Myl A Case Study

Finally, changes in government programs such as Medicaid, social security, and others will bring changes to the prescription drug industry. Health insurance and those changes that the industry might go through if the health reformed is passed by congress will also have a major impact on Walgreens and how products are priced.

Finally, in a February 2012 proposed regulation, CMS proposed that state Medicaid agencies reimburse pharmacies for retail drugs based on actual acquisition cost. CMS recognized, however, that states may not be able to determine the actual price paid by a pharmacy for a drug billed to Medicaid, so it suggested that states survey pharmacies or rely on other data to calculate an average acquisition cost for drugs purchased and billed by retail community pharmacies. The article reviewed the association between benefit caps, prescription drug use, and the costs associated. It also detailed drug cost sharing, additional medical costs, and specific health outcomes. Using observational data, the studies analyzed the changes and did a cost comparison of outcomes at two points of time, before and after the pharmaceutical benefits changed. The article detailed the impact of pharmaceutical drugs was often difficult to analyze because some data analyzed utilization while others analyzed actual pharmaceutical spending. The data surrounding utilization compared as many as five factors such proportion

1 Kaiser Family Foundation Report on the Uninsured. Available at http://www.kff.org/uninsured/7451.cfm. 2 Danzon, P., et al. “The Impact of Price Regulation on the Launch Delay of New Drugs.” Health Economics, 2005; 14(3): 269-292. Available at http://hc.wharton.upenn.edu/danzon/html/Journal_Articles.htm. 3 The Boston Consulting Group. “Ensuring Cost Effective Access to Innovative Pharmaceuticals – Do Market Interventions Work?” April, 1999. Available at http://www.bcg.com/impact_expertise/publications/files/Ensuring_Cost_Effective_Access_Innovative_Pharmaceuticals_Apr1999.pdf 4 Thorpe, K. et al. “Differences in Disease Prevalence as a Source of the U.S.–European Health Care Spending Gap.” Health Affairs (Web Exclusive) Oct. 2, 2007. Available at www.healthaffairs.org.

The 2009 H1N1 influenza vaccination shortage demonstrates how scarcity affects these stakeholders. In 2009 a new flu strain appeared that scientists did not predict. Researchers rushed to discover a new vaccine, and once they did, there was a limited amount of vaccine (Barr, 2011). The Center for Disease Control and Prevention was tasked with creating a prioritized list for the vaccine, which included the elderly, pregnant women, caretakers of young children, young children, young adults, and medical personnel (Barr, 2011). Obviously, the shortage meant that not every consumer was able to have equal access to the flu vaccination. Providers were affected in that they had to explain the shortage to individuals. Meanwhile, policy makers and the CDC were tasked with quickly creating policy to help those at most risk of getting the H1N1 flu strain.

The pharmaceutical and biotech industry agreed to contribute billions of dollars to healthcare reform. Having agreed early in political negotiations to contribute any-where from an estimated $80 billion to $105 billion in fees, rebates, and discounts to help move the legislation forward (Nussbaum, 2010). By agreeing to support healthcare reform with their money and policies, they were able to avoid issues that had plaques their industries for years such as drug importation and the ability to negotiate drug prices for Medicare D. In return, the pharmaceuticals and biotech firms would agree to discount drugs purchased by Medicare beneficiaries, affected by the doughnut hole, of the Part D program by 50 percent (Spatz, 2010). Congress also proposed additional government subsidies to be added to the discounts that would further shrink the gap; beneficiaries will pay 25 percent copayment

Throughout the past few years the healthcare industry has taken some precautions due to the recent bill passed that affect it, that being the healthcare reform or the Affordable Care Act (Kavilanz, 2010). In the past years healthcare has not been a concern of the average American, but this is changing rapidly. Though in 2014 healthcare was not among the top three concerns it did fall at number four (Cook, 2015). While at number four on the list last year it’s surely to increase in concern as the healthcare act becomes in full swing in 2015 (Cook, 2015). As Lindsay cook points out in her U.S News article on health care 2015 will be the year doctors see a pay cut and Americans without insurance see a penalty (Cook, 2015). Just like the rule of supply and demand, when the money supply of hardworking Americans decrease, the demand or concern in this case will increase.

