NEJM - State Initiatives to Control Medication Costs - Can Transparency Legislation Help?

Today's blog features an exclusive audio interview with Dr. Armeet Sarpatwari on state bills that aim to reduce drug spending by requiring companies to disclose R&D costs. Dr. Sarpatwari is an epidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital. To listen to the full interview, please click here!


HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/

Providing Cancer Drugs In Multiple Vial Sizes Could Save Patients and Payers Money

On March 1, 2016, Health Affairs published an article in the BMJ showing how in the US nearly $3 billion will be spent on discarded cancer drugs this year because companies package drugs in vials that contain too much of the drug for most doses, creating expensive leftover product. We proposed that companies in the US should either package drugs in more appropriate vial sizes to reduce the leftover amounts, or provide refunds for leftover drug.

Since the time of our article’s publication, numerous Senators have written letters to the Food and Drug Administration (FDA) urging action on vial sizes, and calling for the Department of Health and Human Services Office of Inspector General (HHS OIG) to investigate which companies sell their drugs in smaller vials outside the US than they offer to US patients. The Centers for Medicare and Medicaid Services (CMS) has also mandated that beginning July 1 2016, all health professionals billing for infused cancer drugs (and other Part B drugs) to distinguish between claims that are for drugs that a patient actually receives and those claims that are for leftover drug.

  

Need to know more? Check out Health Affairs blog post titled, "Yes, Providing Cancer Drugs In Multiple Vial Sizes Could Save Patients and Payers Money".  

HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/

Health Insurers Push to Tie Drug Prices to Outcomes

Health insurer Cigna Corp. will get extra price discounts from drug makers if new cholesterol medications don’t help patients as much as expected, a significant step in a broader push to tie the cost of drugs to how well they work. 

Such "value-based" deals are becoming more common as rising costs spur customers to demand assurances they are getting what they pay for. 

To read more on this story, be sure to check the Wall Street Journal published article, "Health Insurers Push to Tie Drug Prices to Outcomes". 

HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/

Five Diabetes Rx Trends to Explore Ahead of ADA '16

Approaching the American Diabetes Association 76th Annual Scientific Sessions, Express Scripts explained the five key factors driving spend in the costliest traditional therapy class. 

For the fifth consecutive year, diabetes is the costliest traditional therapy class for payers. Plans spend an average $77.60 per member per year on diabetes medications in 2015, a 14% increase from 2014, driven equally by increases in use and cost of medications in the class. 

So what are these five trends that are increasing these costs, exactly? Make sure to read the Express Scripts published article, "Five Diabetes Rx Trends to Explore Ahead of ADA '16" to find out!

HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/

3 Solutions Healthcare Payers Need Now

Over the past 18 months, SafeGuardRx solutions have helped healthcare payers address key threats to affordable pharmacy care. For each of these innovations, Express Scripts has taken a comprehensive approach to a specific class of drugs or industry challenge, they identified novel ways of partnering with drug manufacturers, and they ultimately delivered to their clients superior levels of care, lower drug costs, and protection from future uncertainty. 

To learn more about these solutions, be sure to read the Express Scripts published article titled, "3 Solutions Healthcare Payers Need Now". 

HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/

Over the past 18 months, our SafeGuardRxSM solutions have helped healthcare payers address key threats to affordable pharmacy care. For each of these innovations, we took a comprehensive approach to a specific class of drugs or industry challenge, we identified novel ways of partnering with drug manufacturers, and we ultimately delivered to our clients superior levels of care, lower drug costs, and protection from future financial uncertainty. - See more at: http://lab.express-scripts.com/en/lab/insights/drug%20options/3%20solutions%20healthcare%20payers%20need%20now#sthash.TRoCKB0L.dpuf

Over the past 18 months, our SafeGuardRxSM solutions have helped healthcare payers address key threats to affordable pharmacy care. For each of these innovations, we took a comprehensive approach to a specific class of drugs or industry challenge, we identified novel ways of partnering with drug manufacturers, and we ultimately delivered to our clients superior levels of care, lower drug costs, and protection from future financial uncertainty. - See more at: http://lab.express-scripts.com/en/lab/insights/drug%20options/3%20solutions%20healthcare%20payers%20need%20now#sthash.TRoCKB0L.dpuf

Baby Boomers Will Become Sicker Seniors Than Earlier Generations

The next generation of senior citizens will be sicker and costlier to the health care system over the next 14 years than previous generations, according to a new report from the United Health Foundation. We're talking about you, baby boomers. The report looks at the current health status of people ages 50 to 64 and compares them to the same ages in 1999. 

The upshot? There will be about 55 percent more senior citizens who have diabetes than there are today, and about 25 percent more who are obese. Overall, the report says that the next generation of seniors will be 9 percent less likely to say they have good or excellent overall health. That's bad news for baby boomers. Health care costs for people with diabetes are about 2.5 times higher than for those without, according to the study.

Do you fall into this category and want to learn more? Be sure to read the NPR published article titled, "Baby Boomers Will Become Sicker Seniors Than Earlier Generations". 

HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/

CFOs And HR Execs Facing Millions In Personal Liability Due To Unmanaged Health Benefits Plans

The first shots across the bow have been fired highlighting how benefits leaders need to pay as close attention to health benefits as they have been paying to retirement plans. The most recent lawsuits name the HR leaders in the companies involved (GAP and CB&I) as defendants since they are listed as the plan administrator (sometimes CFOs are the plan administrators). It’s clear that there is going to be the increased scrutiny for health benefits that has been commonplace for retirement benefits.

 

Read more of the Forbes published article, "CFOs And HR Execs Facing Millions In Personal Liability Due To Unmanaged Health Benefits Plans" to learn more about this evolving story. 

HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/