François de Brantes
It’s no mystery why this country has both the highest per capita health care costs and the lowest overall percentage of people with coverage. The two are connected, but as if on a teeter-tooter: As one goes up, the other goes down.
Saurabh Nagar, BPharm
Jeetvan Patel, PhD
Richard H. Stanford, PharmD, MS
Resource use and exacerbation among patients with COPD are weighed in a preliminary study. Subjects treated with a combination of long-acting muscarinic antagonists (LAMA) and long-acting β2-adrenergic agonists (LABA) cost more to manage than those receiving LAMA alone, although emergency department and outpatient visit costs were less. The authors say those starting the LAMA+LABA therapy may have more severe COPD.
A British study of 296,535 people added to evidence that the so-called obesity paradox—that being overweight or obese does not necessarily mean a greater chance of getting a heart attack—simply does not exist. Many of us could stand to lose a few pounds to lower our cardiovascular risk.

News Wire

Scientists find new molecular target for developing safer pain medications
Drug used in combination with bortezomib, melphalan, and prednisone
Six states will also participate in the litigation
First drug approved to treat MS in patients as young as 10 years old
Peter Boland
On the one hand, the PCMH is an admirable effort to gather in one place all the disparate and disorganized clinical and social supports the patient needs. At the same time, though, medical homes employ provider-defined business models and conventional performance measures, belying the patient-centered in the name.
Charlotte Huff
The deadliness of liver cancer is undisputed, but a growing body of data shows that too often, patients, and particularly those who are uninsured or nonwhite, miss out on earlier diagnosis and potentially life-saving surgery.
Jeremy Schafer
The breast cancer mortality rate in 2012 declined 49% compared with the expected baseline, and 63% of that reduction was from treatment drugs. You’d think that patients would take their cancer medicines no matter what. But when cost sharing reached between $100 and $500, the abandonment rate soared to 32%.
CURRENT ISSUE May 2018

Miracles Aren’t Cheap: How Can the Health Care System Pay for New Cancer Treatments?

Lee Newcomer, MD, a former senior vice president at UnitedHealthcare puts it succinctly in our cover story: “We have a limited set of dollars.”

Take CAR-T therapies, for example. Our story shows just how financially perplexing this can get. The $475,000 one-time cost of Kymriah exceeds the cost for conventional chemotherapy by almost $330,000. It would also provide a child with about eight extra years of life on average. Who’s going to say “no?”

One way of dealing with price concerns is through indication-specific drug pricing. The idea is gaining steam, and an IMS report states that by 2020 most new oncology drugs will have three or more indications.

Does anyone have any solution about balancing cost, outcomes, and human decency?

UPCOMING MEETINGS

Boston
June 11-12, 2018
Philadelphia
June 11-12, 2018
Boston
June 11-12, 2018
Philadelphia
June 17-18, 2018
Richard Mark Kirkner
A federal bill would expand access to experimental treatments, but critics say right to try would take away FDA oversight and create a ‘Wild West.’ Meanwhile, most states’ right-to-try laws have gone unused.
Are we seeing the beginning of the end of the independent physician? Between July 2015 and July 2016, U.S. hospitals bought up 5,000 independent physician practices. In 2012, about 14% of practices were owned by hospitals. Four years later, that percentage had more than doubled to 29%.
Eric Bender
The drugs often are more effective and have fewer side effects. The science—often just amazing. Medically, cancer treatment has never been in a better place. But are high prices making it unaffordable? Payers, providers, policymakers, and drugmakers themselves are wrestling with the issue. Meanwhile, many patients are being priced out of treatments that could save their lives.