The implementation of the Affordable Care Act (ACA) will propel changes that were on the horizon for pharmaceutical and biotechnology firms. Pharmaceutical and biotechnology industries knew there was going to be some type of healthcare reform so they began to take the necessary precautions to prepare. The ACA had key provisions related to the pharmaceutical and biotechnology industry affecting Medicare and Medicaid. Legislation in the ACA will reduce cost for brand name prescriptions (Rx); this will reduce drug cost for patients, but increase rebates and discounts for pharmaceutical and biotechnology firms, therefore, imposing cost on the firms. The pharmaceutical and biotech industry was key in creating legislation for the ACA, according to CMS (2009), “despite

Government/Payers: There is a medium level threat from the government and payer forces. Payers, including managed care organizations and insurances, conduct a cost/benefit analysis of every new product and services that is introduced and performed. The ACA mandate has forced the population healthcare pay model that is to be used for Medicare and Medicaid reimbursement, but the insurance industry has also adopted the underlying idea of managed-care. As a result of the mandate we should also expect to see a decrease in self-pay patients, as a huge proportion of the self-pay patients that were uninsured become insured. Based on the future trends of healthcare delivery reimbursement there will be a need to decrease costs while simultaneously increasing

These increases in the prices leave a huge impact on Americans that can’t pay the ridiculous fees that their prescriptions leave. An example would be Marlene Condon, a nature writer who suffers from rheumatoid arthritis. In 2014 she paid $32 for 180 tablets of her medication. In September of 2015, those prices increased to a shocking $500 out of pocket. This led Condon to stop taking her pills to get out of the stacking bills. Due to her decision to stop taking her medication, her arthritis pains worsened leading to her not being able to do every day tasks such as washing the dishes.

The article “What the CVS-Aetna deal means for the future of health care,” by Carolyn Y. Johnson, introduces the proposed merger between CVS and Aetna. CVS is the largest pharmacy chain in the United States and Aetna is the third largest health insurer in the United States, which will create a business partnership that could transform how healthcare is dealt with in this country. Overall, the article was neutral in its reporting. It presented both the advantages as well as the drawbacks of this deal. The short term advantages of this deal would be that copays may initially be low for customers of both CVS and Aetna. This may lead to more affordable medications, but this is completely dependent on their choice to lower or raise prices. However,

Hospitals, with nothing else to do for the patients to shoulder this debt by charging outrageous prices for emergency medicine. This action is morally wrong, it cause a majority of people to suffer under the weight of hospital bills, so few can live good at the top. This companies will never truly be satisfied either, they will continue to raise their prices, as they already have, and people will continue to buy from them, because what choice do they have. I believe that they shouldn't be able to do this. Pharmaceutical companies should have to keep their prices for life saving medicine at a reasonable price, and hospitals in return should as well. While these lower prices have the potential to hurt the companies in the long run I don't think it will have that great of an impact. Because the prices would be lower, hospitals and people would be willing to use them more

Many of the clinical signs and symptoms of AML are the result from displacement or interference of dysfunction, immature cells with the normal differentiated blood cells. As explained earlier, in AML, myeloblast are most often not able to differentiate into mature differentiated cells. Even though in some cases they do differentiate, they will more likely differentiate into immature differentiated cells. These immature cells, also called blasts, do not have the ability as the normal cells do. With no ability to function, many of them were just floating in the circulation and died and destroyed at the end of their life span. The rest of the myeloblast that are not able to differentiate are just building up in the place where it is produce, the bone marrow. In either scenario, the circulating normal differentiated cells components, like erythrocytes, monocytes, granulocytes, and megakaryocytes are deficient. This is a condition called pancytopenia.

There are several business elements of health care that are unique or perhaps define health care as a market place. One of those being the healthcare industry has never been in need of new business, the demand is already high for health care and medication. As a result of this reality, greedy pharmaceutical executives and their drug companies will practice price gouging (pricing above the market price when no alternative retailer is available), in this practice sellers spikes the prices of product and or services, in most cases, to benefit shareholders. Such action will fundamentally contribute to the drastic increase of health care expenditures, and creates inequality in resource distribution. According to Penner (2004), Market Economist defines a market as a mechanism that facilitates the efficient allocation of resources. Compared to the health care industry, traditional marketplace will not benefit from price gouging and other self-centered practice due to other competitors looking to gain consumer business: Consumers are able to find other competitors to conduct business with.

There are some concerns for the use of the CBCL. The preschool version of the CBCL is questioned in reliability and validity on some of the scales. It is common to see to this as an issue because early diagnosis and identifying behaviors in younger children are often difficult. It cautioned that the CBCL not be used as a diagnosing tool, however used as a screening tool. Review’s mention that the ASEBA system as a whole lack a strength based approach and that the Social Competence scale is not yet well developed. The Social Competence scale should measure both positive and negative aspects of a child’s behavior.

For 1 of 25 (4%) transactions reviewed selected from 17 branches, a branch did not obtain the minimum required information such as the SSN or passport number for a non-existing customer who had purchased a cashier's check. In addition, the FCIU's AML Investigations Officer who receives the weekly branch monetary instruments reports did not detect that the required information was not obtained and maintained by the branch (Ontario) until it was detected by Internal