Tag Archives: Health Policy

CA Drug Price Relief Act Begins Campaign with 73% Support

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http://www.yeson61.com/statewide-poll-shows-strong-support-proposition-61/

STATEWIDE POLL SHOWS STRONG SUPPORT FOR PROPOSITION 61

Yes on Prop 61/Californians for Lower Drug Prices today released the results of a statewide survey that demonstrates strong, across-the-board support for Proposition 61, The California Drug Price Relief Act, a measure to reduce drug prices paid by the State of California.

“We’re pleased that California voters have expressed such strong support for this initiative to cap drug prices,” said Garry South, lead strategist for the Yes on Prop. 61 campaign. “We don’t underestimate the effect of Big Pharma’s $100-million campaign of lies, distortions and self-serving misstatements about Prop. 61, but we start off in a very strong position. We’ll see if voters get as sick and tired of the Pharma ads against 61 as they are of the omnipresent drug-pushing ads that dominate the TV screen.”

Tulchin Research conducted the statewide survey on behalf of Yes on Proposition 61 to assess the prospects of the statewide ballot measure to help reduce the state’s prescription drug costs by requiring the state to purchase drugs from drug companies at the lowest price those companies charge the federal government. The results reveal strong bipartisan support for the measure across the state. The survey finds that nearly three-quarters of voters would vote yes in support of Proposition 61 (73% yes with leaners, 66% without leaners).

Struggling to Stabilize the Exchanges

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Struggling to Stabilize the Exchanges

Six years after passage of the Affordable Care Act (ACA), the individual and small-group insurance markets—the markets that the ACA remade—are still having growing pains. Health insurers have endured large losses and a number of ACA-created co-ops and other small insurers have failed. Consolidation among providers and insurers is an increasing and concerning trend. And many insurers are poised to raise premiums substantially for 2017, further stoking frustration with the insurance industry.

Even as the press vilifies insurers, however, the ACA’s supporters can’t afford to be indifferent to their struggles. Private insurers sell the managed care plans that are the central vehicle for expanding access to middle- and lower-income Americans. One day, those plans may cover many of the 11 percent of Americans who remain uninsured.

Part of insurers’ difficulty is that the risk pool in the individual and small-group markets, particularly on the exchanges, is sicker and smaller than originally projected. But the three programs—reinsurance, risk corridors, and risk adjustment—that the ACA’s drafters would hope stabilize premiums in the revamped markets have also not performed as expected. Dashed expectations have led to market instability and to a flurry of lawsuits around the “3Rs.” What does this unpredictable and difficult situation mean for 2017 and for the ACA more generally?

5 reasons to take hospital ratings with a big grain of salt

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5 reasons to take hospital ratings with a big grain of salt

It’s hospital ratings season in America, that time of year when marketing executives kick it into high gear to trumpet — and spin — the way their hospitals are graded by outside organizations.

This year, their workload has been especially heavy. In addition to annual rankings released Tuesday by U.S. News & World Report, the federal Centers for Medicare and Medicaid Services (CMS) just released its star-rating system for hospitals nationwide. While the ratings offer some valuable information to consumers, here’s why you shouldn’t put too much stock in the results.

No matter how objective the metrics, ratings are inherently subjective

The federal government and private organizations use a vast array of hospital data to break down their performance and boil it into easy-to-understand ratings for consumers. U.S. News & World report formulates its rankings by relying on a mix of physician surveys and data reported to trade groups and the federal government. CMS ratings are based solely on data hospitals are required to report to the agency.

The information itself may be objective, but which data points are used — and how they are weighted — can lead to contradictory conclusions. Consider the following:

Of US News & World Report’s’ top five hospitals,  only one  — Mayo Clinic — received a top, five-star rating from CMS. The rest — Cleveland Clinic, Massachusetts General Hospital, UCLA Medical Center, and Johns Hopkins — were not even in CMS’ top 100. (Johns Hopkins did not receive a rating from CMS because of incomplete data).

J.B. Silvers, a professor of health care finance at Case Western Reserve University, said the information, while boiled down into simple lists and stars, can be difficult for consumers to unpack, especially when hospitals are working behind the scenes to figure out ways to better their scores every year. “Some hospitals are better at working the numbers than others,” he said. “My guess is the safety net hospitals aren’t as good at it as richer hospitals.”

 

Some biosimilars are just as good as some pricey biologics

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Some biosimilars are just as good as some pricey biologics

A new study suggests that a group of biosimilar drugs, which are used to treat such afflictions as rheumatoid arthritis, psoriasis, and inflammatory bowel disease, appear as safe and effective as their more expensive brand-name counterparts, which are known as biologics. A biosimilar drug is a nearly identical variant of a biologic and is expected to provide the same result in patients.

The analysis arrives as the US health care system, which is increasingly overwhelmed by high-priced medicines, looks toward biosimilars to provide savings. In the United States, where regulators have approved just two such drugs, some estimates say prices will be 20 percent to 30 percent less than the cost of biologics.

But until more biosimilars become available, there is some debate over the extent to which physicians will become sufficiently comfortable prescribing these drugs. Biologics are made from living cells and the brand-name biotech industry, for instance, says the complex processes needed to develop biosimilar drugs may produce slight changes that can affect safety and effectiveness. The threat of lower-priced competition has prompted brand-name drug makers to petition the Food and Drug Administration to delay approvals, among other tactics.

