- Medicaid enrollment declines for the first time in more than a decade as strong US economy boosts income for poor Americans (cnbc.com)50-State Survey Finds Flat Medicaid Enrollment Tied to a Stronger Economy and New Eligibility Systems (kff.org)
Medicaid enrollment fell for the first time since 2007, declining by about 0.6 percent in fiscal year 2018, according to a new report from the Kaiser Family Foundation...States are budgeting for a "minimal" increase in enrollment of 0.9 percent in 2019, the report says..."States largely attribute the enrollment slowdown to a strengthening economy, resulting in fewer new low-income people qualifying for Medicaid," Kaiser says...Federal and state Medicaid spending still grew despite the drop in enrollment. Combined federal and state spending rose by 4.2 percent in fiscal 2018...The report also listed other factors that contributed to the rise in spending, including more expensive prescription drugs and states spending more money to treat substance abuse and mental health...
- How Mergers Will Affect Pharmacists (drugtopics.com)
The Cigna-Express Scripts merger has gotten a go-ahead from the Department of Justice, but DOJ has not ruled on the CVS-Aetna merger at press time...Both deals have shareholder backing... I think it’s part of an overall trend...Effects on Pharmacists...Frederick S. Mayer...CEO of Pharmacists Planning Services Inc...fears that they could result in loss of pharmacy jobs due to closures of independent pharmacies that can no longer compete. Chain pharmacists could also have less job security as locations may close. Mayer also says consolidation could lead to higher prices, lower quality, and less choice for consumers...Pharmacists...trained eight years for their PharmD, and now they are counting, pouring, and typing due to mergers,” says Mayer, who adds that pharmacists in larger settings don’t have adequate time for patient counseling...Over the past 10 years, mergers have resulted in poorer choices of medication for consumers and patients...Chains that are in one of these vertically integrated systems have guaranteed volume without competition on price...Perry Cohen, CEO of The Pharmacy Group...Companies responding to the need for new care models for healthcare services. The marketplace needs new care models and wants to embrace these companies that get ahead of the curve...More Mergers Coming... more vertical mergers and acquisitions...The horizontal is being driven a lot by the reimbursement pressure...The vertical is much more strategic around the control of the overall person’s healthcare...
- This Week in Managed Care: October 19, 2018 (ajmc.com)
Laura Joszt, Managing Editor at The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network
- Azar deals woe to DTC—and a slap to Big Pharma—with vow to force prices into drug ads (fiercepharma.com)U.S. TV drug ads to carry information on prices (reuters.com)
Pharma might have thought it could fend off the Trump administration's bid to get drug prices into consumer advertising, but it was wrong...Even a last-ditch set of concessions—announced by PhRMA Monday morning—couldn't forestall HHS Secretary Alex Azar's own proposal Monday afternoon. The pharma plan was "a small step," Azar said, before saying he'd require DTC television ads to include the list price on all $35-and-up drugs covered by Medicare or Medicaid, which is essentially every drug in the pharmaceutical universe...And Azar didn't just counter. He took direct aim at the just-announced PhRMA idea.
- CMS eyes Part D catastrophic coverage reforms that would shift risk to insurers (fiercehealthcare.com)
The Trump administration is looking for ways to change the Medicare Part D drug program that would shift more risk to plan sponsors when members reach the final catastrophic coverage stage...The catastrophic coverage tier of Part D kicks in when a member reaches $5,000 in out-of-pocket costs. At that point, patients pay a flat fee or 5% of the negotiated retail drug cost, and the federal government picks up 80% of the remaining costs and plan sponsors pay 15%...That could change. Catastrophic coverage under Part D was initially developed to encourage private insurers to participate, Centers for Medicare & Medicaid Services Administrator Seema Verma said...A lot has changed since then, and now it’s “one example where Part D could be updated or modernized.”...We’re at the point now where it would be better for Part D plans to manage that portion of the benefit,” she said. “That way we could bring competition and negation to that piece as well.”
- Advancing Toward the Goal of Global Approval for Generic Drugs: FDA Proposes Critical First Steps to Harmonize the Global Scientific and Technical Standards for Generic Drugs (fda.gov)
...FDA launched a Drug Competition Action Plan that focuses on three key areas designed to facilitate more generic competition, promote patient access, and improve the economics of developing generic medicines...While we’ve made substantial progress in fostering more competition by resolving obstacles that can make it difficult to win approval of generic versions of certain complex drugs, increasing the speed of generic approvals, and closing down ways that branded companies game the system to prolong drug monopolies, there’s still more work to be done...So we’re opening up some new policy fronts when it comes to our Drug Competition Action Plan. And we’re re-launching that plan for 2019 with some additional initiatives. Chief among them is a new effort that FDA has proposed to the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH), a key international body comprised of other regulatory authorities and the pharmaceutical industry: The pursuit of common global development standards for generic drugs...The ultimate goal of this global harmonization of scientific and technical requirements would be the attainment of a single global generic drug development program that can support simultaneous regulatory filings across multiple markets. Harmonization of these requirements is foundational to achieving a future goal of enabling global approval for high quality generic drugs.
- October 19 Pharmacy Week in Review: Drug Prices in Television Ads and Possible Link Between Weight Gain and CRC in Women (pharmacytimes.com)
Nicole Grassano, PTNN, Pharmacy Week in Review, this weekly video program provides our readers with an in-depth review of the latest news, product approvals, FDA rulings and more.
- As elections near, PhRMA’s lobbying spend on track for potential record-breaking year (fiercepharma.com)
Pharma has found itself an easy political target in Washington, and as a critical election nears, the industry's lobbying spend shows drugmakers are taking the threat of pricing reform seriously—and shelling out big-time to avoid it...Through the third quarter, pharma's top trade group PhRMA has spent $21.5 million lobbying lawmakers, a 10% increase over the same period last year...The figure puts PhRMA on track to beat last year’s spending of $25.43 million...
- Drug giant Pfizer offers early retirement ahead of layoffs in memo to employees (cnbc.com)
...Pfizer is offering early retirement to U.S. workers ahead of layoffs early next year, it announced internally to employees…The company...employs more than 90,000, didn't say how many people it plans to cut. But it told employees…that all business units and divisions will likely lay off nonunion workers, according to materials outlining the workforce reduction program…As we prepare for growth we are creating a simpler more efficient structure which will affect some managerial roles and responsibilities. We are offering enhancements to certain benefits to lessen this effect...Overall, its workforce will shrink by "a couple percentage points,"
- 5 questions on the Trump admin’s bid to mandate prices in drug ads (biopharmadive.com)
The Trump administration took one of its more combative moves on drug pricing Monday, when Health and Human Services Secretary Alex Azar introduced a proposal requiring drugmakers to disclose list prices in television advertisements...The proposal sets up what is expected to be a confrontation between the drug industry and the federal government. It also raises a slate of legal, political and regulatory questions that will be debated in the coming months. Here are five of the most pressing, and what experts are saying about them:
- Can the administration actually do this?
- Would putting prices in TV ads actually help?
- Will PhRMA sue?
- Why did the Trump administration choose to make this a signature proposal?
- Which drugmakers would hate this most?