Unbiased Analysis of Today's Healthcare Issues

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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“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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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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International Reference Pricing

What is international reference pricing (IRP)? IRP is system whereby a country states that they will pay no more than the price paid by another country or a basket of countries. In theory, countries could also regulate drug prices by saying that they would not pay more than X% of country A’s price or X% […]

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Depression Among the Elderly & Medicare Part D

How did the enactment of Medicare Part D affect the mental health of the elderly? This is the question Ayyagari and Shane attempt to answer in their recent JHE paper. The authors use data from the Health and Retirement Study (HRS) between 2010 and 2010 to measure changes in depressive symptoms among patients aged 60-70. […]

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Why isn’t there more mental health drug innovation?

There have been a number of efforts emphasize the importance of mental health and put mental health treatments at the same level of respect as physical health.  For instance, there was the Mental Health Parity Act of 1996 and also The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) , which: …requires group […]

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Donuts and drugs

Medicare patients are likely to discontinue their medication in December. Why? Are they busy with the Christmas holidays? Do they have additional expenses for gifts and limited funds for prescription drugs? Perhaps. Another idea advanced by Kaplan and Zhang (2014) is that Medicare’s benefit structure encourages discontinuation. Why is that? Medicare’s Part D drug plan […]

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