The city of Bend is one step closer to breaking ground on a major overhaul of its surface water system.  Thats after a new Forest Service analysis concluded the project wouldnt do any lasting environmental harm. 

Art Appreciation

Kentucky banker Bernard Trager was well known in his community for the millions he donated to local institutions like the Jewish Community Center and the University of Louisvilles athletic programs. But the Republic Bank founder (his son, Steve Trager, runs the bank now) also steered his giving in ways that reflected his lifelong passion for the arts. In one of his last major gifts, Trager donated $150,000 to construct a courtyard on the universitys campus and financed the restoration of a sculpture that was a fixture at the school for 40 years before getting displaced because of a 2008 campus renovation project.

The new plaza was dedicated to Trager last summer, commemorating his philanthropy and in particular his support of the local arts community. Sculptor Ed Hamilton and other local were on hand to salute him.

It was one of the last public appearances for Trager, who died in February. He was 83.

The artwork that Trager helped restore for the campus, Truth and Justice by the late Kentucky art legend Barney Bright, now stands before a shallow reflection pool in the new commons area bearing Tragers name.

Prime Promotion

Sandie OConnor is back in a treasury function role at JPMorgan Chase, and this time its the biggest treasury function role at the firm. OConnor, who previously managed the companys hedge fund relationships as the head of Prime Services, was named treasurer of the company last month, focusing her attention on the management of the firms capital, liquidity and funding, along with its ratings agency relationships. She also joins JPMorgan Chases executive committee.

Her 24 years with the firm include a stop in the companys Treasury amp; Securities Services group. Earlier in her career she was treasurer of Morgan Guaranty Trust Co. of New York, during completion of the merger between JPMorgan and Chase Manhattan.

A memo from her new boss, CFO Doug Braunstein, referred to OConnor as a role model for many colleagues, citing her role as co-chair of the companys Investment Bank Womens Network.

Fox in the Henhouse?

When Fannie Mae in February hired Anthony Tuck Reed and put him in charge of customer strategy, a question arose: why Reed?

The longtime capital markets expert for SunTrust Mortgage and later Wells Fargo Home Mortgage had been a loud voice calling for radical reform of the GSEs. Ideas he backed included the shifting of mortgage guarantee programs from the government to regulated private capital groups.

Does letting Reed into the henhouse portend sweeping changes in Fannies mission?

Unlikely. But it does show that the historically insular Fannie, which also recently hired former ResCap/GMAC Mortgage executive Adam Glassner to manage small-lender relationships, is seeking experienced players to help widen the breadth of servicers and lenders it works with.

I would say the real news is that theyre bringing in people from the outside, says Mary Lou Christy, a former investor relations chief for Fannie who is now a managing director at the Collingwood Group.

MVBs Wealth MVP

MVB Bank in Fairmont, W.Va., has launched a wealth management division led by Sam Guarascio, a new hire but an old hand at investment advisory work. The West Virginia native has spent three decades in the industry and came to MVB as a consultant. The new Wealth Management Solutions group which will offer investment services through Raymond James.

Gig for Watson

Following his success in a Jeopardy champions match in 2011, Watson has landed his first job in financial services. The IBM supercomputer was hired by Citigroup, which wants to use Watson for customer service analysis and for processing financial, economic and client data. IBM has been pushing Watson as an intelligence tool for banks in areas such as fraud and risk monitoring, given his natural-language search and learning capabilities. He may not be able to correctly pronounce Flowers of Algernon in the heat of battle, but Watsons ability to analyze context and meaning in human language could help Citi rethink and redesign the various ways in which our customers and clients interact with money, says Don Callahan, head of operations and technology at Citi.

Occupy Stumpfs Street

John Stumpf had something of an out-of-body experience a few weeks ago when protestors rallied outside his San Francisco home: demonstrators brought life-size cardboard cutouts of the Wells Fargo CEO, tagged with the unflattering label Wall St. Robber Banker. The activists challenged Stumpf to meet with local residents in danger of foreclosure, as part of a larger effort to get a moratorium on foreclosures until a deal to help distressed borrowers is struck. We realize who runs Wells Fargo, so we visited the CEO since hes refused to meet with people in foreclosure here in San Francisco, said Buck Bagot, a longtime activist and a leader with Occupy Bernal, a group in the San Francisco neighborhood Bernal Heights. The group also staged a faux foreclosure and auction of Stumpfs home.

