Links
ICER’s reference case. Digital therapeutics: What the US can learn from Europe. Digital clinical trials in mental health. What happens to health programs if the government shuts down? Medical debt in the US.
Techniques pharmacy benefit managers use to lower cost
How do pharmacy benefit managers (PBM) claim they can reduce cost? A Health Affairs Forefront article by Brennan and Shrank (2023) identify 6 key pathways: Mail order. Mail order alternative is often cheaper than dispensing at the retail pharmaciesdue to greater scale and automation Negotiating power. PBMs leverage purchasing power to lower dispensing fees. PBMs…
What’s new in the 2023 ICER Value Assessment Framework?
On September 25, ICER released its 2023 value assessment framework. What is new? What stays the same? Here are a few key points you need to know. Special cases for ultra-rare and single or short-term therapies (SST): These did not change from previous. Adaptations for ultra-rare disease (from Jan 2020) Single or short-term therapies (from…
Does the 340B program improve quality of care?
According to a paper by Smith et al. 2023, the answer is ‘no’. The authors use data from AHRQ’s Healthcare Cost and Utilization Project (HCUP) State Inpatient Data, Hospital Cost Reporting Information System Data, Office of Pharmacy Affairs Information System Data, and American Hospital Association Annual Survey for 15 states between 2008 to 2014. The…
FDA Guidance on using Real-World Data for regulatory Decision-Making
Last month, FDA released guidance on the use of real-world evidence to support regulatory decision-making for new drugs. Below are some of the key points from this guidance document: Legislative mandate. The 21st Century Cures Act (Cures Act), signed December 2016, mandated that the FDA consider how to incorporate real world data (RWD) into regulator…
Health gains from rare disease, specialty and expedited review drugs
James Chambers has put together a series of papers looking at health gains (and cost effectiveness) using the Tufts Cost Effectiveness Analysis Registry. In these studies , he finds that treatments for rare diseases, specialty drugs, and those that receive expedited review are more likely to provide the largest health benefit (≥0.9 QALYs gained versus…
Links
Biosimilar “skinny labels” Expensive generics? EU to ban payment for milk, sperm and blood Google Health on AI. Victor Fuchs has passed away..
Increased number of rural counties do not have any local primary care physicians
How did the number of pediatrician and family medicine physician (FMP) change between 2010 and 2020, particularly for rural areas? A paper by Ramesh and Yu (2023) use data from the Health Resources and Services Administration (HRSA) Area Health Resources Files and and county characteristics from the American Community Survey and find that: From 2010…
Who gets a better deal: Health plans or self-insured employers?
The answer is health plans according to a new paper by Sen, Chang and Hargraves (2023): Using the Health Care Cost Institute’s data set of claims for one-third of the US population with employer-sponsored insurance, we found that unadjusted prices were higher in self-insured plans for most of the services we studied, with the largest…
The long-term effectiveness and cost-effectiveness of public health interventions; how can we model behavior?
That is the title of an interesting review paper by Squires et al. 2023. The abstract is below: The effectiveness and cost of a public health intervention is dependent on complex human behaviors, yet health economic models typically make simplified assumptions about behavior, based on little theory or evidence. This paper reviews existing methods across…