Honestly? Not a lot caught my eye this week. Maybe we were all heads down getting stuff done before a long weekend?
You say MPPP, I say smoothing. Late yesterday afternoon the Centers for Medicare & Medicaid Services released Draft 2 guidance for the Medicare Prescription Payment Plan. I’ve heard Michael Ward from Alliance for Aging Research calls it MP3 and once you see that, it is hard to go back. I still say smoothing because the Medicare Prescription Payment Plan just doesn’t seem right. Either way, the guidance focuses primarily on communication and education. 30 day comment window.
Resource Alert. Medicare Advantage will likely be buzzy this year on the Hill and elsewhere. The Advance Notice proposed cuts for next year and with more beneficiaries than ever enrolling in these plans, cutting benefits will likely draw attention. Especially in an election year. Add in concerns about spending in Medicare Advantage versus Original Medicare and you’ve got a game. If you’re sort of aware of Medicare Advantage but know you should know more – Commonwealth Fund has you covered.
Understanding (good) PBM reform. Pharmacy benefit managers (PBMs) are the companies behind the scenes that manage prescription drug benefits for insurance plans and, as you might be aware, there is a lot of talk in Congress about PBM reform. Unlike other parts of the prescription drug supply chain, PBMs never take ownership of the product but are typically responsible for formulary management and negotiation. With so much time being spent on reform, this could be the year we see some legislation pass but … it feels like a maybe. And even if we’re talking reform, it has to be meaningful and here is what that could look like. Having presented with him before, I can safely say that if Dr. Worthing is selling it, I’m listening.
Piece of the puzzle. Federal Trade Commission is looking at Group Purchasing Organizations and how their purchasing patterns could drive shortages. There might be something there but it’s only one piece of the puzzle. The drive towards lowest price possible just creates a flywheel that’s hard to get off until it all crashes.
That’s NICE? This week Lilly’s weight loss drug Mounjaro became available in Great Britain. What’s notable is the starter dose prices (under $300/month). In the U.S. it is closer to $1,100 but sometimes it is covered by insurance or there are savings program.
Cold Hearted. On Valentine’s Day, a heart medicine got new life as an approved frostbite treatment.
No Good Choices. The American Cancer Society’s Cancer Action Network released survey results that showed nearly 1/3 of cancer patients or survivors have felt they had to choose between purchasing food and affording their care, 12% have gone without adequate food for a period of time and 11% have skipped or delayed a treatment in order to afford food. Because having cancer wasn’t bad enough.