I dont know where the nickname came from, but its not a bad thing. -Terri Dial

In a 2006 interview with American Banker, Dial shared her thoughts on being known as the human cyclone. The tenacious banking veteran, who rose from teller to the executive ranks of Wells Fargo and later ran consumer banking at Lloyds TSB Group and Citigroup, died in Miami on Feb. 28 from pancreatic cancer. She was 62.

But those who want to see the end of commercial oyster operations in the national park say she is being fed misinformation by those who support Drakes Bay Oyster Co. in an effort to have its lease renewed.

Last week Feinstein, D-Calif., issued a statement calling the National Park Services analysis its latest falsification of science at the Point Reyes National Seashore.

Feinstein takes issue with a section of the report that states the noise from oyster boats in Drakes Bay would disturb the solitude of nearby wilderness.

Here is the problem: the noise did not come from oyster boats, nor did it come from anywhere near Drakes Estero or the Point Reyes National Seashore, she wrote in a letter to Ken Salazar, secretary of the US Department of the Interior, dated Thursday.

Amazingly, the decibel recordings the park service attributed to Drakes Bay oyster boats came from jet skis in New Jersey 17 years ago.

Those who oppose the oyster operation renewing its lease say it is standard scientific practice to use standardized noise levels even if gathered at other sites.

In its own letter to the Department of the Interior, the Environmental Action Committee of West Marin wrote, These representative values are reasonable, understate the actual (Drakes Bay Oyster Co.) noise level impacts and directly contradict . . . Sen. Feinsteins unfounded allegations of NPS misconduct.

Point Reyes officials declined comment.

The Drakes Bay Oyster Co. lease, allowing it to grow and harvest oysters in Drakes Estero, ends on Nov. 30. Point Reyes National Seashore has indicated it wants to return it to a wilderness area thereafter.

The National Park Service issued its draft environmental impact statement on the issue last September, but it doesnt identify a preferred alternative for oyster operations.

This was the second time the senator has issued a statement on the environmental impact analysis. Feinstein, who has long been critical of the National Park Services position on oyster farming in Drakes Estero, issued a statement when it first came out saying she was troubled by the draft report. She said the report largely ignores the conclusion reached in 2009 by the National Academy of Sciences that there is a lack of strong scientific evidence that shellfish farming has major adverse ecological effects on Drakes Estero. A final environmental impact statement is due out later this year and Salazar will make a determination on the Drakes Bay Oyster Co. lease.

There is a customer service revolution afoot. Consumers will no longer put up with poor customer service. As the number of product and service alternatives rises, the companies that provide the best customer experience will gain and retain, while the companies that donâ??t struggle to stay afloat. I swear I didnâ??t mean for both of those to rhyme.

Corporations are paying closer attention to the value of their customers. Those of you who follow Net Promoter Score are aware that detractors of your company (unhappy customers who feel trapped in a bad relationship with the company) are 3x more likely to speak about their experience and 2x more likely to speak negatively to 10 or more people. On the other end of the spectrum, Net Promoter Score leaders, ie those whose customer base contains primarily promoters (loyal enthusiasts who continue buying from the company and â??promoteâ? the company to people they know), are growing at more than 2x the rate of their competitors.

So how do you provide good customer service? Although that subject extends beyond the scope of this post, I can tell you where you can start, which coincidentally is probably the last place youâ??re looking: your automated system.

Most companies are focusing on adding channels to their customer support, such as social media, live chat, and smart-phone apps, and simultaneously adding features to enhance their contact centers, such as click-to-call or allowing premium status callers direct access to a live agent (as weâ??ve seen with the Chase Sapphire Preferred credit card). However, they all seem to be dancing around the subject of their IVR. Instead, they are looking for ways to boost every channel around the automated system in efforts to reduce the impact of a detrimental IVR or to reduce the call volumes into their contact centers. Whatâ??s the point of creating a brilliant multichannel customer support chain, if your IVR is a broken link in that chain? I will now defer to the overused, yet appropriate clichà putting a band aid on an open wound.

Why is my IVR so bad?

