a contract change (β = 0.887, P < 0.05), whereas other bargaining activities were not significantly related to PDP reimbursement. However, for the generic drug lisinopril, no bargaining activities were found to be significantly related to the PDP reimbursement. Pharmacy request for a contract change was associated with higher reimbursement rates for the brand-name drug atorvastatin calcium in PDP contracts, after controlling for pharmacy quality attributes, local market structures, and area socioeconomic status; this finding likely applies to other brand-name drugs because of the structure of the contracts. Our results suggest that independent pharmacies are more likely to acquire higher reimbursement rates by engaging in active bargaining with third-party payers.

  5. Planning for chronic disease medications in disaster: perspectives from patients, physicians, pharmacists, and insurers.

    PubMed

    Carameli, Kelley A; Eisenman, David P; Blevins, Joy; d'Angona, Brian; Glik, Deborah C

    2013-06-01

    Recent US disasters highlight the current imbalance between the high proportion of chronically ill Americans who depend on prescription medications and their lack of medication reserves for disaster preparedness. We examined barriers that Los Angeles County residents with chronic illness experience within the prescription drug procurement system to achieve recommended medication reserves. A mixed methods design included evaluation of insurance pharmacy benefits, focus group interviews with patients, and key informant interviews with physicians, pharmacists, and insurers. Most prescriptions are dispensed as 30-day units through retail pharmacies with refills available after 75% of use, leaving a monthly medication reserve of 7 days. For patients to acquire 14- to 30-day disaster medication reserves, health professionals interviewed supported 60- to 100-day dispensing units. Barriers included restrictive insurance benefits, patients' resistance to mail order, and higher copay-ments. Physicians, pharmacists, and insurers also varied widely in their preparedness planning and collective mutual-aid plans, and most believed pharmacists had the primary responsibility for patients' medication continuity during a disaster. To strengthen prescription drug continuity in disasters, recommendations include the following: (1) creating flexible drug-dispensing policies to help patients build reserves, (2) training professionals to inform patients about disaster planning, and (3) building collaborative partnerships among system stakeholders.

  6. 42 CFR 417.592 - Additional benefits requirement.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Additional benefits requirement. 417.592 Section... PLANS, AND HEALTH CARE PREPAYMENT PLANS Medicare Payment: Risk Basis § 417.592 Additional benefits...) Additional benefits. Provide its Medicare enrollees with additional benefits in accordance with paragraph (c...

  7. 42 CFR 417.164 - Effect of revocation of qualification on inclusion in employee's health benefit plans.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Effect of revocation of qualification on inclusion... Qualified Health Maintenance Organizations § 417.164 Effect of revocation of qualification on inclusion in... rules apply: (a) The HMO may not seek inclusion in employees health benefits plans under subpart E of...

  8. 42 CFR 417.164 - Effect of revocation of qualification on inclusion in employee's health benefit plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Effect of revocation of qualification on inclusion... Qualified Health Maintenance Organizations § 417.164 Effect of revocation of qualification on inclusion in... rules apply: (a) The HMO may not seek inclusion in employees health benefits plans under subpart E of...

  9. Ontario Universities Benefits Survey, 1987-88. Part I: Benefits Excluding Pensions.

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    Results of the 1987-1988 survey of benefits, excluding pensions, for 17 Ontario, Canada, universities are presented. Information is provided on the following areas: administration and insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, maternity leave policy, Ontario health…

  10. Drug waste minimization as an effective strategy of cost-containment in Oncology

    PubMed Central

    2014-01-01

    Background Sustainability of cancer care is a crucial issue for health care systems worldwide, even more during a time of economic recession. Low-cost measures are highly desirable to contain and reduce expenditures without impairing the quality of care. In this paper we aim to demonstrate the efficacy of drug waste minimization in reducing drug-related costs and its importance as a structural measure in health care management. Methods We first recorded intravenous cancer drugs prescription and amount of drug waste at the Oncology Department of Udine, Italy. Than we developed and applied a protocol for drug waste minimization based on per-pathology/per-drug scheduling of chemotherapies and pre-planned rounding of dosages. Results Before the protocol, drug wastage accounted for 8,3% of the Department annual drug expenditure. Over 70% of these costs were attributable to six drugs (cetuximab, docetaxel, gemcitabine, oxaliplatin, pemetrexed and trastuzumab) that we named ‘hot drugs’. Since the protocol introduction, we observed a 45% reduction in the drug waste expenditure. This benefit was confirmed in the following years and drug waste minimazion was able to limit the impact of new pricely drugs on the Department expenditures. Conclusions Facing current budgetary constraints, the application of a drug waste minimization model is effective in drug cost containment and may produce durable benefits. PMID:24507545

  11. Ontario University Benefits Survey. Part I (All Benefits Excluding Pensions). December 1, 1979.

    ERIC Educational Resources Information Center

    University of Western Ontario, London.

