Pharmaceutical Purchasing: a Review of the Landscape and Implications for Antidotal Therapies
Authors:
- 30 May 2023
- journal article
- review article
- Published by Springer Nature in Journal of Medical Toxicology
- Vol. 19 (3) , 262-267
Abstract
The management of the poisoned patient often requires the utilization of uncommonly used pharmaceutical interventions. These interventions can be associated with significant costs to both the patient and treating institution. Pharmaceutical supply shortages and issues with accessibility of antidotal therapies complicate the management of many toxic exposures. These challenges are an inherent property of the pharmaceutical purchasing infrastructure in the United States, which is a complicated network of public and private intra-institutional agreements. The cost and availability of any given therapy is dependent on the individual contracting agreements between the treating institution, payer, pharmacy benefit manager, manufacturer or wholesaler, and in some cases a specialty pharmacy. Small or remote hospitals may experience greater challenges related to insufficient patient volume to achieve predicable prescribing patterns of rare and expensive medications, necessitating consignment purchasing arrangements. Although pharmaceutical costs are the focus of recent legislative attention, these reforms are not expected to significantly alter the cost or availability of antidotal therapies.Keywords
This publication has 21 references indexed in Scilit:
- Changes in Teaching Hospitals’ Community Benefit Spending After Implementation of the Affordable Care ActAcademic Medicine, 2018
- Combating Substandard and Counterfeit Medicines by Securing the Pharmaceutical Supply Chain:INNOVATIONS in pharmacy, 2018
- Association of a Negative Wealth Shock With All-Cause Mortality in Middle-aged and Older Adults in the United StatesJAMA, 2018
- Expert Consensus Guidelines for Stocking of Antidotes in Hospitals That Provide Emergency CareAnnals of Emergency Medicine, 2018
- ACMT Position Statement: Addressing the Rising Cost of Prescription AntidotesJournal of Medical Toxicology, 2017
- Mystery Of The Chargemaster: Examining The Role Of Hospital List Prices In What Patients Actually PayHealth Affairs, 2017
- Rising cost of antidotes in the U.S.: cost comparison from 2010 to 2015Clinical Toxicology, 2017
- The High Cost of Prescription Drugs in the United StatesJAMA, 2016
- The Association Between Income and Life Expectancy in the United States, 2001-2014JAMA, 2016
- Billing and Reimbursement for a Bedside Toxicology Service at a Tertiary Care Academic Center During Its First Fiscal YearJournal of Medical Toxicology, 2014