Crab cakes and … horse racing. That’s what Maryland does. Mine will come with a side of Smith Island cake which I’m making tomorrow morning. Wish me luck.
Odds aren’t stacked. The Centers for Medicare & Medicaid Services (CMS) announced that the Medicaid rule won’t contain the stacking provision. A little odd to pre-announce it, but it stops me from checking the Federal Register 3 times a day so I’ll take it. If you want a refresh of what stacking is about, here you go.
No credit where credit is due? We are up to about half of voters over the age of 65 being aware of Medicare negotiation. Among all voters we are at about 36%.
Golden nuggets. IQVIA put out its annual report on U.S. medicines. Lots of talking points and things to look at. I did like this factoid – 90% of prescriptions have cost-sharing less than $20 and 1% exceeded $125. Manufacturers provided $23B in assistance. But more than half of new prescriptions aren’t filled because of high cost and formulary/utilization management.
On a roll. Senator Sanders is certainly making noise on the cost of GLP-1s. A few weeks ago it was with the belief that they should be reimbursed based on what they cost to manufacturer (hahahahahahahaha) and now it is that they will bankrupt our country with lots of facts that are poorly researched and/or misleading.
One of my dinner conversations this week centered on whether he believed what he was saying or was it just a way to stir stuff up and see what happens. Here’s the thing, these drugs appear to be amazing. And yes, they are costly, for now. But, in the scheme of things, we aren’t that far from generics (see IQVIA stat above.) And even before that happens, there will be a lot of competition which should drive costs down.
Of course, my weird dream would be that the government would turn to the manufacturers and say we’ll give you $X for coverage of our state/this population/etc. I did preface it with weird.
Not dead yet. Pharmacy benefit manager (PBM) reform took a step forward this week in the House.
Hopefully overthinking. You know those topics that if you think too much about it, you’d have to change your life in major ways (like what AI took over all our cars at the same time?) – in my case, it is about our dependence on China to manufacturer active ingredients and many of the pharmaceuticals on which we depend. Want to wage war in a new way? Cut off our supply, use the data, etc. And there is no easy fix. NIMBY is real when it a lot of this manufacturing.
BIOSECURE, which is working its way through the House of Representatives, would prohibit government agencies from purchasing drugs from certain companies owned by the Chinese government. It doesn’t address the problem of all the other drugs but probably the most immediate threat.