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High U.S. Drug Costs & Can For-Profit PBM Actually Lower Healthcare Costs?


IP Blog | Dave Melin | January 18, 2015

BioBlog Weekly oncologyThis week in healthcare, the New York Times compares U.S. and European drug costs and Express Scripts advocates for earlier involvement in the decision-making process to lower oncology drug costs.

Why Drugs Cost So Much

The New York Times takes a look at why drugs cost so much more in the US than in Europe. Their answer? “Companies are taking advantage of a mix of laws that force insurers to include essentially all expensive drugs in their policies, and a philosophy that demands that every new health care product be available to everyone, no matter how little it helps or how much it costs.”

UPDATE: Express Scripts sees opportunity to lower cancer treatment cost

Pharmacy benefit company Express Scripts has said it believes greater savings on cancer treatment costs could be achieved if it was “involved earlier in the decision-making process.” This is the latest in a series of strong statements by Express Scripts, including its recent decision to end coverage for hepatitis C drug Sovaldi because of its high cost.

How Can We Encourage Participation in Clinical Trials?

While the cost of sponsoring a clinical trial startup site is $50,000, up to 60% of clinical trials fail to enroll even a single participant. This Forbes article explores the factors behind a low 3% participation rate of cancer patients in clinical trials and offers some solutions for how to increase clinical trial participation, including increased education and new technological tools.

Ex-UnitedHealth exec named acting Medicare chief

On Friday, CMS named Andy Slavitt, formerly of UnitedHealth, as its acting administrator. In an internal announcement, Secretary of Health and Human Services (HHS) Sylvia Burwell called Slavitt “a key member of the team that helped turn around the website last year.”

State exchanges: Process smoother second time around, but problems persist

The second round of ACA exchange enrollments is a story of good news / bad news. There is plenty of good news — including almost 1 million enrollees signing up for state exchange coverage that began January 1 — but despite a much better technical process overall than last year some exchanges are still struggling with technological glitches. FierceHealthPayer gives updates state by state.

Report: 8% of insured lives covered by provider-led plans

According to a recent report, 8% of insured lives — about 18 million members — are covered by 107 provider-led plans. About half of these members — 8.9 million — are enrolled in some form of Medicare.

Cost Savings and Outcomes Aren’t Enough to Change Cancer Treatment [log-in required]

A new study published in the Journal of the American Medical Association found that “despite strong evidence that some women with early stage breast cancer can achieve the same results with a shorter course of treatment, many radiation oncologists haven’t changed their treatment regimens.”

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