Today's News and Commentary

About pharma

Using External Reference Pricing In Medicare Part D To Reduce Drug Price Differentials With Other Countries: CMS and the White House have been floating the idea of using reference pricing for Medicare Part D drugs to save money. The idea would be to peg our prices to what other countries pay. This study looks at the impact of such a plan.
The research compared price differences between the US and the UK, Japan, and Ontario (Canada) for “single-source brand-name drugs that had been on the market for at least three years.” The authors found that prices “averaged 3.2–4.1 times higher in the US after rebates were considered. The price differential for individual drugs varied from 1.3 to 70.1. The longer a drug remained on the market, the greater the differential. The estimated savings to Medicare Part D of adopting the average price of drugs in the reference countries was $72.9 billion in 2018.”
Of course pharma will come back and say the reduced payments will cut into R&D, which will affect our country’s leadership in innovation.

Read the research (Health Affairs requires a subscription; abstract is available)
Read a related article

A $2 Million Drug Is About to Hit the Market: Novartis has set the price of its gene therapy drug Zolgensma (to treat spinal muscular atrophy) at $2million. This price would make it the most expensive treatment ever. Since the treatment is for infants, analysis includes lifetime economic benefits. The article discusses high cost therapies, with attention to genetic interventions.

Read the story (Wall Street Journal -may need a subscription)

Drug-resistant tuberculosis reversed in lab: This story could be one of the biggest pharma/public health announcements of the year. Researchers identified a compound that would impair the TB bacterium’s ability to form a coating that makes it resistant to drug treatment. The compound (called C10) makes the organism susceptible to even first line drugs like isoniazid (the oldest anti-TB medication).

Read the announcement

Trump directs Azar to work on Florida drug import plan: As previously reported, Florida has passed legislation allowing Canadian drug imports to lower healthcare costs in the state. The obstacle would be FDA approval since the practice, as planned, is illegal. Now the President has instructed HHS Secretary Azar to help the state with its initiative. The law goes into effect July 1.

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About healthcare IT

NIH launches beta version of Data Browser for PMI cohort: The National Institutes of Health is conducting a Precision Medicine Initiative called All of Us. The purpose of the program is to gather very large data bases of individual health statistics that can be used for research to inform precision medicine decisions. The beta version of the first round of data was launched yesterday. The disease-specific information is very sparse now and is mainly frequency of conditions by sex- which is skewed toward female participation. The other topics include such issues as healthcare literacy and self-reported health status.

Until the number get very large, one still has to be careful of self-selection bias in the reporting.

Read the announcement

Medtronic’s iPad-Based Pacemaker Programmer Receives FDA Clearance: This Bluetooth-enabled cardiac implant device allows programing and data downloads using the Apple iPad.
Sounds great…what about hackability?

Read the announcement

About the public’s health

Trump May Redefine Poverty, Cutting Americans From Welfare Rolls: One way to reduce welfare benefits is redefine who is eligible. This article is about lowering income targets for welfare eligibility. The issue of Medicaid coverage is not discussed but certainly is of concern if this measure is implemented.

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The measles epidemic continues
Three related article on this topic.
Federal health officials dispute connection between measles outbreak, 'conscience rule': Some have claimed states will not be able to enforce elimination of religious exemptions for vaccination because of the “conscience rule” issued last week. However, an unidentified HHS official stated: “The final rule only provides enforcement mechanisms for Federal conscience and anti-discrimination laws that Congress has enacted. It does not create new substantive conscience protections.” Apparently the states can act as they wish in this regard.

Poll: 72 percent say parents should be required to vaccinate their children: This NBC News/Wall Street Journal poll is very discouraging. 72% is nowhere near enough support to achieve herd immunity.

Number of US measles cases continues to climb, now with 764 reported: The results speak for themselves.