Unbiased Analysis of Today's Healthcare Issues
KFF reports on the increased use of copay accumulators: Oscar Health is one of many commercial health insurers that use what are often called copay accumulator programs to keep funds that are meant to defray patients’ out-of-pocket costs for expensive specialty drugs. Over the past decade, more insurers have adopted such strategies to reduce their prescription…
Many policymakers are looking for ways to reduce drug spending. Federal policymakers are not the only ones looking at the issue. In recent years, state Prescription Drug Affordability Boards (PDABs) have formed to reduce drug prices. A paper by Barthold et al. (2026) describes the what PDABs are: As of April 2025, 12 states had…
That is the topic of a JAMA Health Forum article by my USC colleagues Dana Goldman and Erin Trish. In it, the note that the Congressional Budget Office (CBO) does good work, but the scope of their analysis is limited. CBO only estimates the impact on policies on government budgets; CBO’s remit does not evaluate…
Today I attended the very interesting ISPOR Health Policy Leadership Exchange (HPLE) in Washington DC on the topic of Most Favored Nation (MFN). There were a number of important points made and I’ll summarize a few of them. First, US drug prices are much higher than in other OECD countries. An ASPE report from 2024…
That is the title of a recent white paper written by myself and Kristy Piccinini alongside a team from the Health and Fitness Association (Greta Wagner, Amy Bantham, Ken Griffin, Richard Beddie, Zach Weston, Cameron Saunders). Below is an excerpt: In recent years, glucagon-like-peptide-1 (GLP-1) receptor agonists have emerged as a transformative treatment option, enabling…
The answer is provided by EFPIA’s annual WAIT indicator (press release, report). First, we see a large decrease in the share of pharmaceuticals fully availbity, drive by a small increase in reduced availability but a much larger increase in the number of drugs that only have a limited availability. Specifically, Historically full availability was the…
If you are a payer or a policymaker, should you except the results of a global clinical trial or require additional evidence that a drug works in your country. There are a few options to consider. Delay approval until local confirmatory trial. Approach enacted in several Asian countries (see Habr et al. 2024). While this…
That is the argument made by Ike Brannon and Anthony Lo Sasso in a recent Health Affairs Forefront article. 340B allows hospitals serving low income communities to purchase pharmaceuticals at discounted rates, but then receive full price reimbursement from payers (e.g., commercial insurers, Medicare). It is not clear that the 340B program even benefits low-income…
An NBER working paper by Barwick, Xia and Xia (2026) provides the answer: In 2010, China accounted for less than 8% of global clinical trials; by 2020, it had surpassed the US in annual registered clinical trial volume…We provide strong evidence that China’s rise was primarily driven by the National Reimbursement Drug List (NRDL) reform,…
What factors should a physician consider on whether to use a new medical innovation on a patient? Of course, the potential benefits and risk of the innovation to the patient matter most. But another factor could play a role in the physician’s decision: malpractice liability. Specifically, (i) is the use of the innovation more likely…