Unbiased Analysis of Today's Healthcare Issues
How should you report the methodology, results and limitations of your economic model? One of the most commonly used approaches is the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. CHEERS was developed in 2013 (Husereau et al. 2013) and a new version has been developed this year (Husereau et al. 2022). Below are the…
In 2021, the Food and Drug Administration’s Center for Drug Evaluation and Research (CDER) approved 50 new drugs, either as new molecular entities (NMEs) under New Drug Applications (NDAs), or as new therapeutic biologics under Biologics License Applications (BLAs). FDA summarizes these approvals in their recently released report titled: Advancing Health Through Innovation: New Drug…
New pharmaceutical products aim to help individuals live longer, healthier lives. However, when new drugs come to market, they are typically indicated for a specific disease. In the real world, however, many individuals face multiple conditions. In fact, 57% of Americans have 2 or more medical conditions and 27% have 5 or more medical conditions.…
Specialty drugs have delivered significant improvements to patient health, but oftentimes they pay be expensive. To try to insure that these treatments are used appropriately, some health plans impose a utilization management tool known as “prescriber requirements” where only certain types of physicians may prescribe a drug. While this may be useful for some complex…
While generic drugs frequently replace their branded counterparts after the latter lose their market exclusivity, the uptake of biosimilar products is often slower. Further, biosimilars are relatively more expensive compared to generic small molecule drugs. A key question then is how much could payers save by switching to biosimilars after loss of exclusivity. The is…
Clayton 2019 is an interesting study on the impact of drug spending on Medicaid beneficiary mortality levels. The author uses variation in the roll out of Medicaid drug coverage by state across different Medicaid eligible groups in order to isolate plausibly exogenous variation in drug expenditures. Using this approach, Clayton finds that: …a $1 increase…
In the provider space, alternative payment models are increasingly common. These models aim to pay more money when providers improve quality and lower total cost and pay providers less when quality is suboptimal or total cost rise. Because there is significant uncertainty in quality of care and variability across providers, value-based purchasing is sensible in…
Perhaps surprisingly, the answer is PBMs, not drug manufacturers. That is one of the conclusions discussed in a recent commentary by Good and Hernandez (2021). They try to get to the bottom of this question, writing: Most explanations for increasing drug costs start with drug companies, and indeed they are an easy target. Manufacturers in…
As the number of infections that are anti-biotic resistant grows, we need to have more novel antibiotics in our arsenal. The problem is that many antibiotics are not commercially viable. For instance, if a new antibiotic is marginally better than the existing one, few payers will be willing to cover this cost. However, if new…
If you are on Medicare, how much will you pay for insulin? The answer is in the graph below (via MedPAC’s Payment Basics) Seem confusing? Well it is. Medicare Part D beneficiaries have a deductible, then the standard coverage phase with 25% cost sharing, then a coverage gap where beneficiaries pay 25% of cost (manufacturers…