Hey, Iâ??m glad you asked! Your IVR is so bad because it lacks the ability to understand your callers. Your callers are frustrated with your automated system before they even use it due to an abysmal track record and a lack of innovation in traditional Automated Speech Recognition (ASR) for the past 10 years. Callers expect:

• The need to repeat information in the IVR that they give in the IVR
• The need to repeat information to the live agent that they give in the IVR
• Low expectation that they will be routed to the correct destination
• Menu options that donâ??t fit their needs
• Difficulty in reaching a live representative

Where does your ASR fall short?  Do your customers have to repeat information to the live agent that was given in the IVR? Intelligent CTI will take care of that. Do they have difficulty reaching a live agent? If you truly care about your customers, you could design an IVR capable of addressing that problem. However, if your system suffers from speech recognition failures, an inability to granularly route, and inadequate menu options, you probably canâ??t do anything about that with the technology youâ??re currently using.

Why is my IVRâ??s automated speech recognition so crappy?

Donâ??t be so hard on yourself, itâ??s not your fault. Our traditional copper wire phone lines carry only audio quality that is easily understood by the human ear and brain. That â??standard-definitionâ? audio has a limited amount of data. Yes, even when someone is calling in on their iPhone 4S, with its â??high-definitionâ? microphone, their voice is still ending running on a â??standard-definitionâ? telephone system. Itâ??s like the difference between hearing a song on the radio, and hearing it on those tinny 2001 ringtones much more difficult to identify the song from the ringtone.

This is why, when youâ??re interacting with an IVR during your coffee break at Starbucks and you have a Scottish accent, youâ??re SOL. Background noise and accents are an ASRâ??s worst enemy. Simple triggers can also set it off, such as the minute difference between b,c,d,e (they all have an â??eeeâ? sound)  when you are spelling out your first name, or words that sound similar, such as Boston and Austin.

The basic limitations of audio quality explain why, with traditional Automated Speech Recognition, you will not be able to capture e-mail addresses, log-ins, and other alphanumeric data to a high degree of accuracy. If your automated system requires any account identification or authorization, you have to find a creative way to dance around alpha-numerics. In fact, most IVR systems today focus on creative ways to make it easier for the automated speech system to recognize the caller, and less so on how to make it easier for the caller to use the IVR system. Even with data strings your ASR should be able to capture, itâ??s likely your callers will be forced to confirm or to repeat themselves. And if their responses include verbal disfluencies like uhm, ya know, or yeah, the likelihood is even higher. For most callers, this is a major frustration point.

While itâ??s true that Automated Speech Recognition and Natural Language are getting better every year, there will always be a disparity between ASR technology and human understanding that prevents your callers from communicating in their own words. Your caller doesnâ??t want to Technical Support -gt; Home -gt; Internet Router, she wants to fix her broken Internet! Natural Language, at its best, still doesnâ??t allow your callers to speak in their own words. Directed Dialogue forces your callers into speaking in a way that works for the system. Youâ??ve heard them before: â??How can I help you? You can speak to me in full sentences, but you can only say â??make a reservationâ?? or â??cancel an appointment.â??â? Clearly, Iâ??m exaggerating, but my point remains. Your callers want to express their problems in their own way because they believe that their call is unique (which is why they are calling they probably already looked to complete their request on your website) and that your automated system wonâ??t be able to meet their needs.

So what am I supposed to do?

Call Interactions. No, Iâ??m just joking. But seriously. You need to think creatively. ASR works in many areas, but as I explained, there are many areas in which it fails. Supplementing your ASR with human-assisted understanding provided by several thought-leading companies, such as Interactions, can make your IVR work. (If you are unfamiliar with human-assisted understanding, check out a demo.) This approach will eliminate the pain points, providing greater understanding that will enable you to build more functionality into your system. That being said, many IVR companies have tried to build human-assisted understanding IVRs themselves, but have been unable to meet their ROI requirements. When they quantify the benefits to the call center infrastructure and compare that number to the price tag for improving their system, the math doesnâ??t work. But at the risk of sounding like a marketing professional (which I am), I have to tell you that Interactions has cracked the code. Our many customer-centric clients can attest to that.

Do I need analytics to tell me what Iâ??m doing wrong?

Yes, of course you do. You need to know the route your customers are traversing. Are you receiving a heavy call volume for something that could easily be accomplished in self-service? On that note, you also want to know why they hitting the contact center. Is the self-service functionality not prevalent enough? Is there even a self-service functionality on the website for that command? Perhaps an abnormally heavy call volume for that command can even alert you to a bug on that part of the website.

Analytics allow you to have great control over the flow of your customer support channels, identify bottlenecks, and better design your support structure to optimize customer experience and improve your economics.

