The economics and challenges of breast cancer in a managed care environment. Based on a presentation by Alan H. Heaton, PharmD.
Breast cancer and its population effect are inseparable. One of the challenges managed care organizations (MCOs) face is instilling the idea that patients are part of a population, and in turn, that population is composed of patients. Therefore, there is a need to treat both patients individually and populations as a whole. Because breast cancer, like other major illnesses, involves large-scale expenditures for drugs, pharmaceutical benefit management companies are working with MCOs to look not only at drug costs but at global healthcare expenditures. Whereas treatment of breast cancer has direct costs to a healthcare plan, it is associated with a great deal of comorbidity as well. In dealing with such potential financial exposure, the challenge to health plans is to find individuals at risk, enable them to access the healthcare system, and see that they get proper care. A proactive communications effort involving such media as patient newsletters and a website can educate healthplan members, thereby facilitating the self-assessment of risk factors.
D001943:Breast Neoplasms / Q000188:drug therapy / Q000191:economics*; D015897:Comorbidity; D017281:Cost of Illness; D016527:Drug Costs; D004502:Education, Medical, Continuing; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015273:Insurance Selection Bias; D008329:Managed Care Programs / Q000191:economics* / Q000706:statistics & numerical data; D018802:Patient-Centered Care; D013629:Tamoxifen / Q000191:economics; D014481:United States
D013629:Tamoxifen