    Results of a survey of benefits (excluding pensions) provided by Ontario universities are presented. Responses are presented by university concerning the following aspects of general benefits: administration and insurance plans, communication of benefits, proposed changes in benefits, provision of life and dismemberment insurance, and maternity…

  12. The role of insurance claims databases in drug therapy outcomes research.

    PubMed

    Lewis, N J; Patwell, J T; Briesacher, B A

    1993-11-01

    The use of insurance claims databases in drug therapy outcomes research holds great promise as a cost-effective alternative to post-marketing clinical trials. Claims databases uniquely capture information about episodes of care across healthcare services and settings. They also facilitate the examination of drug therapy effects on cohorts of patients and specific patient subpopulations. However, there are limitations to the use of insurance claims databases including incomplete diagnostic and provider identification data. The characteristics of the population included in the insurance plan, the plan benefit design, and the variables of the database itself can influence the research results. Given the current concerns regarding the completeness of insurance claims databases, and the validity of their data, outcomes research usually requires original data to validate claims data or to obtain additional information. Improvements to claims databases such as standardisation of claims information reporting, addition of pertinent clinical and economic variables, and inclusion of information relative to patient severity of illness, quality of life, and satisfaction with provided care will enhance the benefit of such databases for outcomes research.

  13. The Drug Facts Box: Improving the communication of prescription drug information.

    PubMed

    Schwartz, Lisa M; Woloshin, Steven

    2013-08-20

    Communication about prescription drugs ought to be a paragon of public science communication. Unfortunately, it is not. Consumers see $4 billion of direct-to-consumer advertising annually, which typically fails to present data about how well drugs work. The professional label--the Food and Drug Administration's (FDA) mechanism to get physicians information needed for appropriate prescribing--may also fail to present benefit data. FDA labeling guidance, in fact, suggests that industry omit benefit data for new drugs in an existing class and for drugs approved on the basis of unfamiliar outcomes (such as depression rating scales). The medical literature is also problematic: there is selective reporting of favorable trials, favorable outcomes within trials, and "spinning" unfavorable results to maximize benefit and minimize harm. In contrast, publicly available FDA reviews always include the phase 3 trial data on benefit and harm, which are the basis of drug approval. However, these reviews are practically inaccessible: lengthy, poorly organized, and weakly summarized. To improve accessibility, we developed the Drug Facts Box: a one-page summary of benefit and harm data for each indication of a drug. A series of studies--including national randomized trials--demonstrates that most consumers understand the Drug Facts Box and that it improves decision-making. Despite calls from their own Risk Communication Advisory Committee and Congress (in the Affordable Care Act) to consider implementing boxes, the FDA announced it needs at least 3-5 y more to make a decision. Given its potential public health impact, physicians and the public should not have to wait that long for better drug information.

  14. The Medicare Drug Benefit (Part D) and Treatment of Heart Failure in Older Adults

    PubMed Central

    Donohue, Julie M.; Zhang, Yuting; Lave, Judith R.; Gellad, Walid F.; Men, Aiju; Perera, Subashan; Hanlon, Joseph T.

    2010-01-01

    Background Adherence to pharmacotherapy for heart failure is poor among older adults due, in part, to high prescription drug costs. We examined the impact of improvements in drug coverage under Medicare Part D on utilization of, and adherence to, medications for heart failure in older adults. Methods We used a quasi-experimental approach to analyze pharmacy claims for 6,950 individuals age≥65 years with heart failure enrolled in a Medicare managed care organization two years before and after Part D’s implementation. We compared prescription fill patterns among individuals who moved from limited (quarterly benefits caps of $150 or $350) or no drug coverage to Part D in 2006 to those who had generous employer-sponsored coverage throughout the study period. Results Individuals who previously lacked drug coverage filled approximately 6 more heart failure prescriptions annually after Part D (Adjusted Ratio of Prescription Counts = 1.36, 95% Confidence Interval=CI=1.29-1.44; p<0.0001 relative to the comparison group). Those previously lacking drug coverage were more likely to fill prescriptions for an angiotensin converting enzyme inhibitor/angiotensin II receptor blocker plus a beta blocker after Part D (adjusted ratio of odds ratios=AROR=1.73; 95% CI=1.42-2.10; p<0.0001), and more likely to be adherent to such pharmacotherapy (AROR=2.95; 95% CI=1.85-4.69; p<0.0001) relative to the comparison group. Conclusions Medicare Part D was associated with improved access to medications and adherence to pharmacotherapy in older adults with heart failure. PMID:20598987

  15. Selection bias between 2 Medicare capitated benefit programs.

    PubMed

    Leutz, Walter; Brody, Kathleen K; Nonnenkamp, Lucy L; Perrin, Nancy A

    2007-04-01

    To assess enrollment selection bias between a standard Medicare health maintenance organization (HMO) and a higher-priced social health maintenance organization (SHMO) offering full prescription drug and unique home-based and community-based benefits and to assess how adverse selection was handled through SHMO finances. Kaiser Permanente Northwest offered the dual-choice option in the greater Portland region from 1985 to 2002. Analysis focused on 3 "choice points" when options were clear and highlighted for beneficiaries. Data collected included age and sex, utilization 1 year before and after the choice points, health status data at enrollment (1999-2002 only), mortality, and cost and revenues. Data were extracted from health plan databases. Hospital, pharmacy, and nursing facility utilization for 1 year before and after the choice points are compared for HMO and SHMO choosers. Health and functional status data are compared from 1999 to 2002. Utilization and mortality data are controlled by age and sex. SHMO joiners evidenced adverse selection, while healthier members tended to stay in the HMO, with leaner benefits. Despite adverse selection, the health plan maintained margins in the SHMO, assisted by frailty-adjusted Medicare payments and member premiums. This high-low option strategy sought to offer the "right care at the right time" and may be a model for managed care organizations to serve aging and disabled beneficiaries under Medicare's new special needs plan option.