Youâ??re not telling everything, are youâ?¦

Youâ??re right. Analytics are great in theory but most companies and self-service analysis providers treat customers like sheep. The predominant thinking is â??I have this huge call volume and these expensive agents, I need to save some money, so letâ??s build this menu option here, and this self-service functionality there, and link them to the website here. In turn, weâ??ll increase containment, cut down Average Handle Time (AHT), and increase customer experience.â?

Thatâ??s all well and good. However, I return to my original point:

You can gather and analyze all the customer data you want, but if you are still relying solely on ASR to respond to all your customersâ?? needs, you are missing a big piece of the puzzle. Instead of forcing the customer to communicate in unnatural ways that suit your system, you need to build a system that accepts and responds to what they have to say. You have to accept responsibility for your communication mediums and stop forcing your customers to speak in the way thatâ??s best for the IVR. Itâ??s time to get creative. Stop thinking about your IVR as a gateway to your representatives, and start viewing it as a critical, strategic initiative.

The US Army will hold voluntary flight demonstrations for its nascent Armed Aerial Scout (AAS) programme, but any would-be contractors must prove their helicopter offers are better value for money than a life-extended Bell OH-58F Kiowa Warrior.

The services default plan is to extend the life of the current reconnaissance fleet.

We will extend the service life of the Kiowa fleet today, says Maj Gen Tim Crosby, the armys executive officer for aviation, because Armed Aerial Scout is unaffordable – thats kind of our baseline.

The US Department of Defense is expected to sign off on the services analysis of alternatives, which says the army needs a new manned reconnaissance helicopter. The only way to get there is a full-scale development, Crosby adds.

But the service faces a dilemma. It could do nothing, it could solider on with the OH-58F fleet, or it could buy a new helicopter – but money is the problem.

We have put in the budget what we call a service-life extension, Crosby says, pointing out that the service is willing to accept the risk posed by not having a new scout helicopter.

The Kiowa cannot perform every mission the service wants, and although the army can cope with this state of affairs, it is willing to evaluate new machines that may prove more capable than the OH-58F.

The only way were going to know that is to demo [the other aircraft], Crosby says. However, he stresses the tentative nature of the exercise. It is not a fly-off. It is not a competition, he says.

Maj Gen James Rogers, commander of the army aviation and missile command, says: Everyone says theyve got something thats better than a [life-extended OH-] 58. All we want to do is say show us.

Funding for the AAS would be drawn from another army programme, hence the need to ensure any replacement aircraft is worth the investment.

The army is expected to get the go-ahead on 23 April from the Defence Acquisition Board to proceed with the review. That will allow the service to release a new request for information, which will then lead to a new round of aerial demonstrations. But officials are unwilling to commit to a timeframe.

In the meantime, would-be contractors are displaying their hardware at the Army Aviation Association of America forum in Nashville, Tennessee.

APIs Tax Policy Manager Stephen Comstock told reporters this morning that the proposal now before the Senate to raise taxes on selected oil and natural gas companies would do nothing to reduce gasoline prices but would damage job creation, oil and gas production, and energy security. He said API was launching a major advertising campaign to inform the public about the possible consequences of raising the industrys taxes:

Lets be clear: the Senate proposal is not about addressing gasoline prices. Higher taxes will not result in lower fuel prices. In fact, a recent Congressional Research Service analysis concludes that actions like this could increase fuel prices. And 76 percent of Americans agree with this, according to a recent poll by Harris Interactive. Strong majorities of people of every age, gender, political party, and educational background agree.

Theres a better path forward. Put policies in place that would allow our companies to do more at home producing the oil and natural gas our nation will use. Had those policies been in place over the last few years, it would already be reflected in additional government revenues. We would not have lost an estimated $5B from slower development in the Gulf of Mexico, for example. In fact, a full program of development would be delivering to the government far more additional revenue than the Senate tax increase proposal could ever hope to provide.

The tax increase proposal now in the Senate may serve someones political goals but it would be a Trojan horse to our economy and to our energy security. Its a bad idea – a destructive idea – and we urge all senators to oppose it.

About API
API represents more than 500 oil and natural gas companies, leaders of a technology-driven industry that supplies most of Americas energy, supports 9.2 million US jobs and 7.7 percent of the US economy, delivers more than $86M a day in revenue to our government, and, since 2000, has invested more than $2T in US capital projects to advance all forms of energy, including alternatives.

