Happy Father’s Day! In this week’s Innovation Partners BioBlog, we look at how the changing world of drug prices and health care laws impact pricing. U.S. drug prices fell but may rise sharply depending on future marketplace events. New markets are open now for Paxman’s scalp cooling product, and Express Script signed an agreement that adds Praulent to their formulary. A look at this week’s headlines and more.


U.S. drug prices hit by insurer tactic against copay assistance: analysis

Real U.S. drug prices, including discounts and rebates, fell 5.6 percent in the first quarter of this year, compared to a 1.7 percent drop in the same period a year ago, according to Sector & Sovereign research analyst Richard Evans. Evans attributed most of the decline to ‘copay accumulator’ programs introduced by pharmacy benefits managers, who manage prescription drug benefits and negotiate on behalf of insurers and other payers. Drugmakers, meanwhile, might circumvent these programs, which could cause prices to double or even triple over the next year.
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Express Scripts Inks Deal with Praluent Manufacturers

Mail order pharmacy Express Scripts signed a deal with the manufacturers of Praluent, (alirocumab), one of two expensive PCSK9 inhibitors on the market. This deal gives PBM a lower net price on the drug in exchange for streamlined patient access and an exclusive spot on the Express Scripts national formulary. Regeneron and Sanofi, makers of Praluent, announced in March that they would lower the net price of Praluent for payers willing to reduce access barriers for appropriate patients.
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Paxman Announced FDA Clearance for Expanded Indication of Scalp Cooling System in the USA

Paxman has received FDA clearance for expanded indication of its scalp cooling system, used to reduce the likelihood of chemotherapy-induced alopecia (CIA) in cancer patients. The system is used with patients diagnosed with solid tumors such as ovarian, breast cancer, colorectal, bowel and prostate cancer. This clearance opens the market to an additional potential one million or more patients in the USA who can use the Paxman product.
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Analysis: Mandatory bundled payments have few advantages over voluntary bundles

Both mandatory and voluntary bundled payment requirements at hospitals seem to be effective regardless of organization size, a recent report finds. Research published in the June issue of Health Affairs found that hospitals in the voluntary Bundled Payments for Care Improvement model were typically larger and had a higher mean patient volume compared to hospitals in the mandatory Comprehensive Care for Joint Replacement model. However, the quality of care and the ability to control spending were about equal regardless of the institution size.
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How health providers, consumers could be impacted by latest Trump administration move against ACA

The Trump administration recently submitted a legal filing saying it would not “defend the constitutionality” of key provisions of the Affordable Care Act in support of a lawsuit filed by Republican-led states filed a lawsuit earlier this year. Attorney General Jeff Sessions took the position that provisions such as the individual mandate and protections for patients with pre-existing conditions should be invalidated starting in January 2019. Experts predict that this action will have both immediate and long-term impacts on insurers, consumers, and healthcare providers.
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