Unbiased Analysis of Today's Healthcare Issues
In recent decades, drug prices have risen. To offset this cost, pharmacy benefit managers have negotiated increasingly large rebates which drug manufacturers pay health insurers. PBMs argue that rebates help keep net drug prices down. Manufacturers argue that PBMs want higher list prices so they can negotiate larger rebates. Patients may not like rebates if…
How do you get your prescription drugs? For most people, it involves going to your local pharmacy and picking up your pills. But what if the drugs you needs are infused treatments that have to be administered at a physician’s office? Typically, you just show up at a physician’s office and it’ll be ready for…
Conventional wisdom holds that the prices of pharmaceuticals are higher in the US than in other countries. But is that really the case? And if so, by how much? Which price? The question we need to answer is “which price” do you mean? There is the manufacturer wholesale price (i.e., gross price) which is how…
In general, you would think the answer is no. If there are multiple treatments available, patients have more choice. Further, the treatments may need to compete with one another which may lead to lower prices. One issue with drug prices is that the the list (a.k.a. gross) price affects patient cost-sharing, but the net price…
That was the conclusion of The Economist on his decision to suspend intellectual property protections for the makers of COVID-19 vaccines. In the article “Ten million reasons to vaccinate the world“, they write: Many experts argue that, because some manufacturing capacity is going begging, millions more doses might become available if patent-owners shared their secrets,…
Conventional wisdom would hold that the prices are rising…aren’t they? To correctly answer this question, one must define which prices you are talking about. Are we looking at the list price that is widely available or the net price after we take into account discounts are rebates life sciences firms pay? A paper by Sarpatwari…
Leah Rand and Aaron Kesselheim have an interesting commentary in Value in Health reviewing some of the challenges of implementing international reference pricing (IRP) in the U.S. IRP would set drug prices in the U.S. as no higher than a basket of drug prices in other developed countries. This issue is of particular interest due…
Medicare Part D has a confusing benefit system. Prior to 2011, patients had a deductible, then a general coverage benefit (with 25% coinsurance) then a donut hole (with no coverage) and then catastrophic insurance (with a 5%) copayment. When the Affordable Care Act passed, it aimed to fill the donut hole. Beginning in 2011, Part…
The cost to bring a drug to market is a hotly debated topic. The costs include not only the costs for basic science and clinical trials. However, one must also take into account the cost of capital (since most cost are incurred up front, but revenue begins only after drug approval) and the likelihood of…
A new drug comes on the market. Is the health benefit worth the cost? What is it’s value? Value assessment frameworks are one way to answer this question. Value frameworks take the evidence of the treatments benefits, risk and cost and output some notion of the treatment’s value. Ideally, if anyone applied a given value…