Resource-based relative value scale (RBRVS) is a schema used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all health maintenance organizations (HMOs).
The American Medical Association (AMA) is an American professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was 271,660 in 2022.
Prescription drug list prices in the United States continually are among the highest in the world. The high cost of prescription drugs became a major topic of discussion in the 21st century, leading up to the American health care reform debate of 2009, and received renewed attention in 2015. One major reason for high prescription drug prices in the United States relative to other countries is the inability of government-granted monopolies in the American health care sector to use their bargaining power to negotiate lower prices, and the American payer ends up subsidizing the world's R&D spending on drugs.
Memorial Sloan Kettering Cancer Center is a cancer treatment and research institution in Manhattan in New York City. MSKCC is one of 72 National Cancer Institute–designated Comprehensive Cancer Centers. Its main campus is located at 1275 York Avenue between 67th and 68th Streets in Manhattan.
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately.
In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosis is the assessment that a particular medical condition is present while an indication is a reason for use. The opposite of an indication is a contraindication, a reason to withhold a certain medical treatment because the risks of treatment clearly outweigh the benefits.
Josep Baselga i Torres, known in Spanish as José Baselga, was a Spanish medical oncologist and researcher focused on the development of novel molecular targeted agents, with a special emphasis in breast cancer. Through his career he was associated with the Memorial Sloan Kettering Cancer Center, Vall d'Hebron Institute of Oncology, and the Massachusetts General Hospital in their hematology and oncology divisions. He led the development of the breast cancer treatment Herceptin, a monoclonal antibody, that targets the HER2 protein, which is impacted in aggressive breast cancers.
Lung cancer screening refers to cancer screening strategies used to identify early lung cancers before they cause symptoms, at a point where they are more likely to be curable. Lung cancer screening is critically important because of the incidence and prevalence of lung cancer. More than 235,000 new cases of lung cancer are expected in the United States in 2021 with approximately 130,000 deaths expected in 2021. In addition, at the time of diagnosis, 57% of lung cancers are discovered in advanced stages, meaning they are more widespread or aggressive cancers. Because there is a substantially higher probability of long-term survival following treatment of localized (60%) versus advanced stage (6%) lung cancer, lung cancer screening aims to diagnose the disease in the localized stage.
Disease or patient registries are collections of secondary data related to patients with a specific diagnosis, condition, or procedure, and they play an important role in post marketing surveillance of pharmaceuticals. Registries are different from indexes in that they contain more extensive data.
Blinatumomab, sold under the brand name Blincyto, and known informally as blina, is a biopharmaceutical medication used as a second-line treatment for Philadelphia chromosome-negative relapsed or refractory acute lymphoblastic leukemia. It belongs to a class of constructed monoclonal antibodies, bi-specific T-cell engagers (BiTEs), that exert action selectively and direct the human immune system to act against tumor cells. Blinatumomab specifically targets the CD19 antigen present on B cells. In December 2014, it was approved by the US Food and Drug Administration under the accelerated approval program; marketing authorization depended on the outcome of clinical trials that were ongoing at the time of approval. Blinatumomab is given via intravenous infusion.
In economics, supplier induced demand (SID) may occur when asymmetry of information exists between supplier and consumer. The supplier can use superior information to encourage an individual to demand a greater quantity of the good or service they supply than the Pareto efficient level, should asymmetric information not exist. The result of this is a welfare loss.
Healthcare in the United States is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance. The United States spends more on healthcare than any other country, both in absolute terms and as a percentage of GDP; however, this expenditure does not necessarily translate into better overall health outcomes compared to other developed nations. Coverage varies widely across the population, with certain groups, such as the elderly and low-income individuals, receiving more comprehensive care through government programs such as Medicaid and Medicare.
David M. Eddy is an American physician, mathematician, and healthcare analyst who has done seminal work in mathematical modeling of diseases, clinical practice guidelines, and evidence-based medicine. Four highlights of his career have been summarized by the Institute of Medicine of the National Academy of Sciences: "more than 25 years ago, Eddy wrote the seminal paper on the role of guidelines in medical decision-making, the first Markov model applied to clinical problems, and the original criteria for coverage decisions; he was the first to use and publish the term 'evidence-based'."
Sachin H. Jain is an American physician who held leadership positions in the Center for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC). From 2015 to 2020, he served as president and chief executive officer of the CareMore Health System. In June 2020, it was announced that he would join the SCAN Group and Health Plan as its new president and CEO. He is also adjunct professor of medicine at the Stanford University School of Medicine and a Contributor at Forbes. In 2018, he was named one of American healthcare's most 100 most influential leaders by Modern Healthcare magazine (#36).
Unnecessary health care is health care provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending in 2012.
The Specialty Society Relative Value Scale Update Committee or Relative Value Update Committee is a volunteer group of 31 physicians who have made highly influential recommendations on how to value a physician's work when computing health care prices in the United States' public health insurance program Medicare.
Steven Pearson is an American physician, bioethicist, and the Founder and President of the non-profit health policy and comparative effectiveness research organization Institute for Clinical and Economic Review in Boston, MA. He conducts research on cost-effectiveness analysis and healthcare technology assessment. He is also a lecturer in Harvard's Department of Population Medicine and a member of the National Institutes of Health (NIH) Comparative Effectiveness Research Steering Committee.
Carol L. Brown is the Nicholls-Biondi Chair for Health Equity at Memorial Sloan Kettering Cancer Center and a professor at Weill Cornell Medical College. She is a surgeon known for her work on gynecological cancers.
Nancy Keating is an American physician who works at the Brigham and Women's Hospital and is a professor at Harvard Medical School. Her research considers the factors that influence quality care for people suffering from cancer.
Deborah Schrag is the Chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center. She currently holds the George H. Bosl Chair. She is a medical oncologist known for her work in patient care and examination of patient outcomes.
