Unbiased Analysis of Today's Healthcare Issues
New Year’s Eve is a day with significant alcohol consumed. In fact, New Year’s Eve falls behind only Mardi Gras in terms of the number of drinks consumed for that holiday. According to the National Institute of Health, excess alcohol consumption has a number health consequences including impacts on the brain, heart (increased risk of…
Last month, the Government Accountability Office released a report on the cost of rare disease. The report is interesting, and especially interesting is Appendix 1 which has a detailed list of studies of the cost of rare disease for about 50 rare diseases. Below are some highlights: Currently, there are no treatments or cures for…
While generic drugs frequently replace their branded counterparts after the latter lose their market exclusivity, the uptake of biosimilar products is often slower. Further, biosimilars are relatively more expensive compared to generic small molecule drugs. A key question then is how much could payers save by switching to biosimilars after loss of exclusivity. The is…
Where does the Centers for Medicare and Medicaid Services see Medicaid and the Children’s Health Insurance Program (CHIP) heading in the future. Based on a Health Affairs commentary from Brooks-LaSure and Tsai, the three key priority areas are (1) coverage and access, (2) equity, and (3) innovation and whole-person care. I review each of these…
As the number of infections that are anti-biotic resistant grows, we need to have more novel antibiotics in our arsenal. The problem is that many antibiotics are not commercially viable. For instance, if a new antibiotic is marginally better than the existing one, few payers will be willing to cover this cost. However, if new…
Created by Section 3021 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Innovation (CMMI; aka The CMS Innovation Center) has been tasked with creating new reimbursement strategies to improve quality and decrease costs. Over the past decade, CMMI has tested over 50 new payment models, and in just the last 3…
The price of pharmaceuticals are much higher in the U.S. than in other countries. Some policymakers have claimed that international reference pricing could be used to lower the cost of drugs in the U.S. For instance, the Lower Drug Costs Now Act (HR 3) proposed setting the maximum negotiated price Medicare would pay at 120%…
That is the question that a recent JAMA study–Mulcahy et al. (2021)–aim to answer. The authors use IQVIA MIDAS data to estimate sales price and volume in the US. These can can be used to estimate drug wholesale acquisition cost (WAC), but they ignore rebates. To account for rebates in the US they use SSR…
I have written previously about the need for distributional cost-effectiveness analysis (DCEA) which would increase the value of treatments who improve the health for individuals who currently have the worst expected quality-adjusted life expectancy (QALE). I’ve written about this in AJMC and Health Affairs among other places. One key question many individuals may have is…
It stands to reason that policies that aim to reduce drug prices or squeeze life science companies profits are likely to decrease incentives to finance the research and development needed to bring a drug to market. Previous estimates claim that bringing a new drug to market may cost over $2 billion, and life science companies…