SOURCE: API

The Hydra was a mythical swamp beast whose multiple heads grew back after being severed. Obamacare is a real Washington monster whose countless hidden bureaucracies keep sprouting forth even after theyre rooted out. As soon as combatants lop off one of the laws unconstitutional agencies, another takes its place.

On Thursday, as the behemoth federal health care law marked its second anniversary, House Republicans repealed the infamous Independent Payment Advisory Board. The mother of all death panels, IPAB would have unprecedented authority over health care spending through a rogue board of 15 Medicare spending czars. The House repeal has a snowballs chance in hell of surviving the Senate. But IPABs legality is being challenged in federal court by the conservative Arizona-based Goldwater Institute. And the more the public knows about these freedom-usurping, taxpayer-soaking institutions buried in the health care law the less they like it.

Seven House Democrats crossed the aisle to vote for the GOP majority rollback. Analysts on both sides of the political aisle have decried IPABs complete lack of accountability and insulation from judicial review. Critical decisions about public and private health insurance payment rates would be freed from the normal administrative rules process – public notice, public comment, public review — that governs every other federal commission in existence. Rep. Todd Akin, R-Mo., summed up bipartisan opposition: IPAB embodies the very thing Americans fear most about ObamaCare — unaccountable Washington bureaucrats meeting behind closed doors to make unilateral decisions that should be made by patients and their doctors.

The problem with piecemeal repeal is that for every old IPAB, theres a new, multibillion-dollar bureaucracy waiting in the Obamacare wings. Senate Republicans and fellow medical doctors Tom Coburn and John Barrasso point to a $10 billion entity called the Innovation Center that would test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid and the State Childrens Health Insurance Program (CHIP).

According to a new Congressional Research Service analysis of this little known office to be operated by the Centers for Medicare and Medicaid Services, there would be no administrative or judicial review of the directors payment experiments. Coburn and Barrasso explain that (t)his means that the administrator of CMS is the sole individual in the entire federal government with the power to decide whether or not models tested negatively impact seniors quality of care and meet the financial requirements spelled out in law.

This innovation super-czar would be allowed to tinker behind closed doors — and then impose whatever experiments the innovation center chooses without any checks or balances on the methods or results. Moreover, at least two other sub-offices within CMS (subject to normal open meetings and open records rules) have already been tasked with researching payment and delivery models. Health care blogger Tevi Troy at NationalReview.com warns: The innovation center appears to be one more way in which the health-care law is going to interfere with the practice of medicine, and one that physicians should start paying more attention to.

Its not just physicians who need to pay attention. Every taxpayer has a stake. At the end of the month, this shadowy agency will start doling out $1 billion in grants to payment experiment groups and data-tracking system builders. Sounds like yet another pipeline for political payoffs and Chicago-style boodle that will result in less patient autonomy, fewer health care choices, more government intrusion and lower-quality care.

Final diagnosis: The Obamacare beast wont die until its eradicated completely, root and branch.

NEW YORK, March 28, 2012 /PRNewswire via COMTEX/ –
Reportlinker.com announces that a new market research report is available in its catalogue:

Pricing and Reimbursement of the Healthcare System in India – Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure

http://www.reportlinker.com/p0804705/Pricing-and-Reimbursement-of-the-Healthcare-System-in-India—Low-Levels-of-Drug-Reimbursement-Lead-to-a-High-Out-Of-Pocket-Expenditure.html #utm_source=prnewswire&utm_medium=pr&utm_campaign=Managed_care

Pricing and Reimbursement of the Healthcare System in India – Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure

Summary

GBI Research, the leading business intelligence provider, has released its latest research “Pricing and Reimbursement of the Healthcare System in India – Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure”. It provides a comprehensive overview of the healthcare system, and pricing and reimbursement process in India with a detailed analysis of the different regulatory mechanisms used in India. The report closely scrutinizes the major changes in pharmaceuticals related pricing and reimbursement in the recent past, and the impact these changes will have in the future. The health insurance is responsible for facilitating demand by making high-cost prescription drugs more affordable. Although the per capita income is rising in India, the modest income of most of the population keeps the high cost drugs and medicines out of reach of the majority of the population. Drugs would become more expensive with the enforcement of product patents and so the sales of the expensive drugs depend on the growth and the maturity of the health insurance sector. If the health insurance industry does not mature, the market for patented drugs would experience adverse effects. The next three to five years will see a significant growth and change in the Indian health insurance industry as new insurance players and insurance products respond to the increased demand.

