Early returns suggest that "consumer-directed" health plans can restrain health care costs and utilization, but whether these high-deductible plans can accomplish this without deterring consumers from seeking needed care is still up for debate. So report economist Melinda Beeuwkes Buntin and colleagues at RAND in a lead paper of a seven-article Health Affairs Web-Exclusive package on consumer-directed health care, published October 24 on the journal's Web site with the support of the California HealthCare Foundation.
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.25.w516

Oregon has been a leader in studying the comparative effectiveness of prescription drugs, but the state's efforts to translate this research into clinical practice changes in its Medicaid program have been hampered by an enforcement retreat. So report Oregon State's Daniel Hartung and coauthors in the Sep/Oct Health Affairs. When Oregon required physicians prescribing drugs not on the state's preferred drug list to specify "dispense as written," the result was a 28 percent shift in market share toward preferred drugs in affected classes. A later requirement that physicians prescribing non-preferred drugs listen to an educational message about comparative effectiveness evidence produced another 43 percent market-share shift to preferred agents. But when both requirements were revoked in October 2003, the shifts in market share were largely reversed, Hartung and coauthors say.

James Robinson, professor of economics, University of California, Berkeley, writes: "The biotechnology industry has grounds for complaint. The research pipeline is disgorging breathtaking new treatments for cancer, rheumatoid arthritis, multiple sclerosis, and other once-intractable diseases. But instead of praise, or in addition to praise, the industry finds itself subjected to ever-louder criticism of prices and earnings."
http://healthaffairs.org/blog/2006/10/23/biotech-value-based-pricing-in-biotechnology/