Unbiased Analysis of Today's Healthcare Issues
How did Medicaid expansion affect prescription drug use? At first glance, one would think that prescriptions increased; more insurance lowers patient out-of-pocket cost so we would expect more prescriptions. Medicaid insurance may crowd out other forms of insurance; if those other forms of insurance covered more drugs, then perhaps utilization would go down. A study…
Seven CEOs from large pharmaceutical firms were brought before Congress today. And they got an earful from both Demogratic and Republican Congressmen. The executives were critique for selling too many opioids. They were critiqued for legal manuevers to extend brand name drugs’ patent life. But most of all, they were critiqued for high drug prices.…
The answer appears to be ‘yes’ according to a survey by Mahendraratnam et al. (2019). After surveying subject matter experts that were senior representatives from payer organizations and pharmaceutical manufacturers on value-based pricing arrangements (VBA), they found: More than 70% of VBAs implemented between 2014 and 2017 were not publicly disclosed. Furthermore, although consideration of…
Measuring treatment value is difficult. Costs are relatively easier to measure but benefits are often more difficult, particularly impact on caregiver burden, productivity, quality of life and other factors. Not only that, but the “benefits” that accrue to a person may vary by individual. Some individuals may prefer treatments that are more effective, but with…
The priority drug review process was enacted in 2012 in order to stimulate drug development for rare pediatric diseases. Drugs granted priority review had the typical ten-month FDA review timeline shortened to 6 months. For a drug to be eligible for this program, it must not only be for a rare disease but it must…
If you have multiple sclerosis, effective disease modifying therapies (DMTs), can help to reduce relapse rates and slow disease progression. That is, if you can get access to them. A paper by Hartung et al. (2019) found the following when examining 2007-2016 Prescription Drug Plan Formulary files concerning DMT coverage among Part D plans: Among…
Although the high cost of pharmaceuticals is often in the news, these costs are offset by improved health benefits. However, it may not be clear the extent to which new pharmaceutical products lead to improved health at the national level. A paper by Lichtenberg (2018) aims to examine this question looking at the introduction of…
In one of his first acts as California Governor, Gavin Newson has proposed a way to reduce drug price: let California use its size to negotiate directly with pharmaceutical firms. As the N.Y. Times reports: [O]n Monday, Mr. Newsom signed an executive order proposing a plan that would allow California to directly negotiate with drug manufacturers. The…
According to a recent study in Health Affairs by Hernandez et al. (2019), the answer is ‘no’. The authors use pricing data from First Databank and pharmacy claims from UPMC Health Plan between 2008-2016 to track trends in drug prices over time. They found that the costs of oral brand name drugs increased 9.2% per year…
The 21st Century Cures Act, enacted December 2016, mandated that the FDA consider how to use real-world evidence (RWE) to bring innovative treatments to market faster. To meet this statutory requirement, the FDA has provided guidance outlining its policies for using RWE to support the approval of a new drug indication. What is real-world evidence?…