When your job is to stay on top of the news but you also just want to turtle a little bit, there are challenges that eventually have to be faced. Skimming the news, here is what caught my eye…
340B Bonanza. I have been devouring the 340B coverage of J&J, Lilly and BMS suing the Health Resources and Services Administration (HRSA) and the Department of Health and Human Services (HHS) for blocking the implementation of a 340B rebate model. Then there was Cost Curve and Drug Channels covering the Minnesota 340B data release, making the most of the limited data that was there.
Opinions are like … I almost didn’t mention this one because I’m not sure it deserves any airtime. I just found it overly simplistic in its reasoning. That being said, this Health Affairs article on why drug prices are high is worth noting because of how badly I think it misses the point in so many ways that it would take a white paper to respond to. Drug prices are not one set number. Are we talking about 340B? Best price? Average manufacturer price? Wholesale acquisition prices? Etc. And we do value a marketplace with choice. We don’t have to decide that we need the latest oncology drug but we want it. Other countries say no – not an option. We have built a system that mandates huge discounts for Medicaid, 340B, Part D and wonder why the list price goes up. Instead…
Rent-free. This post by Peter Kolchinsky has been rattling around my brain this week. It is exactly how I think of branded drugs. They represent 8% of healthcare spending but the value is so much higher. One day they will be generic and the prices will drop. I think about Wegovy and Mountjaro. They will be generic relatively soon and think about that will mean for millions of people. I especially like the little graphic conveyer belt image.
If a tree falls in the forest. The Washington Post reported that the Texas Maternal Mortality and Morbidity Review Committee will not review cases from 2022 and 2023, the first two years after the near total abortion ban began in Texas. They said that this will help them overcome the backlog and be more relevant to policymakers.
Not that you asked. The New England Journal of Medicine had an interesting article on overcoming patent thickets. I think it still sounds like too much work. I feel like we should say 15 years (at most).
Minding the Gap. Health Affairs Scholars had a piece about Medicare Advantage beneficiaries looking at Medigap when they begin taking a Part B drug (more affordable under Medigap) but challenging to get depending on the state they live in and their health status. While premiums during the first 6 months of Medicare eligibility are based on community rating, beneficiaries looking to enroll after that time may face higher premiums based on their health status and may be denied coverage. Hence the term “Medicare Advantage Trap.”