The study authors, however, argue their findings should put some of those concerns to rest. After analyzing 19 studies, they maintain the available data indicates biosimilar drugs based on brand-name versions of anti-TNF inhibitors should be considered interchangeable. The anti-TNF inhibitors include such big sellers as Amgen’s Enbrel, AbbVie’s Humira, and Johnson & Johnson’s Remicade.

“This is the $1 billion question — are the biosimilar versions comparable? And we found, in just about every outcome examined, that the biosimilars fare very well,” said Dr. Caleb Alexander, who is codirector of the Johns Hopkins University Center for Drug Safety and Effectiveness, and one of the authors of the study, which appeared today in the Annals of Internal Medicine.

Health Care Payment Is Shifting to Reward Value, but Can Information on Health Care’s Value Be Shared?

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https://morningconsult.com/opinions/rewarding-value-means-sharing-information/

If you wanted to know the headlines in 1962, you watched the evening news, read the daily newspaper, or listened to the radio. Those were your only options.

But if you want to know the headlines today, the range of sources available to you is nearly limitless.

As news has evolved, we also have seen a rapid transformation in access to health care news and information. When the Food and Drug Administration began to regulate communications around the marketing of pharmaceuticals in 1962, neither the FDA nor Congress could have predicted the evolution of our health care system or the information explosion we have seen in the past 20 years.

When Congress enacted the Food and Drug Administration Modernization Act of 1997, which created a pathway through Section 114 for pharmaceutical companies to proactively communicate health economic information with specific stakeholders, health care looked dramatically different than it does today. We did not yet have biologics or personalized medicine. We got our information through paper health care records, not real-time feedback from mobile health devices, searchable electronic health records, and other data sources. We have revolutionized how we treat many conditions, and who pays for medications now includes Medicare Part D, exchanges, and consumer directed health plans.

Given these changes, broader exchange and communication of how treatments work in the “real-world,” how they compare to alternatives, and their related impact on the total cost of care is needed. In fact, the ability to communicate valid, reliable information from many sources is critical to helping us achieve the common goal of delivering more efficient, high-quality health care.

Unfortunately, despite the best intentions of FDAMA Section 114, the exchange of information remains limited.

Ambiguities in the law’s language, coupled with a continued lack of guidance about its scope, have led to a lack of information exchange due to concerns from biopharmaceutical companies regarding the risk of penalties for violating standards.

Healthcare Coverage Reform Proposals

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Click to access RyanPlanAnalysis-brief.pdf

 

Mortgages For Expensive Health Care? Some Experts Think It Can Work

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http://khn.org/news/mortgages-for-expensive-health-care-some-experts-think-it-can-work/?utm_campaign=KHN%3A+Topic-based&utm_source=hs_email&utm_medium=email&utm_content=31951328&_hsenc=p2ANqtz–8SiGg-U7-uqCJzvDdlmdTr13cm6_QwxOxPWQhSFf56IDJ_6x3RsADDrrTFOdx7U5UTQJLx5niCgAX-2Qr4rGYVGGuSw&_hsmi=31951328

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A Massachusetts Institute of Technology economist and Harvard oncologist have a proposal to get highly effective but prohibitively expensive drugs into consumers’ hands: health care installment loans.

Writing last month in the journal Science Translational Medicine, the authors liken drug loans to mortgages, noting that both can enable consumers to buy big-ticket items requiring a hefty up-front payment that they could not otherwise afford.

Some consumer advocates and health insurance experts see it differently.

“Isn’t this why we have health insurance?” asked Mark Rukavina, a Boston-based health care consultant whose work has focused on affordability and medical debt. “Insurance used to protect people from financial ruin for these unpredictable, costly occurrences. Now, with large deductibles, we’ve got coverage for preventive care but not for treatment.”

Andrew Lo, a financial economist at MIT’s Sloan School of Management, and Dr. David Weinstock, an oncologist at the Harvard-affiliated Dana-Farber Cancer Institute, agree that insurance would be a better option. But for many consumers that isn’t enough protection these days.

Sounds Like A Good Idea? Selling Insurance Across State Lines

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http://khn.org/news/sounds-like-a-good-idea-selling-insurance-across-state-lines/?utm_campaign=KHN%3A+Topic-based&utm_source=hs_email&utm_medium=email&utm_content=31951328&_hsenc=p2ANqtz-9Au4A3tKJC2f1doju3f4Dw18KzyED43y2Sj7CoTrEGMjtO3CgeqJDjl3Yfx5eL8yn5TPahpYi4zAzzsZKEKpwIKhMWag&_hsmi=31951328

Presidential candidates like to propose solutions to long-standing problems. Health care is no exception.

But there’s a reason some problems are “long-standing.” They may have no easy solution. Or the solution is not politically feasible. Or there’s a solution that sounds good on the campaign trail but is not likely to actually work.

In this first of a series of videos of health policy promises that “sound like a good idea,” Julie Rovner explores why increasing competition in health insurance by allowing sales of policies across state lines might not be such a good idea after all.

The Deepest and Most Metaphysical Question posed in Healthcare Today

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Transit fare or health care?

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Transit fare or health care?

This is definitely the deepest and most metaphysical question posed by NYC subway ticket machines.