Kc. So et Cs. Tang, Modeling the impact of an outcome-oriented reimbursement policy on clinic,patients, and pharmaceutical firms, MANAG SCI, 46(7), 2000, pp. 875-892
Tackling the steep increase in drug costs is an especially important issue
among many health care providers and insurers. To entice the clinics to bec
ome more cost efficient, the U.S. federal government, as well as many HMOs,
have developed various cost containment initiatives recently. However, the
impact of these initiatives on the patients' well-being, the clinic's prof
itability, and the pharmaceutical firm's profitability has nor been formall
y analyzed. Tn this paper we develop a mathematical model that is intended
to examine the impact of a reimbursement policy for drug usage. Despite the
simplistic structure of our model, the analysis enhances our understanding
of the joint impact of the reimbursement policy on the patients, the clini
c, and the pharmaceutical firm. Thus, our analysis can provide valuable inf
ormation for evaluating the effectiveness of implementing such a reimbursem
ent policy. In addition, we utilize the data gathered from a clinic to help
support the assumptions and results of the underlying model.