Unbiased Analysis of Today's Healthcare Issues
In general, one expects progress. One expects that medical advances will improve life expectancy. In recent years in the U.S., however, that is no longer the case. The CDC reports that: …life expectancy at birth decreased in recent years for the first time since 1993. Between 2014 and 2015, life expectancy at birth decreased 0.2…
A number of people talk about Medicaid “best price”…but what is it really? StatNews provides a concise overview: The Medicaid best price law, enacted in 1990, requires drug manufacturers to charge the Medicaid program the lowest or “best” price they negotiate with any other buyer and send a rebate check to every state Medicaid department so…
CEA and value-based care. Spending dynamics and health shocks. Are we ready for access restrictions based on CEA? Does Amazon lead to higher prices? The political power of pre-existing conditions.
The 340B program requires pharmaceutical firms to give large discounts to hospitals and clinics that serve high volumes of low-income patients. This sounds like a good idea at first: give money to people who can’t afford their medicines. However, when one reads the sentence above closely, it becomes clear that patients don’t receive these discounts:…
CMS recently authorized Medicare Advantage (MA) plans the ability to apply step therapy protocols to Part B drugs. Although it is not clear the degree to which the MA plans will implement step therapy, a good guide is to see what is happening in the commercial insurance market. A Health Affairs blog by Chambers, Panzer and Neumann attempts…
Darius Lakdawalla has an very interesting review article in the Journal of Economic Literature on the Economics of the pharmacuetical industry. Do read the whole thing, but below I have listed some highlights. A model of firm R&D decisions Lakdawalla uses a simple model based on Nordhaus (1969) to derive some important implications about pharmaceutical…
A recent viewpoint from Fendrick and Shope (2018) argues for the need for Precision Benefit Design. Successful implementation of precision medicine will need to address several system-wide challenges, including administrative complexities, the creation of new financing models, and aligning provider- and patient-focused initiatives. The enormous clinical potential of precision medicine sheds light on the critical…
Stan for economists. The state of healthcare in a majority minority state. Will undiagnosed atrial fibrillation become a thing of the past? Does free medical school decrease social justice? A $100,000 heart attack (out-of-pocket with insurance!)
The title of this post comes from a speech from Columbia health policy and management professor Lawrence Brown. For years, Presidents and other politicians have noted that rising health care costs will lead to the collapse of the system. Michael Millenson highlights this state of unending crisis in his Health Affairs blog post titled “Half A…
Innovation in health care often improves quality but also increases cost. That is not always the case. Consider the case of an innovative Bangladeshi physician who was interested in improving care for patients with pneumonia who could not afford the $15,000 cost of the ventilators used in a developing work: However, after a second piece…