Unbiased Analysis of Today's Healthcare Issues
The 340B Drug Pricing Program is a federal initiative designed to help certain healthcare providers, known as “covered entities,” stretch their resources to better serve vulnerable and underserved patient populations. Created in 1992, the program requires pharmaceutical manufacturers to sell outpatient drugs at significantly discounted prices (typically 25% to 50% off) to eligible hospitals, clinics,…
Recently, the Inflation Reduction Act (IRA) is getting a lot of attention, particularly for its provision that allows CMS to start drug price negotiation for selected drugs 9 (small molecules) or 13 (biologics) years after drug launch. However, the Centers for Medicare and Medicaid Innovation (CMMI) has proposed a number of a number of payment…
What is it? The BIOSECURE Act is a bill seeks to stop firms that receive federal funds from using select Chinese service companies. These include the genomics firms BGI, MGI, and Complete Genomics; and WuXi AppTec and WuXi Biologics. These firms are deemed by the bill as foreign “companies of concern”. Why does it matter?…
That is the topic of a U.S. Senate hearing last week. One person testifying was an economist, USC Professor Darius Lakdawalla. While his full testimony is here, his key points of contention are worth reading. These include: The challenge for public policy is to sustain the pace of medical innovation while ensuring that valuable new…
That is the question asked by a recent paper by Nikpay et al. (2023). The authors begin by describing the magnitude of the 340B program: The 340B drug discount program is designed to lower drug costs and increase drug profits for safety-net providers, called “covered entities,” by entitling them to discounts on drugs for all…
As individuals live longer, governments and employers are considering increasing the age at which individuals become eligible for either public or private pensions (e.g., Social Security). Why this fiscal impacts of changing the retirement age has been well-studied, the labor market and health outcomes are less well-known. A paper by Serrano-Alarcón et al. (2023) examines…
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…
That is the finding from a recent report from the Congressional Budget Office (CBO) on the activities of the Centers for Medicare and Medicaid Innovation (CMMI) CBO previously estimated that CMMI’s activities would reduce net federal spending but now estimates that they increased that spending during the first 10 years of the center’s operation and will…
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…
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…