Reducing Costs in Chronic Disease Management
Info: 1667 words (7 pages) Nursing Essay
Published: 9th Apr 2021
Cost and affordability are factors that must be considered when delivering healthcare to the population. The study of economics may provide the structure and tools necessary to evaluate the inferences of individual decision making and assist in defining alternate methods to better allocate resources. Policy based in economic principles must be applied correctly. Knowledge can be gained from basic economics lessons about human behavior and the way individuals make decisions. Choices related to health care funding, the way health care is provided, and distributed are deeply influenced but the economic atmosphere and limits. The cost to treat specific diseases is constantly changing. HIV/AIDS, Diabetes, and Multiple Sclerosis all pose a health care cost burden. Through the trends of the treatment of each disease the efficiency of care delivery and the competitiveness of the delivery system can be analyzed to keep costs down.
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HIV stands for human immunodeficiency virus that causes extreme damage to the immune system. HIV prevents the immune systems function by destroying infection fighting white blood cells. HIV can be acquired through contact with infected blood by way of blood transfusions, by semen, rectal, and vaginal fluids during sexual contact, and also by the injection of drugs and needle sharing. AIDS is the most advanced stage of HIV infection. Because HIV weakens the immune system the infected person is more at risk of developing other infections and cancers and is unable to fight off infections. HIV is often treated by antiretroviral therapy (ART) drugs taken on a daily basis. ART drugs have proven to be effective in reducing symptoms in HIV patients allowing them to live longer and more fulfilling live and also reduce the risk of transmitting the infection to any future partners (U.S. Department of Health and Human Services, 2018).
HIV has the ability to evolve into other infections and illnesses that require extensive and expensive treatment and care. According to Ritchwood, the cost of HIV/AIDS patients care is between 800-900% greater than non HIV/AIDS patients. The next generation of drugs that are fighting HIV/AIDS are highly active antiretroviral therapy (HAART) was that have demonstrated great success in declining the rate of HIV-related morbidity and mortality. These drugs have been so effective that the amount of new yearly infections has shown a decrease by over 60% since 1985. In 2017 it was estimated that approximately 1.2 million people were living with HIV/AIDS. The financial concern is regarding the costs related to treating possible infections, access to health care, medications, and co-morbid conditions (Ritchwood, 2017). With HIV/AIDS patients requiring HAART medications in order live longer lives there is a financial burden on the individual, the private healthcare system, and the government.
There have been notable and specific trends in the cost of care for the treatment and HIV/AIDS. Costs are incurred by both longer lifespans and increased new infections rates among vulnerable populations, specifically young male minority’s include Latino and African American males between the ages of 13 and 24 who have sex with men. According to Ritchwood, between 2005 and 2015, HIV infections rose by 87% among young, African American men. Among Latino men, new infection rates rose by 24% during the same period (Ritchwood, 2017). The statistics of these vulnerable groups are especially concerning because they are less likely to seek outpatient treatment and more likely to engage in-hospital care, which is results in higher costs. The largest costs can be attributed to prescription medications, which increased progressively to account for 66% of total expenditures, costing $17,854 in 2008/2011, which is roughly $4000 greater than medication expenses in 2002/2004 (Ritchwood, 2017). Because the costs are so extraordinary for the individual, private health insurance companies, and the government, it is in the best interest of all parties to invest in prevention and intervention programs to aim to reduce the spread of HIV/AIDS as well as the financial burden.
Diabetes is a disease that disrupts the body’s capacity to process blood glucose, or blood sugar. In the U.S. the approximate quantity of people over 18 years of age with diagnosed and undiagnosed diabetes is 30.2 million. If left untreated, diabetes can result in a buildup of sugars in the blood, which then escalate the possibility of life threatening complications, including stroke and heart disease (Nall, 2018). A study was conducted in 2017 in order to analyze the trends in the cost of care treating Diabetes. The most remarkable findings from the 2017 report are the ongoing proliferation and the extraordinary amount of the total direct costs of diabetes in the U.S.: $116 billion in 2007, $176 billion in 2012, and $237 billion in 2017. Treating diabetes patient’s accounts for 1 in 4 health care dollars spent in the U.S. Care for a person with diabetes now costs an average of $16,752 per year. The 2017 study also discovered increased costs since 2012 due to both an 11% increased occurrence of diabetes and a 13% escalation of the cost per person with diabetes (Riddle, 2018). In order to reduce these high costs and the occurrence of diabetes preventative measures must be taken. Those at high risk of developing diabetes should be screened for regularly and maintain a healthy lifestyle.
