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From Zhu et al. (2025) in Health Affairs: Primary care clinicians have expressed growing interest in concierge and direct primary care practices, which often feature smaller patient panels and greater clinical autonomy compared with traditional primary care models. We assessed practice and workforce characteristics using a national sample of concierge and direct primary care practices…

That is the topic of a recent BioSpace article titled “How Effective Will TrumpRx and Other Direct-to-Consumer Drug Pricing Initiatives Be?” A am quoted in the article as follows: While [direct-to-consumer] DTC has been a growing trend in biopharma for nearly two years now—Lilly launched LillyDirect in January 2024—the number of drugmakers looking to sell their…

A paper in Value in Health by Grueger, Martin and Sullivan (2025) provides some lessons. Together with widespread digitalization of drug compendia (price lists), IRP led to a rapid convergence of list prices across Europe. Although prices often spread ±50% from the average price for drugs first launched in the EU in 1997, this narrowed…

Conventional wisdom holds that orphan drugs treat rare (by definition) and more severe diseases. Because they treat diseases with significant unmet needs, their health benefits per person are large. But are they really? Does conventional wisdom align with the evidence? To answer the question myself and colleagues at FTI Consulting, including co-author Marie Steele-Adjognon, conducted…

Data from the Private Equity Stakeholder Project (PESP) provides the answer. Data below are sorted by most to least number (N) private equity-owned hospitals. One can clearly see that Texas is leading the way in terms of raw numbers but New Mexico has the highest share of hospitals that are PE-owned. You can find more…

That is the title of a new paper published in the American Journal of Managed Care (AJMC) with co-authors Jacob Fajnor, Shurui Zhang, and Donald Nichols. The abstract is below. Objectives: To (1) develop a metric that quantitatively measures the risk that utilization management (UM) policies pose to patients and (2) measure the relationship between…

Likely ‘no‘. While CMS can consider drug prices as part of IRA’s Medicare Drug Price Negotiation, it is limited to considering only U.S. market data. Here is an excerpt from the IRA text: For purposes of negotiating the maximum fair price of a selected drug under this part with the manufacturer of the drug, the…

A press release from CMS today provides the answer: [The Department of Health and Human Services] HHS expects each manufacturer to commit to aligning US pricing for all brand products across all markets that do not currently have generic or biosimilar competition with the lowest price of a set of economic peer countries. The MFN…

From the Conversation with Tyler podcast with Sheilagh Ogilvie: [Ogilvie]: Historically, there was another reason, which was the medical guilds — the equivalent of the American Medical Association, only much, much worse, back in early modern Europe did not like the idea of this new thing, this new technology that they had not approved and that was…