P. Venkata Durga Seshu Priya*1, Dr. P. Venkatesh2, L. Manasa3
1-3Department of Pharmacy, Jagans Institute of Phaarmaceutical Sciences, Jangala kandriga, Nellore, A.P.
The healthcare expenditure is continuously growing at an unprecedented and unsustainable rate. With the shift to value-based care, healthcare organizations are expected to provide consistent high-quality, safe care while reducing healthcare costs. As reimbursements shrink, healthcare organization leadership and clinical providers must identify opportunities to minimize unnecessary practice variation while providing high-value healthcare. In recent years, the therapeutic landscape has changed with the proliferation of specialty drugs, which are used in the management of an array of medical conditions, including cancers, chronic infections, autoimmune disorders, transplantation, and bleeding disorders. Loosely defined based on their high costs, the need for special handling protocols, and close patient monitoring, specialty drugs are projected to account for 50% of the total medical expenditure by 2019. The biologic agents, which are produced or derived from a living organism, are the most rapidly growing class of specialty drugs, and hold promise to revolutionize the management of a range of chronic medical conditions. The challenge, however, is reconciling the potential therapeutic benefit with the high cost of these agents. Specialty drugs contribute significantly to the inpatient diagnosis-related group payment system, often with unproved benefits over less-expensive treatments.
Keywords: Healthcare expenditure, reimbursements shrink, high cost, protocol, biologic agents, medical conditions.