Matches in SemOpenAlex for { <https://semopenalex.org/work/W95417598> ?p ?o ?g. }
Showing items 1 to 85 of
85
with 100 items per page.
- W95417598 endingPage "59" @default.
- W95417598 startingPage "51" @default.
- W95417598 abstract "A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional buy-and-bill model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008.To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members.Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician buy-and-bill reimbursement rates.For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates.This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates." @default.
- W95417598 created "2016-06-24" @default.
- W95417598 creator A5001164795 @default.
- W95417598 creator A5062240500 @default.
- W95417598 date "2011-01-01" @default.
- W95417598 modified "2023-09-25" @default.
- W95417598 title "Estimated Cost Savings Associated with the Transfer of Office-Administered Specialty Pharmaceuticals to a Specialty Pharmacy Provider in a Medical Injectable Drug Program" @default.
- W95417598 cites W2017797910 @default.
- W95417598 cites W2123499780 @default.
- W95417598 cites W2162084286 @default.
- W95417598 cites W2171813799 @default.
- W95417598 cites W2299308758 @default.
- W95417598 cites W23380726 @default.
- W95417598 cites W2415235901 @default.
- W95417598 cites W53781188 @default.
- W95417598 doi "https://doi.org/10.18553/jmcp.2011.17.1.51" @default.
- W95417598 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/21204590" @default.
- W95417598 hasPublicationYear "2011" @default.
- W95417598 type Work @default.
- W95417598 sameAs 95417598 @default.
- W95417598 citedByCount "8" @default.
- W95417598 countsByYear W954175982013 @default.
- W95417598 countsByYear W954175982014 @default.
- W95417598 countsByYear W954175982015 @default.
- W95417598 countsByYear W954175982017 @default.
- W95417598 countsByYear W954175982018 @default.
- W95417598 crossrefType "journal-article" @default.
- W95417598 hasAuthorship W95417598A5001164795 @default.
- W95417598 hasAuthorship W95417598A5062240500 @default.
- W95417598 hasConcept C100406419 @default.
- W95417598 hasConcept C104863432 @default.
- W95417598 hasConcept C121955636 @default.
- W95417598 hasConcept C144133560 @default.
- W95417598 hasConcept C159047783 @default.
- W95417598 hasConcept C160735492 @default.
- W95417598 hasConcept C162324750 @default.
- W95417598 hasConcept C182299520 @default.
- W95417598 hasConcept C20387591 @default.
- W95417598 hasConcept C2522874641 @default.
- W95417598 hasConcept C2778644256 @default.
- W95417598 hasConcept C2779703844 @default.
- W95417598 hasConcept C2780265253 @default.
- W95417598 hasConcept C50522688 @default.
- W95417598 hasConcept C512399662 @default.
- W95417598 hasConcept C545542383 @default.
- W95417598 hasConcept C71924100 @default.
- W95417598 hasConceptScore W95417598C100406419 @default.
- W95417598 hasConceptScore W95417598C104863432 @default.
- W95417598 hasConceptScore W95417598C121955636 @default.
- W95417598 hasConceptScore W95417598C144133560 @default.
- W95417598 hasConceptScore W95417598C159047783 @default.
- W95417598 hasConceptScore W95417598C160735492 @default.
- W95417598 hasConceptScore W95417598C162324750 @default.
- W95417598 hasConceptScore W95417598C182299520 @default.
- W95417598 hasConceptScore W95417598C20387591 @default.
- W95417598 hasConceptScore W95417598C2522874641 @default.
- W95417598 hasConceptScore W95417598C2778644256 @default.
- W95417598 hasConceptScore W95417598C2779703844 @default.
- W95417598 hasConceptScore W95417598C2780265253 @default.
- W95417598 hasConceptScore W95417598C50522688 @default.
- W95417598 hasConceptScore W95417598C512399662 @default.
- W95417598 hasConceptScore W95417598C545542383 @default.
- W95417598 hasConceptScore W95417598C71924100 @default.
- W95417598 hasIssue "1" @default.
- W95417598 hasLocation W954175981 @default.
- W95417598 hasLocation W954175982 @default.
- W95417598 hasOpenAccess W95417598 @default.
- W95417598 hasPrimaryLocation W954175981 @default.
- W95417598 hasRelatedWork W1967758504 @default.
- W95417598 hasRelatedWork W1973001775 @default.
- W95417598 hasRelatedWork W2003372003 @default.
- W95417598 hasRelatedWork W2278349359 @default.
- W95417598 hasRelatedWork W2282880540 @default.
- W95417598 hasRelatedWork W2283907566 @default.
- W95417598 hasRelatedWork W2319404955 @default.
- W95417598 hasRelatedWork W2405306187 @default.
- W95417598 hasRelatedWork W2466694659 @default.
- W95417598 hasRelatedWork W1527902107 @default.
- W95417598 hasVolume "17" @default.
- W95417598 isParatext "false" @default.
- W95417598 isRetracted "false" @default.
- W95417598 magId "95417598" @default.
- W95417598 workType "article" @default.