ORLANDO, Fla., May 16 /PRNewswire-FirstCall/ -- Recent legislative emphasis on price negotiation and physician reimbursement as a means to reduce health care costs are nothing more than "short term patches" that hold no potential for truly reforming health care, former Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mark McClellan told hundreds of health care decision makers today in delivering the keynote address at Medco Health Solutions, Inc. 2008 Drug Trend "Predictions" Symposium.
"We don't seem to be making much progress politically; it's easy to be cynical when it comes to health care," said McClellan, current Director of the Engelberg Center for Health Care Reform and Senior Fellow at the Brookings Institute. "Just focusing on cost reduction doesn't do much to solve the problem of getting more value for what we are spending."
McClellan characterized as unsustainable short-term strategies such as across-the-board reductions in Medicare reimbursement fees for physicians and coverage policies that prevent access to the latest biomedical technologies; yet indicated a shift is clearly afoot within both political parties as candidates move towards a value-based, quality-focused approach to improving care for millions of Americans.
"There simply isn't any additional funding available for new health care programs, but this presents the foundation for changing health care," said McClellan. "Each of the political candidates is demonstrating a new emphasis on improving quality and efficiency of care."
McClellan highlighted improved management of chronic diseases and complications; improved identification of patients at risk for chronic diseases; an increased focus on wellness; and better support for navigation of the health care system as strategies espoused by both parties that have the potential to improve quality of care.
"Both party's candidates are placing a greater emphasis than ever before on strategies like chronic disease prevention and healthcare information technology," said McClellan.
McClellan commented on additional issues facing the current and future health care landscape:
-- Recent rapid advancements in gene-based care such as proteomics and genomics, RNA interference, regenerative medicine and epigenetics are ushering in the "Biomedical Century" and introducing a sea change in personalized medicine that makes "all the spending worth it." -- A key driver of cost is not rising prices or an aging population; in fact, the key driver is simply more people getting more treatments combined with longer life expectancy. However, there is a major problem with the underuse of services for chronic disease management, as patients with chronic diseases get appropriate treatment only about 55 percent of the time. -- While the introduction of biosimilars holds tremendous promise for financial relief, it is unlikely that Congress will act on legislation this year to advance the policies around the emerging therapeutic category. McClellan also noted that the Food and Drug Administration makes a clear distinction between generic similars and interchangeables in oral medications, a distinction that will prove to be inapplicable to biologics and could present unique challenges in crafting appropriate legislation. About Medco
Medco Health Solutions, Inc., is the nation's leading pharmacy benefit manager based on its 2007 total net revenues of more than $44 billion. Medco's prescription drug benefit programs, covering approximately one-in-five Americans, are designed to drive down the cost of pharmacy health care for private and public employers, health plans, labor unions and government agencies of all sizes, and for individuals served by the Medicare Part D Prescription Drug Program and those served by its specialty pharmacy segment, Accredo Health Group. Medco, the world's most advanced pharmacy(TM), is positioned to serve the unique needs of patients with chronic and complex conditions through its Medco Therapeutic Resource Centers(R), including its enhanced diabetes pharmacy care practice through the Liberty acquisition. Medco is the highest-ranked independent pharmacy benefit manager on the 2008 Fortune 100 list. On the Net: http://www.medco.com/.
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