Multiple sclerosis (MS) is a disabling disease of the brain and spinal. The immune system strikes the protective sheath (myelin) that covers nerve fibers and triggers communication glitches amongst the brain and the rest of the body. The disease can cause long-lasting impairment or weakening of the nerves. (Mayo Clinic, 2019). Not only is MS difficult for those suffering, there is also a substantial economic burden on the US healthcare system. The most costly aspect of treating MS are the prescription drugs, specifically disease-modifying therapies (DMTs) which cost over $70,000 a year for a single patient (Hartung, 2017). According to Hartung, “as of November 2014, 12 disease-modifying therapies (DMTs) for MS have been approved by the US Food and Drug Administration (FDA). Despite the availability of more treatment options, costs for all MS DMTs have increased sharply. Between 2008 and 2012, US DMTs sales doubled from $4 billion to nearly $9 billion annually. In 2004, the average annual DMT cost per person was $16,050, accounting for half of all direct medical costs for patients with MS” (Hartung, 2015). The government must step in and regulate drug prices to allow Medicare to negotiate openly with drug manufacturers.
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Businesses and government continue to share the burden of health care costs. Health care spending continues to increase quicker than gross domestic product (GDP) has risen along with inflation, and a growing population and people living longer and longer. Businesses have had to take another look at what they offer to their employees and what is most cost effective to them. This leaves the individuals hanging high and dry having to find a way to afford expensive premiums. The government is in a massive amount of debt and seems to be feeling more and more pressure to take on the financial burden of health care costs. When health care is stretched too thin the supply is down and the demand is up which will result in decreased quality of care.
Lastly, it is important to note trends in the efficiency of care delivery and the competitiveness of the delivery system and the key factors in keeping costs down. Technology and medical advancements are on the rise which then allows for greater lifesaving care. Diseases that used to be considered a death sentence such as HIV/AIDs are now manageable diseases. With more people living longer lives the cost to care for them continues to increase. The goal of improving the quality of care and reducing healthcare costs results in a very competitive marketplace. When competition gains momentum quality must be better tracked for organizations to remain relevant. The two most effective asset a company can possess is the advanced level of quality and affordable healthcare costs.
- Hartung, D. M., Bourdette, D. N., Ahmed, S. M., & Whitham, R. H. (2015). The cost of multiple sclerosis drugs in the US and the pharmaceutical industry: Too big to fail?. Neurology, 84(21), 2185–2192.
- Hartung D. M. (2017). Economics and Cost-Effectiveness of Multiple Sclerosis Therapies in the USA. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 14(4), 1018–1026.
- Mayo Clinic. (2019). Multiple sclerosis. Retrieved from https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269
- Nall, R. (2018). Diabetes: Symptoms, treatment, and early diagnosis. Retrieved from https://www.medicalnewstoday.com/articles/323627.php
- Riddle, M. C., & Herman, W. H. (2018). The Cost of Diabetes Care—An Elephant in the Room. Diabetes Care,41(5), 929-932. doi:10.2337/dci18-0012
- Ritchwood, T. D., Bishu, K. G., & Egede, L. E. (2017). Trends in healthcare expenditure among people living with HIV/AIDS in the United States: evidence from 10 Years of nationally representative data. International journal for equity in health, 16(1), 188.
- U.S. Department of Health and Human Services. (2018). HIV/AIDS: The Basics Understanding HIV/AIDS. Retrieved from https://aidsinfo.nih.gov/un Cowing, M., Davino-Ramaya, C. M., Ramaya, K., & Szmerekovsky, J. (2009). Health care delivery performance: service, outcomes, and resource stewardship. The Permanente journal, 13(4), 72–78.derstanding-hiv-aids/fact-sheets/19/45/hiv-aids–the-basics
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