Author: Peter

The Nevada Senate Health and Human Services Committee heard a bill Wednesday that aims to restrict which medical professionals can administer Botox...The bill, sponsored by State Sen. Joe Hardy...would bar dental hygienists, medical assistants and aestheticians from administering botulinum toxin...one of the biggest reasons for restricting who can administer the powerful toxin is the lack of training some have in spotting infections...The bill was fiercely opposed by dental hygienists...it was unfair to categorize dental hygienists with the other professions included in the bill, claiming they have extensive training in anatomy around the head and neck...No states allow dental hygienists to administer Botox...

Federal authorities are stepping up investigations at Department of Veterans Affairs medical centers due to a sharp increase in opioid theft, missing prescriptions or unauthorized drug use by VA employees since 2009…Doctors, nurses or pharmacy staff at federal hospitals — the vast majority within the VA system — siphoned away controlled substances for their own use or street sales, or drugs intended for patients simply disappeared...Aggravating the problem is that some VA hospitals have been lax in tracking drug supplies...Reported incidents of drug losses or theft at federal hospitals jumped from 272 in 2009 to 2,926 in 2015, before dipping to 2,457 last year, according to DEA data...The GAO review...found the most missed inspections at VA's hospital in Washington, D.C...Monthly checks were missed there more than 40 percent of the time, mostly in critical patient care areas, such as the operating room and intensive care units…Responding to the findings, the House Veterans Affairs Committee planned a hearing on the inspection issue. Its chairman, Rep. Phil Roe, a physician, said failing to follow protocol is serious and "should not be tolerated within VA."

As high pharmaceutical prices strain budgets of payers and patients alike, Harvard Pilgrim is betting so-called pay-for-performance deals will help lower drug costs and improve patient outcomes...The...health insurer announced...it had inked two separate agreements with Amgen and Eli Lilly that tie the costs of Amgen's Enbrel (etanercept) and Lilly's Forteo (teriparatide) with either performance or patient adherence...a number of large drugmakers have begun pushing value- or outcomes-based payments as a potential solution to blowback on rising drug prices. Under these types of deals, insurers and other payers would pay less for drugs that fail to meet specified benchmarks. Drugmakers, on the other hand, would be rewarded for innovative medicines that improve outcomes.

At least one of President Trump's possible picks to head the Food and Drug Administration has a radical idea for when drugs should come to market...Jim O'Neill, managing director at Mithril Capital, has said that he is in favor of approving drugs that are proven to be safe, even before they're shown to be actually effective...Regardless of who Trump picks in the end, his interest in cutting regulation at the FDA is clear..."We're going to be cutting regulations at a level that nobody's ever seen before," Trump said in a meeting with pharma executives...As it exists right now, the FDA approval process can be a long and expensive…

The next few years are likely to see a major attempt to use market mechanisms to reduce the cost of U. S. healthcare. Healthcare costs are rising again, and Republican campaign promises will put huge pressure on the federal budget. Republicans prefer market based solutions to problems, and they harshly criticize the parts of Obamacare that expand health insurance participation by means of entitlements and sanctions...they feature a shift from defined benefit federal health programs like Medicare and Medicaid, which entitle individuals to the care they need mostly at government expense, to defined payment programs that give individuals a fixed payment based on their life status and leave them responsible for buying the care they need…Since the beginning of the digital health era, entrepreneurs have been interested in creating businesses that enable healthcare consumerism...Healthcare consumerism is very hard to pull off. Price data is still hard to access, understand, and compare...I suggest these guiding principles for entrepreneurs seeking to ride the new wave of healthcare consumerism:

• Choose a sector with favorable characteristics: one in which consumers can judge the value of one offering relative to another and, given choices with different prices, they can choose better value without great risk or inconvenience.
• Consider business models that give healthcare consumers the benefit of professional buyers acting on their behalf.
• ...bear in mind that there are many opportunities in digital healthcare beyond business models that enable healthcare consumerism...businesses focused on making healthcare more efficient by other means, or solving long-standing problems of patient outcomes, comfort, safety, and convenience stand to do well...

China has updated its list of medicines covered by national medical insurance, adding some new drugs with a focus on pediatrics and major illnesses such as cancer, hepatitis, and renal and cardiovascular diseases…The overhaul, the first since late 2009, saw the number of "Western-style" and traditional Chinese medicines included in the list grow by 15% to 2,535, among which 1,297 are Western-style meds, an 11% increase...The additions include some blockbuster meds like tenofovir, an antiviral drug to treat hepatitis B and HIV...and cancer drug gefitinib...China’s own non-small cell lung cancer med icotinib…The ministry (Ministry of Human Resources and Social Security) also put 45 drugs on a “to-be-negotiated” list, half of which are targeted cancer therapies...inclusions of new drugs would reduce the financial burden on patients and help support innovations in China's pharmaceutical market...The National Reimbursement Drug List names all the drugs covered by the insurance program, some in full and others partially. Patients must pay the full price out of pocket for those drugs outside the list, which means a huge financial burden, especially when new but more effective drugs are not covered..

Hoping to speed up future regulatory review for its drug candidates, Gilead has agreed to buy a priority review voucher from Sarepta Therapeutics for $125 million...Sarepta had obtained the voucher — a transferrable credit designed to speed review by the Food and Drug Administration by four months — for winning approval of its disease-modifying treatment for Duchenne muscular dystrophy last year...Sale of the voucher, albeit for a lower price than some had expected, will bolster Sarepta's cash position and help fund clinical development of Sarepta's pipeline and manufacturing scale-up…For Gilead, the voucher could be used to speed review for one of its several late-stage candidates. The $125 million is a relative bargain as well, compared to both the recent prices paid by Sanofi and AbbVie as well as to Gilead's large cash hoard.

Nevada Gov. Brian Sandoval said Saturday he would take his concerns about the overhaul of the Affordable Care Act to Capitol Hill where lawmakers are mulling over various proposals to replace Obamacare...The nation’s governors, in town for their annual meeting, are expected to spend Monday talking with Republican leaders and members of Congress about repeal and replacement of the health care act...Many states, including Nevada, broadened Medicaid programs to take advantage of federal funds to help insure more elderly and poor. Officials in those states are concerned about how the federal government will continue its funding commitment for the expanded programs...Sandoval said congressional overhaul of the ACA is a top concern for governors and that the “conversation is ongoing.”...

Laura Joszt, assistant managing editor at The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network

Brian Haug, President of Pharmacy and Managed Markets, Pharmacy Times (PTNN) This weekly video program highlights the latest in pharmacy news, product news, and more.