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ACO:製薬会社に与える影響

Accountable Care Organizations: What Impact on Pharma?

発行 Datamonitor Healthcare 商品コード 342058
出版日 ページ情報 英文 50 Pages
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ACO:製薬会社に与える影響 Accountable Care Organizations: What Impact on Pharma?
出版日: 2015年07月16日 ページ情報: 英文 50 Pages
概要

ACO (Accountable Care Organization:患者に対して責任を持って治療を行う組織) は、米国における新しい医療制度のエンティティです。

当レポートでは、ACOの現状について検証し、さまざまな種類のACOや、医療・製薬情勢に対する影響など、体系的な情報を提供しています。

エグゼクティブサマリー

手頃なケア、責任のあるケア:製薬会社のケアは?

  • 支払改革:量より価値
  • 製薬会社に対するACO問題の成熟化・拡大
  • 価値に応じたケアにおける主な条件と企業
  • 参考文献

ACOは千差万別

  • ACOは構造、規模、文化、リスクの点で異なる
  • ACOのテーマに変化を持たせたもの
  • 変化・統合する提供者の情勢における勝者と敗者
  • 医師主導のACO
  • 参考文献

ACO、製薬会社、投薬管理

  • ほとんどのACOが服薬管理に優先順位を置いていない
  • メディケアのACOの一部が、より多くの薬を使用
  • 民間のACOは短期的なコスト削減に注目
  • 医師に対する役割とインセンティブの変化
  • ACOは製薬会社と契約しているか?
  • 新しい医師としての薬剤師?
  • 薬剤師に対する抑制要因
  • 製薬会社は他の方法でACOを助けることが可能:データ、教育、患者支援
  • 参考文献

ACOのこれまでの結果

  • コスト削減は控えめ
  • ケーススタディ分析:ACOの成功事例
  • 参考文献

付録

図表

目次
Product Code: DMKC0141953

The Affordable Care Act (ACA) passed in 2010 was the catalyst to a range of changes to the US healthcare system. Among the most important of these changes was how healthcare is paid for, with a number of ACA measures aimed at moving away from a fee-for-service reimbursement to payment of providers according to outcomes and quality of care. This shift from volume- to value-based reimbursement is captured most prominently in the establishment of Accountable Care Organizations (ACOs). ACOs are groups of doctors, hospitals, and other healthcare providers that share the risk, responsibility, and reward associated with delivering more cost-effective, higher-quality, and better-coordinated care. There are now over 700 ACOs in the US, spanning both the publicly funded Medicare and Medicaid, as well as the private sector.

The impact of this growing ACO movement on the pharma industry has so far been limited, but this is changing. Pharma firms have opportunities to engage with these restructured providers in new ways, including by helping to influence and set treatment best practice across different therapy areas, providing pharmacoeconomic and outcomes data, and potentially supporting a more prominent role for pharmacists within ACOs.

This report addresses the following questions:

  • What are ACOs and how do they differ from other players in the US healthcare system?
  • How is the role of medication management evolving within ACOs?
  • What impact have ACOs had on the pharmaceutical market so far and how will that change in the future?
  • What strategies for pharma-ACO engagement will be most successful?

TABLE OF CONTENTS

EXECUTIVE SUMMARY

  • 1. Affordable care, accountable care: should pharma care?
  • 2. ACOs come in many shapes and sizes
  • 3. ACOs, pharma, and medication management
  • 4. ACO results so far

AFFORDABLE CARE, ACCOUNTABLE CARE: SHOULD PHARMA CARE?

  • 5. Payment reform: from volume to value
  • 6. Maturing, multiplying ACOs matter to pharma
  • 7. Key terms and players in value-based care
  • 8. Bibliography

ACOS COME IN MANY SHAPES AND SIZES

  • 9. ACOs vary in structure, size, culture, and risk
  • 10. Variations on the ACO theme
  • 11. Winners and losers in a shifting, consolidating provider landscape
  • 12. Physician-led ACOs considered best for care, with health plan support
  • 13. Bibliography

ACOS, PHARMA, AND MEDICATION MANAGEMENT

  • 14. Medication management is not a priority for most ACOs
  • 15. Some Medicare ACOs may be using more drugs
  • 16. Commercial ACOs' focus on short-term savings means drug cost caps
  • 17. Changing roles and incentives for physicians
  • 18. More formulary power to providers
  • 19. ACO-pharma contracting? Not yet, but soon
  • 20. Pharmacists as the new physicians?
  • 21. Barriers to promoting pharmacists, 22.Pharma can help ACOs in other ways: data, education, and patient support
  • 23. Bibliography

ACO RESULTS SO FAR

  • 24. Savings are modest
  • 25. Case study analysis: ACO success stories
  • 26. Bibliography

APPENDIX

  • 27. About the author
  • 28. Scope
  • 29. Methodology
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