As the US health care system moves toward more value-based care delivery models, much needs to be done to reshape how physicians and patients think of palliative care.
With the introduction of multiple biosimilar traztuzumab products in the United States within the next 18 months, it is expected that costs can be further decreased with no detriment to the substantial clinical benefit this agent provides.
In order to deliver value-based care, health care decision makers, eg, insurers and health system administrators, need value data at their fingertips—data that are relevant to their own context and reflect their own perspective on what costs and benefits matter.
With the release of President Trump’s “American Patients First” strategy blueprint to tackle US drug pricing and health care costs, clinical pathway developers and professionals will need to take this proposed plan into consideration.
Changing clinical pathways to incorporate the full spectrum of the patient experience requires a significant shift in how pathways are thought about, how they are developed, and what stakeholders provide during development.
Insights from payers and health systems shed light on drivers of the interest in value-based contracting, important barriers to implementation, and implications for manufacturers seeking to engage in successful value-based agreements.
The principles and structures of Kaiser Permanente and the National Institute for Health and Care Excellence may represent future models of care.
Making the transition from fee-for-service reimbursement to value-based models of care and payments will be slow and difficult.
Health systems increasingly have an inpatient, health plan, and now outpatient formulary, each with their own rules, priorities, and application. These differences and complexities are important to consider to optimize clinical pathway outcomes.
As initial gene and cellular therapies come to market, debate is growing as to the best ways to evaluate the associated economic impact, specifically in the context of the shift to value-based reimbursements.