Cost containment States

Mossialos, E. (1998), Pharmaceutical pricing, financing and cost containment in the European Union Member States , in R. Leidl (ed.), Health Care and its Financing in the Single European Market, Amsterdam IOS Press. 

Aspect of therapy costs of drug targeting preparations should be carefully weighed in relation to the present state of the art in the therapy and cost containment aspects of health care... 

Cunningham, Peter J. Medicaid Cost Containment and Access to Prescription Drugs. Health Affairs 24, no. 3 (2005) 780-789. States have attempted to control the costs they must pay for Medicaid by limiting... 

Third, more sophisticated products and the public expectations of zero risk are driving up the cost of state-of-the-art medicines. At the same time, health care cost containment and demands for better access to pharmaceutical products from an aging population and from third world countries are forcing prices downward. 

The cost differential between ionic and nonionic contrast agents is substantial and is a consideration for cost containment in health maintenance. In 1994 in the United States this cost differential is estimated to be about 10- to 20-fold, and it is far smaller in Europe (852). The cost differential between nonionics and ionics has been reduced to 5 or 6 to 1 in 2002 in the United States, according to one of the reviewers of this manuscript. This reviewer also indicated that ionic contrast media are no longer administered intravenously, but used instead to fill lumens (i.e., bladders, fistulas, etc.). 

In the United States, there is no single coherent drug payment policy. To the extent cost-containment efforts exist, they are applied without regard to the country of manufacture or origin of a drug. Abroad, drug payment policy is generally developed with the two purposes mentioned above in mind. 

B. Abel-Smith and E. Mossialos, Cost containment in the pharmaceutical sector in the EU member states, London School of Economics, London, 1996. 

Bill of Rights , state lawmakers are enacting laws in response to more specific concerns about managed care cost containment efforts. These new state laws cover such topics as requiring health plans to allow women specified minimum hospital stays after childbirth or mastectomy, or requiring physicians to inform certain male patients of specified diagnostic procedures for prostate cancer detection. 

Many member states have over the years approached the World Health Organization for advice or information on the feasibility of measures to controi the growth of expenditure on medicines. Such calls for help led the Oi anization as early as 1983 to undertake a study under the title Dmgs and Money it cutminated in a deliberately concise report, providing a criticai overview of the effectiveness of older cost-containment schemes white atso paying attention to innovative ventures. The report was widely used and repeatedly updated, and this is now its seventh edition. 

Cost containment is one of the most contentious issues in the US debate. In the Senate, the issue will be critical to a large bloc of Democratic senators, many of them from mid-Western or Southeastern states that rely on coal and have lost manufacturing jobs over the last few decades. The support of these Democratic Senators will be critical for successful legislation in the Senate (Broder, 2009). 

Cohen IL, Booth FV. Cost containment and mechanical ventilation in the United States. New Horiz 1994 2 283-290. 

Synthetic Processes. Traditional Solvay plants produce large volumes of aqueous, chloride-containing waste which must be discharged. This fact, in addition to a noncompetitive cost position, is largely responsible for the demise of U.S. synthetic plants. In countries other than the United States, waste is sent to the ocean, rivers, or deep underground wells. The AC and NA coproduct processes produce less aqueous waste than the traditional Solvay and NA mono processes. Related environmental concerns are added whenever a plant complex includes lime quarries and ammonia-producing equipment. 

The basic metal salts and soaps tend to be less cosdy than the alkyl tin stabilizers for example, in the United States, the market price in 1993 for calcium stearate was about 1.30— 1.60, zinc stearate was 1.70— 2.00, and barium stearate was 2.40— 2.80/kg. Not all of the coadditives are necessary in every PVC compound. Typically, commercial mixed metal stabilizers contain most of the necessary coadditives and usually an epoxy compound and a phosphite are the only additional products that may be added by the processor. The requited costabilizers, however, significantly add to the stabilization costs. Typical phosphites, used in most flexible PVC formulations, are sold for 4.00— 7.50/kg. Typical antioxidants are bisphenol A, selling at 2.00/kg Nnonylphenol at 1.25/kg and BHT at 3.50/kg, respectively. Pricing for ESO is about 2.00— 2.50/kg. Polyols, such as pentaerythritol, used with the barium—cadmium systems, sells at 2.00, whereas the derivative dipentaerythritol costs over three times as much. The P-diketones and specialized dihydropyridines, which are powerful costabilizers for calcium—zinc and barium—zinc systems, are very cosdy. These additives are 10.00 and 20.00/kg, respectively, contributing significantly to the overall stabilizer costs. Hydrotalcites are sold for about 5.00— 7.00/kg. 

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