Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Pharmaceuticals' Category

Part B drug reimbursement

In the past Medicare has reimbursed physicians that administer Part B drugs–typically injectable medications administered in a physician’s office–at 6% of the drug’s cost.  The 6% aims to cover the cost of purchasing and storing the drug as well as administering it.  Because physician reimbursement is proportional to the cost of the drug, physicians have […]

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Are drug prices higher or lower in the U.S.

The high price of prescription drugs in the U.S. has received a lot of press in recent years.  However, are drug prices really higher in the U.S. than other countries?  Tomas Philipson makes an interesting point regarding U.S. drug prices: It is well known that free-market prices of branded drugs still on patent are higher in […]

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Value Framework Guidelines

In recent years, a number of organizations have developed value frameworks to assess new treatments.  These organizations include the Institute for Clinical and Economic Review (ICER), Memorial Sloan Kettering Memorial Cancer Center (Drug Abacus), American Society for Clinical Oncologists (ASCO),  National Comprehensive Cancer Network (NCCN), European Society of Medical Oncology (Magnitude of Clinical Benefit Scale). […]

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How does cost sharing affect drug utilization?

Any economist knows that if you raise the price of a good, demand goes down.  Thus, one should not be surprised to find numerous studies that show that increased cost sharing decreases drug utilization.  But how does drug utilzation decrease?  Is it along the extensive margin (i.e., the decision to initiate the drug) or along the intensive margin […]

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Orphan Drugs

How can policymakers incentivize innovators to invest in new treatments for rare diseases? One solution policymakers invoked was enacting the Orphan Drug Act of 1983 which provided a number of benefits–including lower tax rates–for innovators who created drugs to treat rare diseases. Was it effective? According to a paper by Miller and Lanthier (2016), the […]

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Off label prescribing: Q&A

The Duke-Margolis Center for Health Policy has a great overview of some of the issues related to off-label prescribing.  Below is a summary of some key points from this article. What is off-label prescribing? Off-label prescribing and use can take many forms, such as use of an approved drug for an unapproved clinical indication, use at […]

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Can reducing cost sharing save money?

Typically, economists believe that subsidizing goods or services increases utilization and the total amount of funds spent on a good. The RAND Health Insurance Experiment (HIE) proved that lowering cost sharing increases total spending on medical goods. Although reducing cost sharing on all medical care is likely to increase total healthcare spending, subsidizing highly effective therapies can actually […]

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Did Medicare Part D reduce emergency room visits?

In 2006, the Medicare program was expanded to include prescription drug coverage through the Part D program. Previous studies have found that Medicare Part D improved prescription drug coverage rates among seniors (Levy and Weir,2010), increased medication utilization (Duggan and Morton, 2010), decreased out-of-pocket spending (Engelhardt and Gruber, 2011; Ketcham and Simon, 2008), and reduced medication […]

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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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