Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Pharmaceuticals' Category

What is the FDA doing about opioids?

The FDA is planning to put additional scrutiny on the use and approval of opioids in order to prevent opioid abuse and addiction.  Here is their plan: Re-examine the risk-benefit paradigm for opioids and ensure that the agency considers their wider public health effects Convene an expert advisory committee before approving any new drug application for an […]

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Canada’s single payer system doesn’t cover drugs?

Yes it is true.  Wang et al. (2015) report: Unlike physician and hospital services, which are universal in Canada, coverage for prescription drugs dispensed outside hospitals falls outside the Canada Health Act and provincial governments only provide public drug programs for some population groups,primarily seniors and social assistance recipients…Canada is still the only country that […]

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Risk Sharing Agreements video

Previously, I described a paper on risk sharing agreements in the US.  The National Pharmaceutical Council has a nice video from one of the authors that also summarizes the findings.  

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NCCN Evidence Blocks

NCCN recently released a new approach to measure the value of cancer medicines. The approach–known as Evidence Blocks–evaluates medications on 5 dimensions: Efficacy of regimens, Safety of regimens, Quality and quantity of evidence for regimens, Consistency of evidence for regimens, and Affordability of regimens. Each criteria is ranked on a 1 to 5 block scale. […]

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The 340B Program: An Overview

What is the 340B program?  A May 2015 MedPAC report has a nice summary: The 340B Drug Pricing Program allows certain hospitals and other health care providers (“covered entities”) to obtain discounted prices on “covered outpatient drugs” (prescription drugs and biologics other than vaccines) from drug manufacturers. Manufacturers must offer 340B discounts to covered entities […]

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“Best price”

What price does Medicaid pay for drugs? The answer is, the “best price”.  What is “best price?” The 1990 Omnibus Reconciliation Act (OBRA) codified that pharmaceutical manufacturers must give Medicaid steep discounts in order to receive coverage by state Medicaid agency.  How big are the discounts?  The answer is the larger of a fixed percentage of the […]

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The end of dose-based drug pricing?

A Health Affairs post by Dana Goldman and Darius Lakdawalla argues that dose-based pricing for pharmaceuticals is suboptimal.  They make a clear distinction between typical goods, where cost and benefits are roughly proportional to quantity consumed, and pharmaceuticals. Buying two bunches of bananas naturally costs twice as much as one bunch. Twice as many bananas can […]

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Risk Sharing Agreements in the US

Outcomes-based risk sharing agreements tie reimbursement for medical goods or services to patient outcomes.  Despite the increasing demand from policymakers for value-based payment mechanism, risk-sharing agreements are not that comment.  A paper by Garrison et al. (2015) found that there were only 148 risk sharing agreements (RSAs) worldwide between the late 1990s and 2013 and only 18 of the […]

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What influences NICE decisions?

The National Institute for Health and Care Excellence (NICE) claims that although cost-effectiveness is highly valued in its health technology appraisal process, it sates that there are other factors considered relevant.  However, no explicit weight is assigned to these other factors.  Do they matter? A paper by Dakin et al. (2015) tries to answer this question by looking […]

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Does increased use of prescription drugs lower medical costs?

There is a belief that providing better care can reduce cost, at least somewhat.  For instance, some claim that better primary care can avoid unnecessary hospitalizations.  But can increased use of prescription drugs lead to decreased medical spending?  This is exactly what a paper by Roebuck et al. (2015) find.  They write: We found that a 1 […]

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