Last year, for the first time in over 50 years, America spent less on health care than it had in the previous year, according to a study by the IMS Institute of Healthcare Informatics. The price tag was still hefty — $325.8 billion —but it was 1 percent below 2011. Per capita, we spent $898, down $33 from 2011. Experts cite the expirations of patents for such blockbuster drugs as Lipitor and Zyprexa.... Wellness programs take a hit in a new Rand report, Reuters is reporting. Such programs have only modest success, according to the report, which collected data from about 600 employers with at least 50 workers. Al Lewis, founder of the Disease Management Purchasing Consortium, tells Reuters that the most motivated employees tend to sign up, making it impossible to gauge success. Lewis was more blunt when he talked to Managed Care in March, describing the wellness industry as made up..... Testicular cancer rates are on the rise, with the increase seen mostly among Hispanic men, according to new research. The information comes from a national epidemiology database. Researchers tracked testicular cancer rates from 1992 through 2009. The incidence of testicular cancer appears to be increasing very slowly but steadily among virtually all groups that were studied, Scott Eggener, MD, an associate professor of surgery at the University of Chicago tells HealthDay News. “The novel finding is that the most dramatic increase is in Hispanic men.” He does not know why that is.... Black and Hispanic women diagnosed with breast cancer are likely to wait longer to get treatment than white women, according to researchers at the University of California–Irvine. They can’t really say why it happens, as is also true for numerous other studies pointing to disparities in treatment along racial and/or ethnic lines. Researchers analyzed the records of 8,860 women age 15 to 39 who were diagnosed with breast cancer between 1997 and 2006. Eight percent of white women waited six weeks before getting treatment; 15 percent of black and Hispanic women waited the same amount of time.
House Republicans come out with their ACA alternative. A continuous coverage surcharge replaces the individual mandate. But where’s the CBO score?
The biosimilar segment of the pharmaceutical industry is on fire. Some 700 biosimilars are at some stage of development, and more than 660 companies are involved in some way in the biosimilars land rush. Still, only a handful may get on the market in the next few years.
No one knows how much of an effect biosimilars will have on oncology expenditures. Pricing and market share are in a large, opaque “to be determined” cloud. But there’s certainly potential for a major impact that could lower oncology expenditures by millions, if not billions.
The future of biosimilars in this country is nothing if not uncertain. Most immediately, the U.S. Supreme Court is hearing a case that will determine the timing of the 180-day waiting period before a biosimilar can go on the market. But there are larger and longer-term issues at play as well.
While coupons help individual consumers, they are also having a major impact on the insurance industry and anyone responsible for paying health care bills. Insurers and pharmacy benefit managers complain that they foil formularies and other pricing strategies designed to steer consumers to less-expensive drugs.
The hard truth is that telehealth’s future—its size, its contours—will depend a lot on what payers will be willing to pay for. Currently, commercial plans cover only a limited number of services. In addition, research suggests that there may be quality and utilization problems.
Insurers should consider covering new drug-delivery devices that can improve outcomes while lowering disease-specific pharmacy and long-term overall health care costs. Managing these devices in the pharmacy benefit will consolidate volume-based purchasing and capitalize on PBM strategies for improving adherence.
Basaglar is coming on the scene during tumultuous times for insulin products. Manufacturers are under attack for price hikes. There are allegations of backroom rebate deals. And a class-action lawsuit has been brought on behalf of uninsured patients, charging insulin makers with setting artificially high prices.
Evaluating the quality of telemedicine care is about as easy as evaluating the quality of health care, period, and researchers are still ironing out the methodological kinks. That may be one reason research results are all over the place. This article involved reviewing nine such studies, and the findings are a mixed bag.
The results can be tragic. Patients with addictions are unlikely to wait the hours or days it takes health insurers to approve the medications they need. Insurers are changing their practices, but not without some outside pressure.