at a list price of $4,500 for two injectors.<\/a><\/p>\nThe current version of AUVI-Q has been available for eight years, but it wasn\u2019t commonly on the list of drugs and devices that health insurance pays for. <\/p>\n
That changed this year after insurers did the math. <\/p>\n
\u201cIt\u2019s a lot cheaper to cover even a more expensive device than it is to have someone admitted to the hospital or possibly intubated \u2014 or unfortunately pass because they don\u2019t have any device at all or the device they have wasn\u2019t used,\u201d Chadwick said.<\/p>\n
Hyunjee Kim, a health economist at the Center for Health Systems Effectiveness at Oregon Health & Sciences University, said insurance companies looked at \u201cdownstream\u201d costs when making these decisions. <\/p>\n
\u201cIt can save a lot of money downstream by reducing emergency room visits or really lengthy hospitalizations,\u201d Kim said.<\/p>\n
According to Kim, insurers analyze their own member data and compare two groups: those who received access to the drug or device, and those who didn\u2019t. Then, they compare the total cost of care and mortality.<\/p>\n
If insurers don\u2019t have the data to analyze their own patient outcomes, they need good outside evidence that could be \u201crandomized control trials or a really strong, robust retrospective study that shows how the choice of certain drugs or medical devices can affect downstream costs,\u201d said Kim. <\/p>\n
That\u2019s part of how AUVI-Q began being covered by insurers. A recent independent retrospective study found there were 50% lower health care costs and fewer emergency visits after anaphylaxis when AUVI-Q was used during a severe allergic reaction, compared to its competitors.<\/p>\n
That was one factor in Aetna, the third-largest insurance company in the US, making AUVI-Q its preferred epinephrine device for severe allergies. <\/p>\n
Kaiser Northwest, the largest health insurer in Oregon, did the same, partially due to internal pressure from its own clinicians. <\/p>\n
\u201cIf doctors or hospitals strongly believe in the value of certain devices or drugs, I think that can put really huge pressure on the insurer,\u201d Kim said.<\/p>\n
Plus, don\u2019t forget good old-fashioned free-market competition. <\/p>\n
\u201cYou always have to consider what other players do,\u201d Kim said. \u201cIf my competitor does cover it, I better cover it; otherwise, my member will switch.\u201d<\/p>\n
In other words, insurers don\u2019t want to lose in a shot-for-shot competition. And higher upfront costs can make sense if they prevent bigger bills later.<\/p>\n","protected":false},"excerpt":{"rendered":"FILE – In this July 8, 2016, file photo, a pharmacist holds a package of EpiPens epinephrine auto-injector,…\n","protected":false},"author":2,"featured_media":198066,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33],"tags":[163,85,112197,46,482],"class_list":{"0":"post-198065","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-medication","8":"tag-health","9":"tag-il","10":"tag-insurance-health-care-health-insurance-health-healthcare","11":"tag-israel","12":"tag-medication"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/198065","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=198065"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/198065\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/198066"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=198065"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=198065"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=198065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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