India has a dual system of care: a private fee-for-service based sector where the money is paid Out-Of-Pocket (OOP) by individual households and a tax-based public sector where the providers are salaried. The utilization of insurance under both these systems is partly restricted by the affordability of the individual household and availability of the budget. On the other hand, insurance, as a means of financing, is a far more sophisticated mechanism, requiring a comprehensive understanding of the failures that characterize health insurance markets. Despite the improving health status of the Indian population, healthcare infrastructure in India is far from achieving 100% quality, technology and superior healthcare delivery systems. While the Central Government is limited to family welfare and disease control programs, the state governments are responsible for primary and secondary medical care, with a limited role in specialty care. Looking at the healthcare indicators and the growing prevalence of non-communicable lifestyle related diseases, both the government and private sector realize the need to meet this basic demand. Today, the private sector provides 80 percent of the healthcare service.

Scope

Detailed study of the healthcare systems and roles of the key insurance players in the drug reimbursement process

Analysis of the major pricing and reimbursement mechanisms in India.

Key trends that follow from the recent changes brought about in the pricing and reimbursement mechanism.

Build an understanding of the possible major challenges brought about by the enactment of changes in the pricing and reimbursement scene in India.

Reasons to buy

Build understanding of the pharmaceuticals related key pricing and reimbursement mechanisms in India and also specifically in some states of India.

Optimize your investment through the identification and understanding of the changes in the pharmaceuticals regulatory mechanism in the Indian economy.

Develop effective business strategies related to new drug launches through the analytical insight gained from key trends in the pricing and reimbursement scene of India.

Improve negotiations with the government agencies to maximize reimbursement on the drugs by understanding the mechanism.

