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Advice Pool - Family Health Care Plans
According to the latest United States Census Bureau figures, approximately 85% of Americans have health insurance. Approximately 60% obtain health insurance through
According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
their place of employment or as individuals, and various government agencies provide health insurance to 25% of Americans.
Health Insurance can be defined as an o
Health Insurance can be defined as an o
; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.
Examples of combination products may in
Examples of combination products may in
ficial agreement between policy-holder and the insurance company, where in the insurer is committed to pay all the medical bills of the insured person if he becomes
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
ill due to the covered causes or meets an accident.
You can get yourself insured from a private organization or from some government agency. For example, the majo
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
r proportion of the population in United States rely on private health insurance companies, while the dominance of government agencies in this sector can easily be
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
een in the rest of the world.
Further, the health insurance policy generally pays for limited medical benefits of the total number listed in the agreement in terms
Further, the health insurance policy generally pays for limited medical benefits of the total number listed in the agreement in terms
ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
of tests, drugs and the treatments. These limited coverage are known as “covered services”. There is yet another list that the medical insurance companies issue, kn
easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
own as “uncovered services”, which details the kind of services 'not' covered by the policy. For all such medical treatments, you will have to pay from your own poc
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
et.
Well, an insurer generally has several options available to him differing in their 'covered services', and hence it is advisable to choose your plan carefully.
Well, an insurer generally has several options available to him differing in their 'covered services', and hence it is advisable to choose your plan carefully.
and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
Here, I will describe a few standard plans, available to an insurer.
1. Indemnity or fee-for service Plans:
The plan provides medical coverage of an insurer by pa
1. Indemnity or fee-for service Plans:
The plan provides medical coverage of an insurer by pa
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
ing a percentage of the medical bills, generally the 80% of the “usual and customary cost”. The insurer endures the remaining 20%, also known as “coinsurance”.
It
ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.
Following aspects would a
Following aspects would a
would be worthwhile to mention here that the plan usually has some minimum deductible to be paid every year, which having been paid allows the insurer to provide t
dd to the challenges in developing combination products:
Which markets to tap where the combination products can do fairly well?
Which combination prod
Which markets to tap where the combination products can do fairly well?
Which combination prod
e benefits of the plan.
2. Managed health care
Here in, the insurance company forms cooperatives with certain doctors, hospitals and medical centers, which then p
2. Managed health care
Here in, the insurance company forms cooperatives with certain doctors, hospitals and medical centers, which then p
cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
ovide a range of services to the insurer at a reduced cost. In other words, you will have to pay less for your medical services thereby making your treatments cheap
tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
er.
A managed health care plan can broadly be classified in to three sub categories:
· Preferred Provider Organizations (PPOs)
The plan is somewhat similar to in
A managed health care plan can broadly be classified in to three sub categories:
· Preferred Provider Organizations (PPOs)
The plan is somewhat similar to in
t?
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
emnity plan, where in the insurer bears a part of fees (much lower than indemnity plan) while the insurance company pays the rest.
· Health Maintenance Organizatio
· Health Maintenance Organizatio
ping new procedures for reviewing their safety, efficacy and quality.
Professional from academic institutions, pharmaceutical industries, health care indust
Professional from academic institutions, pharmaceutical industries, health care indust
s (HMOs)
The plan offers you a range of health benefits, including preventive care, for a pre-decided monthly fee, if you get your treatment done from the pre-issu
The plan offers you a range of health benefits, including preventive care, for a pre-decided monthly fee, if you get your treatment done from the pre-issu
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
ed list of doctors and medical centers. However, if you decide to move out of the HMO circle, you shall have to bear the entire treatment cost on your own.
· Point
· Point
.
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
of-Service (POS) plans
PMO can be considered as yet another form of HMO, with an indemnity plan option. The plan extends to give you the coverage even outside the
PMO can be considered as yet another form of HMO, with an indemnity plan option. The plan extends to give you the coverage even outside the
elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.
Companies that provide selfless information through particip
Companies that provide selfless information through particip
MO circle, if you get the outside doctor referred by the ones covered in the plan. Alternatively, you can also refer yourself outside the plan and get some coverage
tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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