Today's News and Commentary

About pharma

Another hit for Roche: UnitedHealthcare backs Amgen biosims over blockbuster oncology meds: Biosimilar drugs have been slow to make an impact on healthcare costs in the U.S. As a start to remedy this situation, “UnitedHealthcare (UNH) will put Amgen biosimilars of oncology meds Avastin and Herceptin first in line as preferred products in its commercial, community and Medicare Advantage plans starting Oct. 1… The two biosims, Mvasi and Kanjinti, launched in the U.S. in mid-July at a 15% discount off the original brands.” While the discount is not as much as traditional generics, it is a significant savings.

As specialty drug costs skyrocket, Anthem tests new idea for curbing 'shock' claims: Speaking about the high cost of specialty drugs, “Anthem is launching a new program in Kentucky that aims to work with providers to protect patients from ‘shock’ bills for these therapies. 
Anthem has teamed up with St. Elizabeth Healthcare, one of the state’s largest providers, as the first partner in the new program. In the model, the health system will absorb part of the cost of these services, discounting them by as much as 45%.” This project is a step short of the payer captitating the provider for such services.

Verma: CMS working 'fast and furious' on IPI drug pricing model, but doesn't say when it will be released: Earlier this year, The Trump administration announced its intention to lower drug costs by implementing an International Pricing Index (IPI) model- using prices outside the country as a guide to domestic costs. CMS administrator Verma has an update on this proposal, saying that “we are fast and furious” about getting the model done. When it will be implemented is not yet clear.

New drug disposal regulations to be implemented next week: “Starting Aug. 21, drugs like opioids and chemotherapies will need to be disposed of through proper channels rather than down the drain…” While the regulations are long overdue, compliance will be costly. For example Cleveland Clinic is expected to spend $500,000 per year to set up a complaint system. Perhaps manufacturers of those drugs can offer disposal solutions to customers as a “value-added” service.

About the public’s health

Without court action, Planned Parenthood says its health centers will withdraw from Title X over 'gag rule': “Planned Parenthood Wednesday notified the Ninth Circuit Court of Appeals that unless it steps in by Aug. 19 to block the Trump administration’s new Title X rule, its health centers will be forced out of the federal program in just days.” The previously reported rule bans Title X funding recipients from making referrals for abortion services.

New Look For Cigarettes? FDA Proposes Graphic Warnings On Packages And Ads: If you have seen packs of cigarettes in some other countries, you noticed the graphic “photo-realistic” images warning about the health risks of smoking. Such warnings were supposed to appear on American cigarette packs after passage of a law in 2009. Tobacco companies complained that such a requirement was a violation of their freedom of speech. As a result of an American Lung Association lawsuit against the FDA, “acting FDA commissioner Ned Sharpless told reporters that the 13 warnings the agency plans to plaster on cigarette packs, hew close to the factual dangers of smoking.” That decision is not yet a “done deal,” as tobacco companies are expected to sue. In any case, these messages would not appear at the soonest until 2021.

New York City Is Giving Out Prescriptions For Free Fruits And Vegetables: This article describes “New York City’s Pharmacy to Farm program, which provides extra money each month for fresh produce to people who receive Supplemental Nutrition Assistance Program (SNAP) benefits and are on medication for hypertension. One in five New Yorkers is on SNAP; one in four has high blood pressure.” As the program name explains, the benefits are distributed through a patient’s pharmacy.

For a decade, Francis Collins has shielded NIH—while making waves of his own: This article is a balanced, insightful look at the man running the NIH.

About healthcare quality and patient safety

CMS to require ACA plans to display star ratings for plans starting in 2020: “The Trump administration will require Affordable Care Act exchange plans to display their star ratings received for quality, in a move aimed at boosting transparency.” The requirement will apply to plans offered in the 2020 contract year and appear on such sites as

About health insurance

American Medical Association leaves coalition fighting 'Medicare for All': “The AMA said it is leaving the industry group called the Partnership for America’s Health Care Future, which has been running ads against Medicare for All and public option proposals from the leading Democratic candidates for president. However, the doctors group’s CEO, Dr. James Madara, said in a statement that the AMA still opposes Medicare for All. It just wants to focus its energies on advocating for solutions, such as improving ObamaCare by making its subsidies for helping people afford coverage more generous.” 

Tracking the rise in premium contributions and cost-sharing for families with large employer coverage: The Kaiser Family Foundation has updated its employer-sponsored health insurance survey. Some of the highlights: “…the average family spent $4,706 on premiums and $3,020 on cost-sharing, for a combined cost of $7,726 in 2018. This represents an 18% increase in the health costs borne by employees and their families from five years earlier ($6,571 in 2013), outpacing the 8% increase in inflation and a 12% increase in workers’ wages over the same period.”