The Trump administration’s “American Patients First” drug pricing plan announced last week stops short of enabling Medicare to negotiate drug prices (not currently legal under Medicare Part D), although it was one of Trump’s key campaign themes. It focuses on lowering high list drug prices, reducing out-of-pocket consumer costs and addressing foreign market cost advantages. It also empowers the administration to explore paths to lower Medicare’s drug spend. Health and Human Services Sec. Alex Azar says the agency is considering negotiating for Medicare Part B drug prices; CMS may use PBMs and health plans to do it.
(
Reuters
;
STAT
;
Blueprint to Lower Drug Prices
)
|
|
Health and Human Services Sec. Alex Azar took aim at doctors who take advantage of a Medicare Part B rule that allows them to profit from direct drug sales to patients. The practice, which pays doctors a 6 percent markup over the cost of the drugs they buy up front and then administer to patients, is an incentive to prescribe more costly drugs. Instead of paying physicians a percentage markup, Medicare should pay doctors a fair price for administering the drugs, Azar says. (
MedPage Today
)
|
|
Innovation & Transformation
|
|
The U.S. Department of Veterans Affairs released its final rule this week enabling telehealth services across states, regardless of provider licensing regulations or rules and no matter where the doctor or veteran is located. The VA, the nation’s largest integrated health care system, will expand its current telehealth services to provide care for rural residents and those for whom a fast, convenient in-person visit isn’t practical. (
HealthData Management
)
|
|
The experiment to create an all-payer accountable care organization in Vermont—including Medicare, Medicaid and Blue Cross and Blue Shield—is showing early gains, according to a Commonwealth Fund report. More than half of the state’s physicians and nearly all its hospitals are part of the ACO, which supports care coordination for high risk and “rising risk” patients. Those patients have already increased their use of primary care and behavioral health services, as well as pharmacy benefits, while decreasing hospital stays and use of the emergency department for care. (
Healthcare Dive
;
Commonwealth Fund
)
|
|
Some specialty drug prices are climbing into the six figures per employee per month, decimating the benefits budget for self-insured employers. Specialty drug prices have escalated since federal regulations began requiring policies cover everyone, regardless of health status. Food & Drug Administration practices that make specialty drugs available more quickly are also behind recent price spikes. Employers are turning to third-party negotiators and deep research into effectiveness to ensure access to needed care while preventing expensive drugs from raising everyone’s premium costs.
(
Forbes
)
|
|
Nearly 14,000 genetic tests have hit the market since 2015—an average of nearly 10 each day—according to a
Health Affairs
study. Clinical demand for better diagnostic, treatment and monitoring tools are fueling the demand, in conjunction with patient demand, increased knowledge and the freedom to market the tests without Food and Drug Administration approval. The writer says prenatal tests capture the largest piece of the genetic spending pie, followed by hereditary cancer tests. (
MedPage Today
)
|
|
Do you have a colleague who needs to keep up with health news and trends? Share
H2R Minutes
today!
|
|
|
Medical device recalls break record:
Software complications and bugs are a significant driver for record-breaking numbers of medical device recalls this year. More than 200 million devices were recalled in the first quarter of 2018, more than the total number of recalled devices in all of 2017. (
FierceHealthcare
)
|
|
FDA names and shames:
As early as today, the Food and Drug Administration plans to provide access to complaint letters it received from generic drug companies alleging that branded pharmaceutical companies have failed to provide needed samples and other anti-competitive activities
. (
The Wall Street Journal
[subscription access])
|
|
Introducing Health2 Resources' Baffled Health™ Podcasts
|
|
Baffled Health™ is Health2 Resources’ podcast series about real people, totally bewildered, on their health care journey. On this five-minute podcast, we hear from Daniel, stymied in his recovery from a serious injury by a neurosurgery practice that wouldn’t give him a 30-day surgery followup appointment. Are arcane billing rules the culprit? Listen and find out. (
Baffled Health podcast
)
|
|
MarketVoices...quotes worth reading
“I don't think Part B envisioned paying 6 percent on top of a half-million-dollar drug." Seema Verma, administrator of the Centers for Medicare & Medicaid Services, at a briefing about Medicare Part B physician reimbursement for up-front patient drug purchases, as quoted by
MedPage Today
.
|
|
Editor
Sandy Mau
Request Media Kit
703.394.5395
|
|
|
Copyright 2009-2018,
H2R Minutes
|
|
|
|
|
|
|
|
