Impact of 340B on the use of biosimilars

Biosimilar drugs for biologic treatments are analogous to generic drugs for branded small molecules. Switching to biosimilars after biologic patent expiry can save payers and patients money. Why doesn’t it happen more often? There are a variety of reasons but a paper by Bond et al. (2023) argues that the 340B program incentivizes hospitals to…

Prescription drug use over a lifetime

That is the topic of an interesting paper by Ho (2023). Prescription drug use has reached historic highs in the United States—a trend linked to increases in medicalization, institutional factors relating to the health care and pharmaceutical industries, and population aging and growing burdens of chronic disease. Despite the high and rising prevalence of use,…

Techniques pharmacy benefit managers use to lower cost

How do pharmacy benefit managers (PBM) claim they can reduce cost? A Health Affairs Forefront article by Brennan and Shrank (2023) identify 6 key pathways: Mail order. Mail order alternative is often cheaper than dispensing at the retail pharmaciesdue to greater scale and automation Negotiating power. PBMs leverage purchasing power to lower dispensing fees. PBMs…

Does the 340B program improve quality of care?

According to a paper by Smith et al. 2023, the answer is ‘no’. The authors use data from AHRQ’s Healthcare Cost and Utilization Project (HCUP) State Inpatient Data, Hospital Cost Reporting Information System Data, Office of Pharmacy Affairs Information System Data, and American Hospital Association Annual Survey for 15 states between 2008 to 2014. The…

Reference pricing in the US for COVID drugs?

Perhaps according to a report from Stat News: A groundbreaking clause in a new deal between the Department of Health and Human Services and the pharmaceutical company Regeneron marks the first time the Biden administration has directly used its leverage to challenge drugmakers’ list prices, experts told STAT.The contract between Regeneron and the government requires…

Measuring the novelty of new drugs

All of us want new, improved medicines. Drugs that provide incremental benefits (often called “me too” drugs) are good, but truly revolutionary therapies are even better. However, how does one separate how “novel” a treatment is? Is there a way to quantify this? In fact there is. One way to do this is based on…