This week’s Innovation Partners BioBlog features updates on the White House’s new budget and proposed changes to reimbursement. Anthem backtracks on a controversial decision aimed at reducing emergency room visit. New drugs reach the market, including drugs to treat prostate cancer and more.
The White House released the Fiscal Year 2019 budget proposal on February 12, 2018. The proposal includes several provisions and budget changes that may affect the cancer community. These include a possible reduction in the reimbursement amount for new drugs from Wholesale Acquisition Cost (WAC) +6 percent to WAC +3 percent and consolidation of Medicare Part B drugs into the Part D program.
Although metastatic triple negative breast cancer (TNBC) is responsible for just 10-15 percent of all breast cancer diagnoses, it is responsible for 35 percent of deaths related to breast cancer. Now, a clinically relevant “liquid biopsy” test can be used to profile cancer genomes from blood and predict survival outcomes for patients (TNBC).
A new report examines ACCC’s actions to overcome coordination and communication challenges with education, peer-to-peer learning, and real-time solutions. The report’s findings underscore the need for for education, support, and resources on how to integrate emerging immunotherapies, new indications, and evolving knowledge about the toxicities related to these treatments.
Anthem is adjusting its controversial ER coverage policies after members and providers expressed concern about the insurer’s attempts to limit emergency room visits. Anthem attempted to discourage people from using the emergency room for primary care, but providers worried that patients would attempt to self-diagnose and delay critical emergency treatment.
CMS: Increased Medicare enrollment a major driver behind healthcare spending trends over next decade
Healthcare spending reached $3.5 trillion in 2017, a rate of 4.6% and slightly faster than the previous year’s rate of 4.3%. Medicare spending is also expected to climb as Baby Boomers age into the system. Actuaries predict an increase in spending of 5.5% over the next several years with spending reaching $5.7 trillion by 2026.
The U.S. Food and Drug Administration approved Johnson & Johnson Erleada on Wednesday. Erleada is used for use in prostate cancer patients whose disease has not spread but continues to grow despite hormone therapy. Johnson & Johnson’s previous blockbuster drug, Zytiga, faces competition this year. Generic competition for Zytiga may reach the market in 2018.
Bristol-Myers Squibb announced that it intends to pay a record $1.85 billion to Nektar Therapeutics, a small biotech startup, for rights to its experimental cancer drug, codenamed NKTR-214. Nektar will book 65% of global profits on the drug, should it reach the market, with Bristol getting the other 35%. These and other drugs that spur the immune system to fight cancer are the ‘hottest’ drugs on the market.