1 Table of Contents

1 Table of Contents 3

1.1 List of Tables 5

1.2 List of Figures 5

2 Pricing and Reimbursement in India – Introduction 6

2.1 GBI Research Report Guidance 6

3 Pricing and Reimbursement in India – Overview 7

3.1 Introduction to Healthcare System in India 7

3.1.1 Healthcare Expenditure Highly Correlated with GDP 7

3.1.2 Estimated Public Health Spending as a Percentage of GDP 9

3.1.3 Health Expenditure per Capita 9

3.1.4 Out-of-Pocket Health Expenditure as a Percentage of Private Expenditure on Health 10

3.1.5 Demographics by Age 10

3.2 Public Healthcare System 11

3.2.1 Drug Distribution in the Public Sector 12

3.3 Private Healthcare System 12

3.4 Rationale for Drug Use in the Healthcare Facilities 13

4 Pricing and Reimbursement in India- Overview of Pharmaceutical Regulations in India 14

4.1 PEST Analysis of the Pharmaceutical Industry in India 14

4.2 Regulatory Bodies in the Indian Pharmaceutical Sector 15

4.2.1 National Pharmaceutical Pricing Authority (NPPA) 15

4.2.2 Drug Prices Control Order (DPCO) 16

4.2.3 The Pharmaceutical Policy, 2002 16

5 Pricing and Reimbursement in India- Pricing of Drugs 17

5.1 Introduction 17

5.1.1 Price Registration Process in India 18

5.1.2 International Price Comparison 19

5.2 Price Setting Procedures 21

5.2.1 Essential Drugs List (EDL) Pricing 21

5.2.2 Pricing Methodology for the Essential Drugs 24

5.2.3 Factors Determining the Pricing of the Drugs 25

5.2.4 Criteria for Selection of Drugs for Price Control 26

5.3 Pricing of Formulations 27

5.4 Annual Price Adjustments 28

5.5 Distribution of the Price Reduction Under National Pharmaceuticals Pricing Policy 2011 29

5.6 Branded Generics Share 30

5.6.1 India-Specific Pricing 31

5.6.2 Pricing Approach to Patented Drugs 32

5.6.3 Pricing of the Orphan Drugs 34

5.6.4 Introduction of the Jan Aushadhi Shops 36

6 Pricing and Reimbursement in India – Reimbursement Scenario in India 37

6.1 Introduction 37

6.2 Health Insurance 38

6.2.1 Central Government Health Scheme 39

6.2.2 Employees State Insurance Scheme 39

6.3 Medical Reimbursement in India 40

6.3.1 Reimbursement Plans of Major Insurance Players 40

6.3.2 Private and Public Sector Insurance Companies in India 43

6.4 Reimbursement Policies in Other Countries 44

6.5 Out-of-Pocket (OOP) Expenditures 45

6.5.1 Co-Payment 46

6.5.2 Out-of-Pocket Expenditures in India 47

6.5.3 Comparison of OOP Expenditures 48

6.5.4 Irrational Drug Usage 48

6.6 Universal Health Care 49

6.7 Trends in Drug Reimbursement Policies 51

6.7.1 Health insurance Scenario in India 52

6.7.2 Challenges in Health Insurance 52

7 Pricing and Reimbursement in India – Conclusion 53

8 Pricing and Reimbursement in India – Appendix 54

8.1 Market Definitions 54

8.2 Abbreviations 54

8.3 Research Methodology 54

8.3.1 Coverage 54

8.3.2 Secondary Research 55

8.3.3 Primary Research 55

8.3.4 Expert Panels 56

8.4 Contact Us 56

8.5 Disclaimer 56

8.6 Sources 57

1.1 List of Tables

Table 1: Pricing and Reimbursement in India, Centre’s Expenditure on Health and Family Welfare, 2004-2010 7

Table 2: Pricing and Reimbursement in India, Estimated Public Health Spending (%) of the BRIC nations, the US, the UK and Japan, 2010-2050 9

Table 3: Pricing and Reimbursement in India, Health Expenditure per Capita ($), BRIC, The US, The UK, Japan, 2006-2009 9

Table 4: Pricing and Reimbursement in India, Out-of-Pocket Health Expenditure as a Percentage of Private Expenditure on Health, (%), BRIC, The US, The UK, Japan, 2006-2009 10

Table 5: Pricing and Reimbursement in India, Demography by Age, 2011 10

Table 6: Pricing and Reimbursement in India, Public Healthcare System in India & The US (Rate), 2010 11

Table 7: Pricing and Reimbursement in India, Rationale for Drug Use in India by WHO, 2010 13

Table 8: Pricing and Reimbursement in India, Essential Drugs List, 2011 22

Table 9: Pricing and Reimbursement in India, Categories of Drugs and MAPE, DPCO 1979 24

Table 10: Pricing and Reimbursement in India, Number of Drugs under DPCO, Year-on-Year 1970-2011 25

Table 11: Pricing and Reimbursement in India, Distribution of the Price Reduction of Drug, 2011 29

Table 12: Pricing and Reimbursement in India, Drug Price Comparison, Market Price & Jan Aushadhi Price, 2011 36

Table 13: Pricing and Reimbursement in India, Non-Profit Social Insurance Schemes in India, 2011 39

Table 14: Pricing and Reimbursement in India, Health Insurance Policy of the OICL, 2011 40

Table 15: Pricing and Reimbursement in India, Private and Public Sector Health Insurance Companies, 2011 43

Table 16: Pricing and Reimbursement in India, Reimbursement Policies in the Top Five Countries of Europe, 2011 44

Table 17: Pricing and Reimbursement in India, Co-Payments in Other Countries, 2011 46

Table 18: Pricing and Reimbursement in India, Out-of-Pocket Expenditures in India, 2011 47

Table 19: Pricing and Reimbursement in India, Comparison of OOP Expenditures, 2011 48

Table 20: Pricing and Reimbursement in India, Irrational Drug Usage in India, 2010 48

Table 21: Pricing and Reimbursement in India, Percentage of Untreated Population in India, 2010 49

Table 22: Pricing and Reimbursement in India, Difference between Co-op and Market Price of Generic Medicines, 2011 50

Table 23: Pricing and Reimbursement in India, Trends in Indian Healthcare Industry, 2011 51

1.2 List of Figures

Figure 1: Pricing and Reimbursement in India, Healthcare Expenditure in India, 2010 8

Figure 2: Pricing and Reimbursement in India, PEST Analysis of the Indian Healthcare Industry 14

Figure 3: Pricing and Reimbursement in India- Pricing of Bulk Drugs in India, 2011 17

Figure 4: Pricing and Reimbursement in India, Price Registration Process in India, 2011 18

Figure 5: Pricing and Reimbursement in India, Value-Based Pricing, 2010 19

Figure 6: Pricing and Reimbursement in India, Impact Analysis – Reference Pricing, 2010 20

Figure 7: Pricing and Reimbursement in India, Factors Determining the Pricing of the Drugs, 2011 25

