- This Week in Managed Care: August 31, 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
- Washoe County school board approves Renown contract, will explore other health-care options for next year (thenevadaindependent.com)
The Washoe County School District Board of Trustees voted...to renew contracts with Renown Hospital and its insurance arm while also beginning the process of scouting out alternative options over the next year to address the long-term solvency issues of its health insurance fund...trustees voted unanimously to direct the superintendent to begin a competitive request for proposals process over the next year to explore other health-care options for employees and retirees as the district grapples with the rising costs of health care and an insurance fund balance that isn’t keeping up. They then voted to approve three-year contracts with Renown and Hometown Health...Saint Mary’s Health Network, which had held the longstanding contract to provide coverage to district employees, cried foul about the renewal process for the Renown and Hometown Health contracts this year, saying that it could provide health care more cost effectively but hadn’t been given a fair shot to prove to the district that it could do so. Amber Norris, director of business development and marketing for Saint Mary’s, said at the meeting that the request for proposal is “a move in the right direction” and that the health network looks forward to submitting its proposal...
- FEMA releases after-action report on Las Vegas shooting (reviewjournal.com)Oct. 1 after-action report does not address confusion over UMC’s status (reviewjournal.com)FEMA 1 October After-Action Report (scribd.com)
Las Vegas police and Clark County firefighters experienced numerous communication problems and failed to follow some protocols on the night of the Oct. 1 mass shooting...But the 61-page report also described the response to the attack — which left 58 concertgoers dead and more than 800 people injured — as “efficient” and “coordinated,” crediting the counter-terrorism training of Las Vegas police...The Federal Emergency Management Agency created the report with participation from the Metropolitan Police Department and the Clark County Fire Department. It took nearly a year to complete and includes 72 lessons learned.
The after-action report...makes no mention of confusion surrounding University Medical Center’s bed availability in the immediate aftermath of the...shooting...The report, commissioned with “the intent of distributing best practices and lessons learned for other communities around the country to better prepare for a mass casualty incident,” did not address communication issues surrounding the county-run hospital’s status. Nor does it mention the county-run hospital’s improper use of an “internal disaster” alert.
- This Week in Managed Care: August 24, 2018 (ajmc.com)
- August 31 Pharmacy Week in Review: Digital Health Market Growing Rapidly, Testing For Gene Mutation Linked to Cancer is Underused (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.
- FDA confronts its limits in push on drug pricing (biopharmadive.com)
Legally, the agency has few levers to pull when it comes to addressing prices. But that hasn't stopped Commissioner Scott Gottlieb from taking a more spirited and vocal approach than past FDA chiefs. The effort comes as eye-popping price tags, some spurred by groundbreaking new treatments but others by manipulation of the drug pricing system, have prompted public and political opposition to rising drug costs...Gottlieb has aggressively used public statements to call out drugmakers for blocking or impeding market competition. And, under his leadership, the FDA has continued to ramp up approval of generic and biosimilar drugs, while pushing the boundaries of regulatory flexibility.
- Indirect effect..."Where the FDA does have authority to get involved is in how much, in what way, and how aggressively it approves drugs, or their generic or biosimilar competitors."...While it's an indirect effect, approving low-cost competitors more quickly can be a powerful force for lowering prices.
- Biosimilars showcase hurdles facing FDA...speeding competitors to market can only go so far if other forces block lower-cost rivals from reaching patients. To date, that's exactly what's played out with biosimilars...Gottlieb has expressed frustration that the FDA's steady increase in approving biosimilars hasn't resulted in greater savings. "Competition is, for the most part, anemic,"
- Naming and shaming...Gottlieb has made full use of his public platform to call out market "shenanigans" by drugmakers...Gottlieb received a lot of media coverage by attacking such practices as "regulatory gaming," and has since kept up pressure on drugmakers through public statements.
- Worth cooperating?...As Health and Human Services Secretary Alex Azar and Gottlieb continue to criticize pricing and anticompetitive practices, drugmakers are faced with a choice: ignore the growing chorus or cooperate.
