US Healthcare System Overview

ACA:

Affordable Care Act

ACS:

American Cancer Society

ADA:

American Diabetes Association

AHIP:

America’s Health Insurance Plans

AHRQ:

Agency for Health Care Quality

AHVAP:

Association of Healthcare Value Analysis Professionals

AMA:

American Medical Association

AMCP:

Academy of Managed Care Pharmacy

ANDA:

Abbreviated New Drug Application

APC:

Ambulatory Payment Classification

ASP:

Average Sales Price

AWP:

Average Wholesale Price

BIM:

Budget Impact Model

BLA:

Biologics License Application

CBER:

Center for Biologics Evaluation and Research

CDC:

Centers for Disease Control and Prevention

CDER:

Center for Drug Evaluation and Research

CDRH:

Center for Devices and Radiological Health

CEA:

Cost-Effectiveness Analysis

CHIP:

Children’s Health Insurance Program

CMS:

Centers for Medicare & Medicaid Services

CPT:

Current Procedural Terminology

CSR:

Cost-Sharing Reduction (Subsidies)

DME:

Durable Medical Equipment

DRG:

Diagnostic Related Group

FDA:

Food and Drug Administration

FSS:

Federal Supply Schedule

GDP:

Gross Domestic Product

HCEI:

Healthcare Economic Information

HDE:

Humanitarian Device Exception

HHS:

Department of Health and Human Services

HMO:

Health Maintenance Organization

HTA:

Health Technology Assessment

ICER:

Institute for Clinical and Economic Review

IDN:

Integrated Delivery Network

IND:

Investigational New Drug

KFF:

Kaiser Family Foundation

LCD:

Local Coverage Decision

MCO:

Managed Care Organizations

MDIC:

Medical Device Innovation Consortium

MHS:

Military Health Service

NCD:

National Coverage Decision

NDA:

New Drug Application

NIH:

National Institutes of Health

NPC:

National Pharmaceutical Council

OIG:

Office of the Inspector General

OECD:

Organization for Economic Co-operation and Development

PA:

Prior Authorization

PBM:

Pharmacy Benefit Managers

PCMH:

Patient Centered Medical Home

PDP:

(Medicare Part D) Prescription Drug Plan

PDUFA:

Prescription Drug User Fee Act

PhRMA:

Pharmaceutical Research and Manufacturers of America

PMA

Pre-Market Approval

P&T:

Pharmacy and Therapeutics

PPO:

Preferred Provider Organization

QALY:

Quality Adjusted Life Year

QDIP:

Qualified Infectious Disease Product

SE:

Substantially Equivalent

TNP:

Tiered Network Plan

UK:

United Kingdom

US:

United States

USA:

United States of America

VHA:

Veterans Health Administration

VA:

Veterans Affairs

WAC:

Wholesale Acquisition Cost