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Latest From Cathy Kelly
UnitedHealthcare’s pharmacy benefit manager highlights potential cost pressures from upcoming novel or improved treatments for diabetes, wet AMD, HIV and migraine, as well as luspatercept for beta thalassemia, in its latest pipeline report.
Drug costs make up 60% of the total cost of cancer care, participants in the Medicare Oncology Care Model have found. But efforts to manage spending under the demonstration have so far focused instead on areas that represent a smaller portion of overall costs, such as hospitalizations.
Absent any legislative remedy, an administrative fix could provide manufacturers with confidence that value-based arrangements won’t trigger a new best price, Duke Margolis policy experts propose.
Former US FDA commissioner Scott Gottlieb makes a case for regional or national risk pools to ensure pediatric patients get timely access to gene therapy like the upcoming treatments for sickle cell disease.
If nothing else, the purported draft may be a preview of what Democrats might do if they prevail in 2020. Proposal calls for HHS price negotiation, international reference pricing, price inflation rebates and structural Medicare Part D changes.