This week, Innovation Partners’ BioBlog takes a look at the hidden profits in the prescription drug supply chain and Roche’s acquisition of Flatiron, a data firm backed by Google that has made serious inroads into oncology care. An alliance formed by several groups will effectively cover 7 million employees’ healthcare insurance, and more are all in this week’s news.
CancerCare® announced the publication of a new white paper highlighting perspectives from oncology providers on the importance and utility of including patient priorities in treatment decisions. “Decision Making at the Point of Care: Voices of Oncology Providers” builds on the findings from the first PVI white paper, “Patient Values Initiative: The Many Voices of Value”, published in 2017.
Pharmacy benefit managers far more profitable than they seem, which makes them vulnerable to new competitors. A look at the business side of the hidden profits in the prescription drug supply chain.
AIS Health spoke with several industry experts about their expectations for management strategies and pricing of specialty drugs in 2018. The consensus appears to be that pricing will continue to be a front-page topic. Additionally, experts shared their thoughts about pharmacy and medical claims data and other roles that data may play in healthcare information and decision-making.
A newly released 2019 Advance Notice and draft Call Letter proposes easing several restrictions around Medicare Advantage benefit design, which reflects the administration’s theme of “empowering” MA plans. The Call Letter also calls for uniformity flexibility, which would allow MA plans to reduce cost sharing, offer specific supplemental benefits. Additionally, lower deductibles for enrollees under certain medical situation are also included. And, it permits Special Needs Plans (SNPs) for dual eligible and institutionalized patients to offer specialized, targeted care through enhanced disease management programs. This and more are covered in the article.
Health Transformation Alliance (HTA), a nonprofit cooperative, launched group contracts with managed care companies and PBMs to cover 7 million employees, dependents and retirees starting Jan. 1, 2018. HTA is comprised of 46 large self-funded companies that together spend about $27.5 billion annually on health care. It is expected to save at least $600 million in total over the three-year contracts with PBMs CVS Health Corp. and UnitedHealth Group’s OptumRx. Although the approach is not new, many see the HTA as offering yet another approach to affordable healthcare.
Roche has come to an agreement with Flatiron Health, a takeover that would give Roche ownership over the data and software owned by Flatiron. Flatiron, a Google-backed venture, has built oncology-focused electronic health record (EHR) software and a repository of real-world cancer evidence. The software is now linked to 250 community oncology practices, which could boost Roche’s clinical trials efforts. Roche is expected to pay $1.9 billion for the deal.