Author: Wayne Winegarden

SACRAMENTO – Fixing the current broken system that incentivizes pharmacy benefit managers (PBMs) to enact policies that benefit themselves and insurers at the expense of patients would lead to lower patient drug costs, finds a new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click to download the brief “The current system incentivizes PBMs to implement policies that benefit insurers and themselves, while making drugs less affordable and available,” said Dr. Wayne Winegarden,...

The Federal Trade Commission continues its assault on innovation and consumers’ wellbeing under the guise of protecting us from harms that are, all too often, merely speculative. In a recent example, the FTC commissioners assert that a merger of two closely connected companies poses theoretical harm to competitors. The FTC’s mission is to protect consumers by ensuring that markets are competitive, not to protect competitors. Presumably, the Commissioners imagine that the theoretical harm to competitors will somehow make consumers worse off,...

Peter Marks, director of Food and Drug Administration’s (FDA) Center for Biologics Evaluation and Research noted that “vaccination remains critical to public health and continued protection against serious consequences of Covid-19, including hospitalization and death.” But what is the protection for those Americans who can’t take the vaccine? Read the full article at Forbes.com...

Listen to Dr. Wayne Winegarden, PRI senior fellow in business and economics and director of PRI's Center for Medical Economics and Innovation, discuss his new brief "No Solutions, Only Tradeoffs," which explores how the small health benefits generated by state COVID-19 lockdowns were more than offset by huge losses in education and the economy. TheLarsLarsonShow · Dr Wayne Winegarden Did Covid Restrictions Wreck Our Economy For Nothing...

SACRAMENTO – States that had more invasive COVID-19 restrictions saw small reductions in COVID-19 infection and mortality rates, but saw large negative impacts on employment, economic growth, and children’s education outcomes, finds a new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click to download the brief “Looking at the data, states with stricter COVID-19 public health policies did see small health benefits from reduced infections and mortality rates – but at the...

Immigration, always a strength for the U.S. economy, has the potential to fill a dangerous and growing labor shortage of skilled nurses. According to nurse.org’s 2023 State of Nursing report, “91% of nurses believe the nursing shortage is getting worse, and 79% report that their units are inadequately staffed.” And it’s not just nurses who recognize this problem. 90% of hospital CEOs report that nursing shortages are their most pressing workplace issue. Burnout from Covid-19 is an important contributor to this problem. A survey by NCSBN (an organization...

Beneficial healthcare change is occurring – in a bipartisan manner too. The reform, referred to as the Transparency in Coverage (Tic) rule, improves the functioning of the healthcare market; and unlike the calls for price controls or increased government distortions, improving the efficiency of the healthcare market can achieve the core goals of promoting greater healthcare affordability and improving the quality of care. TiC went into effect July 1, 2022. Unique among today’s partisan rancor, the TiC rule was issued under the Trump...

The Senate Health, Education, Labor, and Pensions (HELP) Committee is currently reauthorizing the Pandemic and All-Hazards Preparedness Act (PAHPA), which is supposed to help us prepare for the next public health emergency. Never missing an opportunity to impose price controls on anything and everything, Senator Bernie Sanders (I-VT) wants to use this legislation to benchmark the price of innovative medicines that received some federal support at the basic research stage to the prices in the other G-7 nations. Since these nations...

Providing cash-based support to the vulnerable to purchase private health insurance would increase access to quality healthcare at roughly the same per enrollee costs as Medicaid programs - finds the latest paper in the Coverage Denied series released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click to download the brief “Tens of millions are stuck in a flawed government-run healthcare system that provides sub-par care to patients, imposes huge taxpayer costs, and harms the...

Despite the rancor, there are many bipartisan opportunities for the divided 118th Congress. Near the top of the to-do list should be reforming the well-intentioned, but poorly designed, 340B drug discount program. 340B enables qualifying institutions to purchase medicines from manufacturers at steep discounts, generally between 25% and 50% off list price, but sometimes even larger. These discounts are supposed to improve the capacity of the clinics and hospitals serving a disproportionate share of low-income and uninsured patients. More and more, this...

