Unbiased Analysis of Today's Healthcare Issues
Many people think that once a treatment is approved, your insurance automatically covers the treatment. However, that is no longer the case. Some health plans may keep certain drugs off of formularies. Others health plans have drugs on formulary but may require step edits (failing another drug first before moving to the novel treatment) and…
Pharmacists are often seen as individuals who just dispense drugs. However, pharmacists are increasingly considered as providers that are part of the broader health care team. My own research has shown that pharmacists are a more cost-effective and safe approach to getting vaccinations compared to primary care providers (see Fontanesi et al. 2009). A Health Affairs Entry…
While the high price of branded drugs often gets a lot of attention in the public, few realize that after patent expiration, prices often plunge dramatically and high quality treatments are available for extremely affordable prices. Granlund and Bergman (2018) estimate the size of this price reduction using data from Sweden. In the long term,…
A recent report from Assistant Secretary for Planning and Evaluation (ASPE) found that for about 30 physician administered drugs, prices are 8 times as high as those charged in other developed countries. To address the high prices, President Trump unveiled a three-part plan to reduce drug prices. Under the “international pricing index” proposal, U.S. drug…
I ask this question in economic terms. Luxury goods are defined as goods that increase as a share of a person’s (or country’s) budget as income increases; necessity goods are defined as goods that decrease as a share of a person’s (or country’s) budget as income increases. There is actually mixed evidence on the topic…
In 2010, Premera Blue Cross (Premera), a large nonprofit health plan in the Pacific Northwest implemented a value-based formulary design for its beneficiaries. In essence, enrollees could purchase high-value treatments for low copayments and low-value treatments for higher copayments. Can we use this change from more standard to value-base formulary designs to estimate the price elasticity…
An interesting study from Garthwaite 2012 examines the removal of Cox-2 inhibitors. Rather than measuring the direct effect of Cox-2 inhibitors on quality of life or health status, Garthwaite examines how this removal affected labor market outcomes. Despite dramatic improvements in medical technology, little attention has been paid to the role of these innovations in…
This is the topic of a recent publication with co-authors Kata Bognar, Katie Everson, Michelle Brauer, Darius Lakdawalla and Felicia Forma. The full title is Does knowledge of patient non-compliance change prescribing behavior in the real world? A claims-based analysis of patients with serious mental illness. The abstract is below, but do read the whole thing…
Pharmaceuticals on the one hand can greatly improve patients health and quality of life. At the same time, some of these treatments are expensive and–despite clinical trial results–evidence from the real-world is lacking at the time of a drug launch. To address these issues, Oklahoma’s Medicaid program is taking the lead by adopting two different…
A number of people talk about Medicaid “best price”…but what is it really? StatNews provides a concise overview: The Medicaid best price law, enacted in 1990, requires drug manufacturers to charge the Medicaid program the lowest or “best” price they negotiate with any other buyer and send a rebate check to every state Medicaid department so…