Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Pharmaceuticals' Category

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 […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

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.  

Read the rest of this entry »

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. […]

Read the rest of this entry »

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 […]

Read the rest of this entry »

“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 […]

Read the rest of this entry »

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 […]

Read the rest of this entry »