Policy and Economic-Related Projects
Updating the Prescription Drug Trends Chartbook. David Kreling, PhD, Principal Investigator. David Mott, PhD, Joseph Wiederholt, PhD, Co-Principal Investigators. Awarded by the Henry J. Kaiser Family Foundation. $9,992. 2001.
The goal of this project was to update the original chartbook on trends in the pharmaceutical industry that was done for the Kaiser Family Foundation. Key charts were duplicated to include more recent data, and new charts reflecting different analyses or aspects of trends were added. The update was intended to enhance understanding of trends and factors contributing to trends related to prescription drugs. The update also is published and distributed by the Kaiser Family Foundation (www.kff.org).
Chartbook on the Trends in the Pharmaceutical Industry. David Kreling, PhD, Principal Investigator. Joseph Wiederholt, PhD, David Mott, PhD,Co-Principal Investigators. Awarded by the Henry J. Kaiser Family Foundation. $75,000. 1999.
A compilation of charts and supporting text was developed to inform policy makers about recent trends related to prescription drugs. Data from the literature and available sources were obtained to exhibit and examine trends and related factors influencing the trends. The chartbook included trends in expenditures, insurance coverage, prices, utilization, promotion, research and development, and characteristics of firms in the channel of distribution for pharmaceuticals (manufacturers, wholesalers, and retail pharmacies). The Kaiser Family Foundation published and distributed the chartbook, it is available at www.kff.org.
Background Paper -- Alternative Payment Methods: Value and Payment of Pharmacy Services. David Kreling, Co-Investigator with Michael T. Rupp, PhD, Associate Professor of Pharmacy Administration at Purdue University. Commissioned and funded by the National Association of Chain Drug Stores. $5,000. 1992.
A literature review for published and unpublished papers on the value of pharmacists' cognitive services was conducted to provide background for a task force assembled by NACDS intended to examine the potential of alternate payment mechanisms that could be used to recognize and reward non-dispensing cognitive services by pharmacists. The literature search was supplemented with descriptions of research projects underway at universities relative to pharmacist cognitive service activities and provision thereof, with particular focus on those valuing the services (outcomes quantification).
The studies and projects identified and reviewed support the notion that professional pharmacy services "add value to" patient care. The scope, magnitude, and cost of drug-related problems are compelling arguments that efforts to improve drug use are warranted. Although the "value" of pharmacists' professional services has yet to be fully quantified, evidence in support of the positive impact that pharmacists' efforts can have on patient health and economic outcomes is substantial.
The Pharmaceutical Access and Prudent Purchasing Act of 1990: Estimating the Economic Impact on Institutional Pharmacy Providers. David Kreling, Principal Investigator. Funded by the American Society of Hospital Pharmacy. $1,000. 1990.
The Pharmaceutical Access and Prudent Purchasing Act of 1990 included provisions whereby manufacturers of pharmaceuticals would be asked via a rebate mechanism to charge Medicaid programs no more than the lowest price charged to hospitals or other organizations serving the indigent. In this analysis, we attempted to project, in the form of revenue shifts, the impact on hospitals that could occur by estimating potential pharmaceutical product price increases and subsequent costs of products purchased by institutional pharmacy providers as a result of the "best price" provision.
The overall impact was estimated as increases in costs for hospital pharmaceutical purchases of approximately 4 to 7 percent. The estimates depended on the discount assumed that Medicaid would achieve from the "best price" provision, the mix of single-source and multiple-source pharmaceuticals used in the hospital, and whether the revenue compensation would occur as price increases on all products or single-source products only.
The Potential Impact of Drug Reimbursement Policy Changes on Community Pharmacies in Wisconsin. David Kreling, Principal Investigator, Funded by Sonderegger Research Center. $13,648. 1985 - 1988.
This research analyzed how varying levels of reimbursement for prescription drug ingredient costs would affect community pharmacies economically. Specifically, the study evaluated whether drug cost reimbursement based on Average Wholesale Price (AWP) less 10.5% or wholesaler cost plus 5.01% would yield amounts above or below what pharmacists paid for products. Purchase costs for a large market basket of products were obtained from wholesalers serving community pharmacies throughout the state. Additional information about purchasing and pharmacy characteristics were obtained directly from pharmacists.
In general, pharmacists were able to purchase drugs at the reimbursement amounts proposed. The "cost plus" reimbursement amounts tended to be more conservative, and variation between pharmacies was related to their purchase patterns, i.e. the wholesaler purchased from and percent of purchases from those wholesalers versus direct from manufacturers. The type of product involved (generic, brand, controlled substances, etc.) was also a factor.