The Condition of U.S. Cancer Research and UnitedHealth to Buy Catamaran for $12.8B
This week in healthcare, an interview on the condition of U.S. cancer research and UnitedHealth’s $12.8 billion acquisition of pharmacy benefit manager Catamaran.
Just before retiring as the director of the National Cancer Institute, Dr. Harold Varmus sat down for a chat with the New York Times about financial constraints in science and biomedical research. Dr. Varmus says that since NIH’s budget has shrunk 25% (adjusted for inflation) since 2003, “a sense of hypercompetition has arisen as large numbers of new scientists are trained for positions and grants that no longer exist. …Right now people feel like they can’t afford to fail.”
Last week UnitedHealth announced it would buy Catamaran, the fourth-largest pharmacy benefit manager in the country, for around $12.8 billion. Once purchased, Catamaran will be merged into UnitedHealth’s existing OptumRx pharmacy benefit service to create an entity poised to compete with Express Scripts and CVS Health, the US’s largest and second-largest pharmacy benefit managers respectively.
A recent article in Bloomberg Business argues that UnitedHealth’s upcoming acquisition of Catamaran to merge it with its OptumRx will “put even more pressure on drugmakers’ high prices for breakthrough medicines.”
IMS Health Study: Reimbursement Approaches Based on Cost-Per-Quality-Adjusted-Life-Year Measures Rather Than Drug Effectiveness May Limit Access to Innovative Cancer Treatments
A recent report from the IMS Institute for Healthcare Informatics compares the effects of reimbursement for nine new cancer drugs between five countries who use “cost per quality-adjusted life year” (CPQ) measures versus those who use non-CPQ methods. The study found that CPQ countries reimburse fewer new cancer drugs, may have lower cancer spending, and may have lower survival rates.
This in-depth article profiles the “Value-Based Health Care Delivery” movement. It includes a profile of MD Anderson’s recent bundled payments cancer treatment pilot program, which puts the risk on doctors and aims to control costs.
In a recent press release, the American Cancer Society announced Gary M. Reedy as its next CEO. Reedy assumed his role at the end of March, and succeeds longtime CEO John Seffrin, who announced his retirement in January 2014.
A new analysis argues that despite more optimistic forecasts about the potential impact of PD-1 inhibitors, “We conclude that the global anti PD-1/PD-L1 market is worth an un-risk-adjusted $10 billion a year, materially less than the optimistic (in our view) $20-30 billion forecasts in the market today.”
Insurers, Providers Experiment With New Oncology Payment Models
As insurers and providers experiment with all sorts of new reimbursement models, this report takes a look at how two companies — Anthem and UnitedHealthcare — developed their own experiments with clinical pathways and episodic payment.
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