June 9, 2014
Health Affairs Asks: Where Can We Find Savings In Health Care?
Reducing Maternal Mortality In Zambia and Uganda. Margaret E. Kruk of Columbia University and co-authors assessed the effectiveness of Saving Mothers, Giving Life, a new global public-private partnership that aims to reduce maternal mortality in eight districts in Uganda and Zambia. They evaluated the first six to twelve months of the program's implementation, its ownership by national ministries of health, and its effects on health systems. According to the authors, early benefits to the broader health system included greater policy attention to maternal and child health, new health care infrastructure, and new models for collaborating with the private sector and communities. However, they also found that the rapid pace, external design and lack of a long-term financing plan hindered integration into the health system and local ownership.If you're between ages 15-39 when you are diagnosed with cancer, the implications later in life extend well beyond your health. Gery P. Guy Jr. of the Centers for Disease Control and Prevention and coauthors examined Medical Expenditure Panel Survey data and determined that survivors of adolescent and young adult cancers had annual per person medical expenditures of $7,417 (USD), compared to $4,247 for adults without a cancer history. They also found an annual per capita lost productivity of $4,564 per cancer survivor compared to $2,314 for adults without a cancer history. They suggest that the disparities are associated with ongoing medical care needs and employment challenges connected to cancer survivorship, and that having health insurance alone is not enough to close the gap. The authors stress the importance of access to lifelong follow-up care and education to help lessen the economic burden of this important population of cancer survivors.
Marketing Barriers For Biosimiliars. Because bringing biosimilars to the market currently requires large investments of money, fewer biosimilars are expected to enter the U.S. biologics market than has been the case with generic drugs entering the small-molecule drug market. Henry G. Grabowski of Duke University and co-authors examine the legislation passed by Congress in 2010 to establish an abbreviated FDA approval pathway for biosimiliars. They found that biosimilars will need to compete with their reference product on the basis of quality; price; and manufacturer's reputation with physicians, insurers and patient groups. Biosimilars also will face dynamic competition from new biologics in the same therapeutic class—including "biobetters," which offer incremental improvements on reference products, such as extended duration of action. The prospects for significant cost savings from the use of biosimilars, say the authors, appear to be limited for the next several years, but their use should increase over time because of both demand- and supply-side factors.