Paul N. Casale, MD, recommends that providers prepare for a new healthcare payment model in the U.S. that rewards value over volume.

Pfizer is looking to introduce an over-the-counter version of its blockbuster cholesterol pill Lipitor (atorvastatin) that could be purchased without a doctors prescription, according to a report released today by the Wall Street Journal. The move could help the company retain revenues for the drug, after Lipitors patent is set to expire this November. Last year, the blockbuster's sales soared to $11 billion.

Creating initiatives that enhance primordial and primary prevention strategies on a national level would help prevent cardiovascular disease (CVD) before it begins, according to an American Heart Association (AHA) policy statement published online July 25 in Circulation. While costs have often been a deterrent to implementing these types of programs, AHA said imparting community-based changes is a good long-term investment to improve the populations health.

As top U.S. blockbuster drugs' patents begin expiring, healthcare may see a dip in bills through the purchase of cheaper, generic drugs. Pharmaceutical companies will undergo tough times when patent expiries occur for big brand name drugs like Plavix (clopidogrel) and Lipitor (atorvastatin), and patents on branded drugs valued at $133 billion expire within the next six years, according to EvaluatePharma, a London-based research firm.

By 2015, 30 to 50 percent of hospitals will face extreme budget shortfalls and have limited access to capital. Cardiology already has endured multiple cuts, including a 36 percent slash in SPECT imaging reimbursement for independent cardiovascular practices, which have forced many private practices to merge with hospitals, creating strain and resistance. Meanwhile, hospitals will need to restructure payment models and care delivery to survive (and possibly thrive) in this increasingly challenging landscape.

As Medicare and third-party payor reimbursement are likely to continue to declineespecially with value-based purchasing slated to begin in 2013 under healthcare reformhospitals will need to become more financially accountable, as well as take responsibility for patient satisfaction and quality.

Thomas M. Tu, MD, an interventional cardiologist, and John M. Mandrola, MD, an electrophysiologist with Baptist Medical Associates in Louisville, Ky., discuss the complex relationships that medical societies and physician specialists form with the cardiac device and pharmaceutical manufacturers that provide the products to support their specialties.

U.S. healthcare is undergoing massive changes. While its often easy to focus on the negative side-effects of this transformation, healthcare professionals should not lose sight of its many opportunities. One of the biggest opportunities, particularly for cardiology, is a movement towards team-based care, which involves using non-physician practitioners and clinical staff to participate in the decision-making, coordination of care and shared responsibility for quality.