Debates continue in the government’s quest to push down the cost of prescription drugs as two new treatments, one for postpartum depression and another for depression hit the market with high price tags. Others are tackling “surprise” medical bills, but the ramifications are problematic. These topics and more in this week’s Innovation Partners BioBlog.
It Will Take More Than Transparency To Reduce Drug Prices, Economists Say
The debate continues between the private sector and the federal government, with the government continuing to try to push the price of prescription drugs down. A new drug to treat postpartum depression, with a price tag of around $34,000, and a new antidepressant costing over $6,000 are re-igniting the debate. While the government’s intentions are good, the question is whether or not they can sweep back the cloud of mystery around how private companies price their medications.
American Oncology Network, LLC (AON) Introduces Specialty Oral Oncolytic Pharmacy
The American Oncology Network (AON) introduces a new specialty pharmacy. The AON Pharmacy has streamlined the process of filling prescriptions for cancer patients who are being treated with oral oncolytic medications. According to the Community Oncology Alliance (COA), approximately 25% to 35% of all cancer drugs are currently available in pill form and that percentage is increasing each year. The new pharmacy will make it easier for patients to receive necessary medications.
NCCN Panel Digs Into Reality of CAR T-cell Reimbursement
The panel discussion during the first day of the 2019 National Comprehensive Cancer Network (NCCN) Annual Meeting, held in Orlando, Florida, focused on CAR T-cell therapy as the centerpiece for the broader problem with innovative cancer treatments. CAR T-cell therapy is saving lives, but leading cancer centers complain they are losing money on Medicare patients. Since that is not sustainable, answers are being sought to how to continue to offer the therapy without losing money.
How the Trump administration’s step therapy policy changes will affect Medicare Advantage plans
At the start of the year, the Trump Administration’s change to Medicare Advantage plans went into effect: allowing Medicare Advantage (MA) plans to apply step therapy practices for medications that are covered under Medicare Part B. This article details each aspect of the change and its effects on Medicare Advantage plans.
How ‘sleeper cell’ cancer stem cells are maintained in chronic myelogenous leukemia
Most patients with chronic myelogenous leukemia can be treated with tyrosine kinase inhibitors. These drugs are highly effective and lead to remission and prolonged survival. However, so-called “sleeper” leukemic stem cells are maintained in microenvironments in the bone marrow. Ravi Bhatia, M.D., and colleagues at the University of Alabama at Birmingham, University of Zurich and Osaka University unravel the mysteries surrounding these sleeper cells and why they persist in this ground-breaking research.
Justice Department urges appeals court to affirm ruling striking down ACA
The Trump administration is calling for a federal appeals court to uphold a lower court decision striking down the Affordable Care Act. The Department of Justice sent a letter to the 5th Circuit Court stating it has “determined the district court’s judgment should be affirmed.” The DOJ, under President Trump, has not taken steps to uphold the AOC. The courts have determined that the individual mandate is essential to the program, and without it, it is not legal.
The challenges facing states looking to curb surprise billing
Rate setting? Payment caps? Policy makers are offering suggestions to help take the sting out of surprise patient bills. Regulators, however, are warning that there are hitches in these solutions that must be considered. Last month, the Brookings Institute released a study in which they proposed two solutions: a “pure billing” regulation in which states would set a limit on out-of-network costs based on what is reasonable in their markets and a hybrid of billing and contracting rules. This article looks at both suggestions and the ramifications of each. State insurance regulators weigh in.