Methodology Matters. The Institute for Clinical and Economic Review (ICER) released their annual Unsupported Price Increase report and I find the whole process maddening. The inflationary metric they used was medical, not general (CPI-U). You might think that didn’t matter but it does. You know what medical inflation was? 0.48%. So anything over 2.48% increase was flagged as a possible candidate for the report. As NPC flags, if we use CPI-U there was a $10 million decrease in drug spending not $815 million increase.
Even in this finger pointing exercise, the most scandalous increase was 9.9% on the Wholesale Acquisition Cost, but we don’t really know the extent to which that was made up for by discounts/rebates. Seems like this report could have been paused after running through the drug selection process and realizing that there wasn’t much to say this year and move the resources to another worthy project…
More please. The National Alliance of Healthcare Purchasers released an infographic on the impact of 340B on employers and working families. I appreciate that the 340B program is used by some covered entities in ways that benefit patients but to every action, there is an opportunity cost. We need to be looking at 340B and asking what tens of billions in value each year is getting various stakeholders and is it worth it.
Pointing fingers. This week there has been a lot of media coverage on the U.S. healthcare system and the anger that so many feel toward insurance companies. The New York Times ran an physician’s opinion piece on her frustration and patient anger, highlighting a case of a patient who should have been admitted to the hospital but was worried about the bill he might receive. Vox had a nice overview of United and other insurance companies and AI/Medicare Advantage.
I don’t think public anger will result in change, our system is mired in its foundations of profit and privatization. Someone has to balance cost and access; we’ve just decided that cost and access needs to be balanced with profit too.