Unbiased Analysis of Today's Healthcare Issues
Copay cards are somewhat controversial. These cards or coupons are used to help patients afford copayments and deductible payments patients owe when using pharmaceuticals. On the one hand, these programs are highly beneficial for patients. Patient out-of-pocket costs have risen dramatically in recent years, even among the insured. For instance, whereas only 7% of workers…
An economist’s algorithm, at its best, values being simple, being reasonably easy to analyze, and having clear mathematical properties that show why it’s optimal (or least-bad) for the task that it’s trying to solve, and ideally proves bounds on how much damage someone can do by trying to exploit it. An engineer’s algorithm, on the…
Do Medicare Advantage beneficiaries understand their plan? How much are doctors paid in England? Health insurance exchanges and reinsurance. Utilization management for Part D cancer drugs. “340B Program participation has not demonstrated improved quality of inpatient care among Medicaid or uninsured patients.” Economic Incentive for timely completion of confirmatory clinical trials.
While the Inflation Reduction Act (IRA) aims to lower the prices of pharmaceuticals, at the same time it exempts drugs treating rare diseases (i.e., orphan drugs) from drug price negotiation. However, this exemption is only valid if the orphan drugs has a single approved indication. Thus, a key question is how frequently orphan drugs are…
How much money will IRA save Medicare? A paper by Hernandez et al. (2023) aims to answer this question. The methods they use are as follows: For the 10 drugs likely subject to negotiation by Medicare in 2026 based on 2020 gross spending and loss of exclusivity, we extracted 2020 data from 5 sources: (1)…
You’re mistaken when they think that technology just automatically improves. It does not automatically improve. It only improves if a lot of people work very hard to make it better. And actually it will, I think, by itself degrade actually. If you look at great civilizations like ancient Egypt and they’re able to make the…
What is the cost of an intervention to improve health? This seems like a simple question, just add up the costs. However, some costs are variable and some are fixed. Thus, adding an extra person to an intervention may not equal to the average cost as fixed costs may not increase. Additionally, there may be…
What is the impact of being insured on health outcomes? This is a difficult question to answer in part because of adverse selection (e.g., sicker patients may choose to be insured). But even absent adverse selection, the ability to diagnosis a disease may vary between the insurer and uninsured. Consider this example from Kaliski (2023):…
Value-based care and operational context. Miss diagnosis. Explaining variation in health care costs: ⅘ utilization, ⅕ prices. All of Us. Enneagrams.
That is the subtitle of an NBER working paper by Charles Gray, Abby E. Alpert & Neeraj Sood. The author examine recent mergers between pharmacy benefit managers (PBMs) and health insurers. On the one hand, integration may beneficial to consumers. It could: (i) improve operational efficiencies, and (ii) better align PBM incentives with those of…