- What the FDA Wants Pharmacists to Know About Generic Drugs (drugtopics.com)
Demand for generics and biosimilars is growing. In 2017, generic drugs generated $265 billion in savings. New biosimilars could play a major role in increasing competition and driving down costs...Drug Topics spoke with officials from the FDA’s Office of Generic Drugs (OGD)and from the Therapeutic Biologics and Biosimilars team (TBB) about how the agency is helping accelerate generics to market, and the role pharmacists play in educating patients about the safety, effectiveness, and quality of generics and biosimilars.
- DT: How is the FDA accelerating generics to market? What are some of the obstacles? What does the generic market look like going forward into 2019 in terms of approvals?
- DT: As more generic drugs enter the market, what role can pharmacists play in educating healthcare providers about using generics? How are pharmacists positioned for this task? How does the FDA disseminate information/reports to the pharmacy community on generic drug development and review?
- DT: What is the status of biosimilars in regard to lowering healthcare costs?
- DT: What do you see as the biggest challenge for the healthcare industry as the new forms of drugs are introduced?
- DT: What else might be important for our readers to consider regarding biosimilars?
- How Can Medicare Save A Billion Bucks? Use Generics (ptcommunity.com)Medicare Spending on Brand-name Combination Medications vs Their Generic Constituents (jamanetwork.com)
In 2016, the cost difference between the amount that the Medicare Part D drug program spent on brand-name combination medications and the estimated cost for generic constituents for the same number of doses was $925 million, according to an investigation in the Journal of the American Medical Association...a retrospective analysis of Medicare drug spending from 2011 through 2016, looked at 29 brand-name oral combination medications, separated into three categories: medications that were available in generic form at identical doses; generic medications available at different doses; and therapeutically equivalent generic substitutes. The savings for all three categories was in the millions of dollars, with the largest discrepancy (an estimated $471 million) seen with the therapeutically equivalent generic substitutes. The authors also found that for the 10 most costly combination products that were available throughout the entire study period, the listed Medicare spending could have been an estimated $2.7 billion lower if the generic constituents had been prescribed.
- Lawmakers push to require price disclosure in DTC drug ads (biopharmadive.com)
The Senate...passed a measure that would provide the Department of Health and Human Services with $1 million to implement proposed rules requiring drugmakers disclose the price of their prescription drugs in direct-to-consumer advertising...Approved as part of a larger spending bill, the bipartisan amendment gives legislative backing for an idea that the Trump administration has pushed as part of its plan to combat rising drug prices...touted the measure as a common-sense step toward greater transparency, it's a proposal likely to generate substantial debate. Drug prices are notoriously opaque, and most patients don't pay the so-called "list price" that such a requirement would likely rely on..."We have FDA and CMS working to examine how to require drug companies to post their list prices in direct-to-consumer advertising. When patients hear about a wonderful new drug, they should know whether it costs $100 or $50,000," said HHS Secretary Alex Azar...The administration's proposal, unsurprisingly, has been met with resistance from drugmakers..."Disclosing list prices in DTC ads would not benefit patients as they are often not the prices insurers pay and are generally not a good indicator of what patients will pay at the pharmacy counter," wrote a spokesperson for PhRMA...
- State OKs contract to move off federal health insurance exchange platform (lasvegassun.com)Nevada health exchange rates expected to see lowest rise yet (lasvegassun.com)
Nevada is looking to save more than $18 million by transitioning the state’s health insurance exchange from healthcare.gov to its own platform under a newly approved contract...The Board of Examiners...approved contracts...that included a $24.4 million, five-year deal with GetInsured for the platform and a call center. The move will save the exchange $18.9 million through 2023 as costs rise to use healthcare.gov, said Heather Korbulic, executive director of the Silver State Health Insurance Exchange...The GOP tax law’s elimination of the individual mandate — a tax penalty for certain people without insurance intended to encourage healthy people to buy plans, which helps stabilize the marketplace — is expected to raise average premiums about 10 percent almost annually for a decade, according to a November 2017 Congressional Budget Office report...Korbulic said a state-run platform will not only save the state money but help protect Nevada from much of the uncertainty in the market as federal health care policies remain in flux. She has said moving away from healthcare.gov would give the exchange more data to understand demographics that are being reached and those that need more targeted resources