Today's News and Commentary

About pharma

Most Osteoporosis Drugs Don’t Build Bone. This One Does: The FDA has approved Evenity, Amgen’s new drug to treat post menopausal osteoporosis. The drug works by a new mechanism that encourages new bone growth. Once the patient has grown enough new bone (after about a year), she is then placed on maintenance therapy with a bisphosphonate to prevent further loss. The downside is a contraindication if the patient has has a heart attack or stroke in the year before administering the medication. Pricing is still unknown.

Read the article(NY Times but appears to be open access)

CVS, Cigna, Humana blame Big Pharma at Senate hearing for skyrocketing US drug prices: As previously mentioned, yesterday was the day big pharma benefit managers (PBMs) testified before the Senate Finance Committee about their role in high drug costs. Predictably, their fingers pointed to “Big Pharma” and not those who manage the benefits.

Read about the hearing

Hikes on Medicare drug premiums could be delayed until after 2020 elections: In a related article, the Trump administration has proposed giving any drug rebates back to patients. Because insurers count on those rebates, their loss would cause an increase in premiums. 2020 proposals for Part D are due in 8 weeks and the rebate issue is still not settled. CMS directer Verma has told companies to use old criteria for their pricing bids. We will need to wait to see how all theses changes play out.

Read the article (Washington Post but appears to be open access)

Invisible Middlemen Are Slowing Down American Health Care: This in-depth article provides a good working insight into how PBMs work (or often do not work).

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Walgreens Unveils Latest Primary Care Partner: VillageMD: In the latest pair-up of pharmacies and healthcare providers, Walgreens is partnering with Chicago-based VillageMD to set up primary care clinics next to their stores in the Houston area. This move is seen as a competitive strategy to answer expanded in-store healthcare services CVS is setting up.

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Sanofi turns to subscriptions to offer patients insulin at $99 per month: Netflix comes to pharma. For a monthly fee of $99, diabetic patients can get all their insulin from Sanofi.

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About health insurance

UnitedHealthcare to expand bundled payments in its Medicare Advantage plans: Continuing a trend of value-based payments, UnitedHealthcare is expanding its bundled payments to providers caring for members in the insurer’s Medicare Advantage plans. The bundles will cover single and double hip joint replacements, single and double knee join replacements, non-cervical spinal fusion, cardiac valve replacement, coronary bypass, and percutaneous coronary intervention. 

Read the announcement

About healthcare IT

Provider, health IT groups praise proposed bills to change patient privacy regulations: Care of opioid-addicted patients requires knowledge about all their health problems. But the law governing disclosure of patient information about substance abuse (so-called 42 CFR Part 2) is very strict and makes necessary information sharing difficult. Now lawmakers are finally standardizing these privacy requirements to harmonize them with HIPAA.

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Federal agencies charge 24 in $1.2B Medicare telemedicine fraud scheme: Did you ever get a robocall asking about your backspin and offering a helpful device that Medicare will cover? If so, your intuition was correct- it was most likely part of a huge international fraud scheme. Read this article for the details and check the youtube video link.

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