How much do narrow networks impact premiums?

Patients hate narrow networks. Anything that limits their choice of physicians or hospitals is disliked. Americans love more choice. Payers, on the other hand, like narrow networks because they save cost–through the ability to negotiate lower rates–and potentially increase quality–if the contracted network has higher quality physicians. In fact, according to the KFF Employer Health…

Impact of Education on Mortality

It makes sense that more educated individuals have lower mortality rates. Better education may improve health literacy. More education can lead to higher income and and more employee health benefits (with better insurance coverage). However, does living in communities with more educated individuals impact mortality separately from whether an individual’s family is highly educated? According…

How would the inclusion of specialty drugs impact CPI-Rx?

The Bureau of Labor Statistics’ (BLS’) Prescription Drug Consumer Price Index (CPI‐Rx) looks at price changes for drugs dispensed at outpatient retail pharmacies. However, many pharmaceuticals–especially infusions and injections–are administered at physician offices or hospitals. How would including physician-administered drugs impact the CPI-Rx? That is the question a paper by Hicks, Berndt and Frank (2024)…

340B costs Medicaid $32b per year

The 340B Drug Pricing Program is a federal initiative designed to help certain healthcare providers, known as “covered entities,” stretch their resources to better serve vulnerable and underserved patient populations. Created in 1992, the program requires pharmaceutical manufacturers to sell outpatient drugs at significantly discounted prices (typically 25% to 50% off) to eligible hospitals, clinics,…

HTA and cell and gene therapy

A paper by Drummond et al. (2023) examines how health technology assessment bodies deal with the challenge of value assessment for cell and gene therapies (also known as Advanced Therapy Medicinal Products (ATMPs) in Europe). To do this the authors: …undertook i) a targeted review of the literature on the clinical and economic evidence needs…

Links

Gene editing without CRISPR? RCTs in economics. Claude and GTP4o on bias-adjusted nearest neighbor matching. Opioid prescriptions falling in workers comp. Since 2010, 149 rural hospitals have closed. Digital Health startups raise $1.1b in Q1 2024.

Drug shortages in the US

The good news: drug shortages in 2023 were down in the US from their recent peak between 2010 to 2012. The bad news: Drug shortages in 2023 were the highest they have been since 2012. These findings are from an FDA Report to Congress. Of note, shortages for biologic drugs (governed by CBER) increased a…

Empirical Estimates of Loss Aversion

Kahneman and Tversky’s Prospect Theory posit that individuals have loss aversion. What is loss aversion? It means that individuals experience losses more intensely than gains of the same magnitude; for instance, the psychological impact of losing a certain amount of money is greater than the pleasure derived from gaining that same amount. A key question…

Is it time to start using a 2% discount rate?

Cohen (2024) argues that health economists should start using 2% discount rates for health economic models. Why is that? I summarize the article below. First, Cohen discusses two different methods for estimating discount rates. Ramsey equation. This approach consider 4 factors: pure time preference, catastrophic risk, wealth effect, and macroeconomic risk. The first 3 factors…