If you’re one of those people who is working from the couch today, I salute you. It really is the most fun day of sports. I was mocked for the way I picked my bracket (where wouId I rather live?) but I had a clean bracket until Kentucky. I blame my newfound like of bourbon.
Wait, Weight, They are Telling You. Technically anti-obesity medications (AOMs) can’t be covered by Medicare (says so in the Medicare Modernization Act of 2003, with a reference to exclusion of “Agents when used for anorexia, weight loss, or weight gain.”
But… there is a lot of pressure on Medicare to consider covering obesity products. This week the Congressional Budget Office (CBO) did a presentation on where they are at with their thinking. If you’re new to the whole CBO world, they give an intro to what they do for about half the slides. If I had to sum it up it would be “Look, we do our best and do what we’re told and operate within certain boundaries. Leave us alone.”
The second half of the presentation gets into the obesity drug part. It basically says, if Congress moved ahead, it would raise premiums and cost money and the offset isn’t there but eventually these drugs will be generic and/or rebated more and/or negotiated so we don’t know the real impact.
BUT the last two slides are interesting. They spell out what CBO is looking for in terms of research and if you work for Lilly or Novo or another company developing an AOM, here’s the info I would try to publish on –
Breathing easier. This week AstraZeneca and GSK joined the $35 inhaler party started by Boehringer Ingelheim. The actual price of the medicines isn’t dropping down to $35 but they are expanding their savings programs. It is really hard to lower list price because the supply chain likes price where it is (or higher). This does however, get patients some relief. It’s mostly a “feel good” moment but there is nothing wrong with that.
Random Factoid for you. This has come up twice over the dinner table the last few weeks. Probably more a reflection of the company I keep? Well and this article about catching snakes in Australia and climate change. There is work going on to make a universal antivenom for snakes. Slip that into your next cocktail chit chat.
Gene-ie, can I make a wish? This week, Lenmeldy, a gene therapy by Orchard Therapeutics for metachromatic leukodystrophy was approved by the Food and Drug Administration. Price tag of over $4 million. If given before symptoms appear or soon after, it can be near curative. This story has hung over me all week. I see the price tag and know it is high; Institute for Clinical and Economic Review estimated the drug would be cost-effective if priced anywhere between $2.3 million and $3.9 million. But even that, really high. And yet I know that I’d do anything to get it to one of my kids if they needed it. I don’t have answers, just all gut-wrenching.
Time check. KFF Fact Checks Biden on Medicare Negotiation. Biden said, “We cut the federal deficit by $160 billion because Medicare will no longer have to pay those exorbitant prices…” Problem? Omission of time frame. But, to be fair, he’s running for office. And might not be able to brag about it during the time frame that the savings actually happen.
Resource that could use useful … Cardinal’s biosimilar report.
New week, new model. I should say that the ACO Primary Care Model caught my eye but I just wasn’t that interested in it. At least not yet.