• Caught my eye — 1/19/23
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Caught my eye — 1/19/23

A thoughtful piece on price hikes. Price hikes are the routine story of January. Look price hikes! But because net price hides behind discounts and rebates, the full story is seldom in media. Here is a story that is (finally) a little more balanced on price hikes (and decreases). It even talks about the new no-cap in Medicaid rebates because of the American Rescue Plan Act. One gap? It misses the Inflation Reduction Act and the inability to raise prices without refunding the amount over inflation back to the government. Depending on a pharmaceutical company’s payer mix, makes it hard to increase prices too much.

Tell me more. This week Senator Bill Cassidy, M.D. (R-LA), ranking member of the Senate Health, Education, Labor and Pensions (HELP) Committee sent letters to Walgreen and CVS looking for information on how they use and generate revenue from the 340B Drug Pricing Program.  This is part of his ongoing look into the 340B program.

Huh. In a survey of just over 500 physicians, only 41 percent reported moderate or better understanding of the Food and Drug Administration’s drug approval process.

Third-party health vendors shudder. This week the New York Times reported on a study that found that workplace mental health wellness programs have little benefit. In fact, trainings on resilience and stress management appeared to have a negative effect. I doubt we’re seeing the end of these programs; I imagine per member, per month these benefits are probably pretty inexpensive for employers. Better to offer it than look like you don’t care.

Sweet or salty? Really? No thanks? The end of marketing to cravings because of obesity products. Realistically there will always be those of us who just can’t eat one. Although I can have none of the Doritos flavored alcohol.

Hospital priorities. What the American Hospital Association is putting front and center for 2024. They are against site neutral payments, looking to delay cuts to disproportionate share hospitals, encourage Medicaid coverage (or finding alternate coverage) and prioritizing workforce issues. Also on the list – prior authorization and the time it takes.

Better timing. This week CMS released a final rule on prior authorization. It does NOT tackle drugs (another rule, another day) nor does it impact many employer plans but it does look to ensure more rapid response to prior authorization requests.

Honk for cardiovascular benefits. I am hoping this does NOT catch on but there are clown cardio classes in Los Angeles.

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