Figure 8: Pricing and Reimbursement in India, Pricing of Formulations in India, 2011 27

Figure 9: Pricing and Reimbursement in India, Trends in Drug Prices, 1995-2010 28

Figure 10: Pricing and Reimbursement in India, Branded Generics Share in India, 2010 30

Figure 11: Pricing and Reimbursement in India, India-Specific Pricing, 2010 31

Figure 12: Pricing and Reimbursement in India, Concerns Regarding the Pricing of the Patented Drugs 32

Figure 13: Pricing and Reimbursement in India, Global Pricing of Orphan Drugs, 2010 34

Figure 14: Pricing and Reimbursement in India, Challenges in Indian Healthcare System, 2011 37

Figure 15: Pricing and Reimbursement in India, Health Insurance in India, 2011 38

Figure 16: Pricing and Reimbursement in India, Specific Disorders Not Covered in the Policy, 2011 42

Figure 17: Pricing and Reimbursement in India, Out-of-Pocket Expenditures in India, 2011 45

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Managed care Industry: Pricing and Reimbursement of the Healthcare System in India – Low Levels of Drug Reimbursement Lead to a High Out-Of-Pocket Expenditure

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CONTACT:Nicolas BombourgReportlinkerEmail: nbo@reportlinker.comUS: (805)652-2626Intl: +1 805-652-2626

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Lohrers briefing attacks some of the numbers the service has used in its comparison between the C-27 and C-130 such as the 25-year lifecycle costs. Schwartz cited the C-27J 25-year lifecycle cost at $308 million. He said the C-130J similarly cost the Air Force $213 million and the C-130H $185 million.

The Ohio Guardsman argues that the Air Force added 53 more airmen than the C-27J needs to its cost analysis to push the 25-year life-cycle price up an additional $112 million. Lohrer said he found early analysis the Air Force did that dropped the C-27J 25-year lifecycle costs all the way down to $111 million.

Kevin Williams, a retired Air Force colonel who is one of the services leading analysts, said Friday he has no idea where Lohrer came up with the $111 million figure.
It doesnt exist in any formal authorized signed document. That then becomes the basis of kind of like a math problem when you have the wrong number of the first step of your process and that error ripples through everything else, said Williams, the deputy director of Air Force Headquarters Studies and Analyses, Assessments and Lessons Learned directorate, better known as A9.

Williams also questioned the figure Lohrer used for cost per flying hour. Williams said the service had tabulated each C-27 marginal flying hour to cost $2,700, not $2,100, as Lohrer had written in his briefing.

Williams said Lohrer was wrong to criticize the manning figures the Air Force used in its C-27 life cycle cost analysis because that data came directly from the Air Guard.

Williams told a group of reporters and defense analysts Friday that Lohrer and the Ohio Air Guard should have consulted the Air Force before publishing his briefing.
We cant find anyone in A9 who ever heard from anyone in the Guard about wanting to validate or verify the numbers they were using, Williams said.

Schwartz and Air Force Secretary Michael Donley have repeatedly said that Guard and Reserve leaders were included in the discussions over service cuts. However, a Guard and Reserve leader was noticeably absent from Fridays roundtable organized by Air Force leaders to explain the services analysis for its 2013 budget.

Williams echoed Schwartz and Donley, saying his dispute over Lohrers data shouldnt be read as an argument between the Guard and the active component. However, the tension between the active and reserve components continues to grow.

The adjutants general for all 50 states along with Guam, Puerto Rico, the US Virgin Islands and Washington DC signed a letter to the Senate Armed Services Committee in February saying the Air Forces budget analysis was filled with flawed processes, assumptions and criteria that produced the Air Force budget request.

Multiple Guard members said the meeting was held specifically to quiet the uproar caused by Lohrer and Walters briefings and to allow the services active component to regain the upper hand in the debate over service cuts.

One Guard official, who asked not to be identified because the person was not authorized to speak officially, asked Military.com to draw an obvious conclusion from the Air Force officials at Fridays briefing.

How many Guardsmen did the Air Force go out of its way to provide you in that budget briefing? the Guard official asked. I bet zero — and theres a reason for that.

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Empirix, Hammer and Hammer Test Engine are trademarks of Empirix Inc.
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SOURCE: Empirix

Schwartz MSL Boston for Empirix
John Moran/Dave Bowker, 781-684-0770
empirix@schwartzmsl.com

Copyright Business Wire 2012