The U.S. Departments of Labor and Health and Human Services has issued a new joint federal rule. Another federal mandate is hardly newsworthy, but one devised under the Trump Administration and eagerly implemented by the Biden Administration is certainly unique. Beyond the politics, the Transparency in Coverage rule, while not without its shortcomings, helps to address on one of the fundamental flaws worsening the effectiveness of the nation’s healthcare system – its opacity. The lack of transparency that pervades the healthcare system...

DOWNLOAD THE BRIEF   Executive Summary Declining productivity growth in the delivery of healthcare is not innate to the sector. It simply reflects the current policy environment. Incentivizing a more productive and cost-effective healthcare provider sector is possible but requires comprehensive policy reforms that eliminate the obstacles blocking progress. These reforms include: Implementing the insurance reforms discussed in Part 5 that, from a provider perspective, will incentivize the creation of innovative payment models. New payment models create opportunities to better align the incentives...

Three days before Christmas, the Institute for Clinical & Economic Review (ICER) is scheduled to publish a draft assessment of two promising treatments for Alzheimer’s disease. Unfortunately for the millions of Americans living with this fatal illness, it is likely that ICER will be giving lumps of coal, not gifts, this holiday season. ICER performs studies that declare how much we as patients value medicines that treat devastating diseases like Alzheimer’s. And depending upon their proclamations, patients’ access to life-altering medicines...

SACRAMENTO – The broken 340B program, designed to provide affordable care for at-risk patients, creates massive profits for providers without necessarily improving patient health outcomes and should be reformed, finds a new issue brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click here to download a copy of the brief “The 340B program is growing unsustainably and isn’t improving health outcomes for at-risk patients,” said Dr. Wayne Winegarden, the Center’s director and the...

CLICK HERE TO READ THE BRIEF In addition to the reforms to the health insurance system, which will help address the problems of drug affordability, reforms tailored to the pharmaceutical sector are necessary. These reforms should eliminate drug supply chain inefficiencies and include: fostering a patient-controlled generics market, creating price transparency through reforms that ensure patients directly benefit from all discounts when purchasing their medicines,  fixing the drug formularies’ systemic biases against low-cost medicines, and encouraging contracting innovations that could create...

The Centers for Medicare & Medicaid Services issued an update to the home health payment system on June 22nd. This proposed rule, rife with legalese and sheer complexity, should be held up as Exhibit A for why socialized healthcare schemes such as Medicare for All will never work. The proposal’s obsessions with “aggregate expenditures” and “overall utilization” reveal one of the fundamental flaws of government-run healthcare – the belief that bureaucrats can efficiently serve individual’s needs by imposing aggregate caps and regulations based on population...

The Centers for Medicare and Medicaid Services (CMS) recent decision on home healthcare services, if implemented, will increase overall healthcare expenditures and decrease the quality of services received by patients. CMS’ overarching goal is praiseworthy – the agency is trying to maintain budget neutrality while changing its payment system rates. A more praiseworthy goal would be to reduce expenditures but that is a different question, the larger problem is that CMS’ proposed expenditure reductions will more likely increase spending over time. At...

Pharmacy benefit managers (PBMs) deploy numerous anticompetitive actions, which have not gone unnoticed. The Federal Trade Commission (FTC) has launched an inquiry to examine whether PBMs have adverse impacts “on the access and affordability of prescription drugs.” The government’s probe is welcome news. But there are many detrimental PBM practices that are creating unwarranted risks to patients’ health and, consequently, require remedying sooner rather than later. The growing restrictions on where providers can source their drugs, a practice referred to as white bagging,...

SACRAMENTO – Biosimilars competition saves patients and the health care system over $11 billion annually and could generate even more savings if the broken drug pricing system were reformed, finds a new issue brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. “Patients living with cancer, autoimmune diseases, osteoporosis, and other illnesses are receiving revolutionary treatment from biologics,” said Dr. Wayne Winegarden, the Center director and the study’s author. “As our research shows,...

CLICK HERE TO READ THE BRIEF Establishing an Efficient Health Insurance Market Cultivating an efficient health insurance market requires reforms that empower patients over payers, which can be achieved by: Making health expenditures and health insurance expenditures tax deductible;  Broadening the availability and usability of tax-free saving accounts to help patients cover the deductibles and out of pocket expenses that could arise should they require costly healthcare services; and Promoting price transparency and insurance competition to enable a more competitive pro-patient healthcare...