  16. Drug Coverage (Part D)

    MedlinePlus

    ... insurance Find health & drug plans Drug coverage (Part D) How to get drug coverage Choose from 2 ... drug coverage. You can choose a Medicare Part D plan. Or, you can choose a Medicare Advantage ...

  17. COMPARISON FRICTION: EXPERIMENTAL EVIDENCE FROM MEDICARE DRUG PLANS*

    PubMed Central

    Kling, Jeffrey R.; Mullainathan, Sendhil; Shafir, Eldar; Vermeulen, Lee; Wrobel, Marian V.

    2011-01-01

    Consumers need information to compare alternatives for markets to function efficiently. Recognizing this, public policies often pair competition with easy access to comparative information. The implicit assumption is that comparison friction—the wedge between the availability of comparative information and consumers’ use of it—is inconsequential because information is readily available and consumers will access this information and make effective choices. We examine the extent of comparison friction in the market for Medicare Part D prescription drug plans in the United States. In a randomized field experiment, an intervention group received a letter with personalized cost information. That information was readily available for free and widely advertised. However, this additional step—providing the information rather than having consumers actively access it—had an impact. Plan switching was 28 percent in the intervention group, versus 17 percent in the comparison group, and the intervention caused an average decline in predicted consumer cost of about $100 per year among letter recipients—roughly 5 percent of the cost in the comparison group. Our results suggest that comparison friction can be large even when the cost of acquiring information is small, and may be relevant for a wide range of public policies that incorporate consumer choice. PMID:22454838

  18. Hospital laboratory outreach: benefits and planning.

    PubMed

    Anderson, Victoria

    2007-12-01

    A laboratory outreach program can benefit the hospital in several ways, such as increasing revenues, filling unused capacity, and solidifying relationships with the physician and patient communities. Building rapport with physicians and the community ultimately brings economic value to the hospital. To service this new market it is necessary to modify current systems and processes and develop new services. The areas most likely to be developed are logistics, service centers, client services, physician connectivity, billing, marketing, sales, and finance reporting. Developing efficient customer-related services is a key to reaping the benefits.

  19. Medicare coverage for patients with diabetes. A national plan with individual consequences.

    PubMed

    Ashkenazy, R; Abrahamson, M J

    2006-04-01

    The prevalence of diabetes in the U.S. Medicare population is growing at an alarming rate. From 1980 to 2004, the number of people aged 65 or older with diagnosed diabetes increased from 2.3 million to 5.8 million. According to the Centers for Medicare and Medicaid (CMS), 32% of Medicare spending is attributed to the diabetes population. Since its inception, Medicare has expanded medical coverage of monitoring devices, screening tests and visits, educational efforts, and preventive medical services for its diabetic enrollees. However, oral antidiabetic agents and insulin were excluded from reimbursement. In 2003, Congress passed the Medicare Modernization Act that includes a drug benefit to be administered either through Medicare Advantage drug plans or privately sponsored prescription drug plans for implementation in January 2006. In this article we highlight key patient and drug plan characteristics and resources that providers may focus upon to assist their patients choose a coverage plan. Using a case example, we illustrate the variable financial impact the adoption of Medicare part D may have on beneficiaries with diabetes due to their economic status. We further discuss the potential consequences the legislation will have on diabetic patients enrolled in Medicare, their providers, prescribing strategies, and the diabetes market.

  20. Medicaid and Children's Health Insurance Programs: essential health benefits in alternative benefit plans, eligibility notices, fair hearing and appeal processes, and premiums and cost sharing; exchanges: eligibility and enrollment. Final rule.

    PubMed

    2013-07-15

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act. This final rule finalizes new Medicaid eligibility provisions; finalizes changes related to electronic Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices and delegation of appeals; modernizes and streamlines existing Medicaid eligibility rules; revises CHIP rules relating to the substitution of coverage to improve the coordination of CHIP coverage with other coverage; and amends requirements for benchmark and benchmark-equivalent benefit packages consistent with sections 1937 of the Social Security Act (which we refer to as ``alternative benefit plans'') to ensure that these benefit packages include essential health benefits and meet certain other minimum standards. This rule also implements specific provisions including those related to authorized representatives, notices, and verification of eligibility for qualifying coverage in an eligible employer-sponsored plan for Affordable Insurance Exchanges. This rule also updates and simplifies the complex Medicaid premium and cost sharing requirements, to promote the most effective use of services, and to assist states in identifying cost sharing flexibilities. It includes transition policies for 2014 as applicable.

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