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March 1, 2022 Briefs, Policy Proposals, Price and Costs, Studies

READ THE REPORT The problem of drug affordability is caused by the perverse incentives created by the third-party payer system that have disempowered patients in favor of insurers and other supply-chain intermediaries. The insurance flaws have created pricing systems that inequitably transfer a disproportionate share of drug costs on to patients. This arrangement inappropriately imposes a drug affordability problem on patients who require expensive medicines. The insurance flaws also incent benefit design policies that create additional affordability burdens and unnecessarily increase...

February 28, 2022 Issues, Price and Costs

Too often, regulations undermine the competitive process in the name of promoting competition. The ill-conceived Right to Repair legislation exemplify the problems and risks. Under the pretense of promoting competition, states as diverse as Texas and California, Arkansas and Hawaii have all considered bills that would violate medical device companies’ intellectual property rights. While many have been defeated, some legislators seem intent on advancing one businesses interest over another, which undermines competitive efficiency and, in the case of medical devices, creates risks to patient care. At issue are the rules...

February 22, 2022 Blog, Policy Proposals

It’s budget season in Sacramento. Governor Gavin Newsom’s spending proposal is the largest in the Golden State’s history. There’s no shortage of expensive and misguided policies in his budget. Chief among them is his push to expand Medi-Cal, the state’s Medicaid program, to cover all undocumented immigrants. Doing so would make Medi-Cal worse for its legacy beneficiaries and nudge the state closer to the government-run, single-payer system that is the long-term goal of Newsom and his progressive allies. The governor proposes spending...

February 22, 2022 Issues, Multimedia, Policy Proposals

Watch PRI’s Wayne Winegarden, director of our Center for Medical Economics and Innovation, discuss efforts by the Federal Trade Commission to considering ordering large pharmacy benefits managers to study the competitive impact of contractual provisions, reimbursement adjustments, and other practices affecting drug prices on Scripps National News. https://youtu.be/DQsjKM44ScQ...

February 10, 2022 Issues, Price and Costs

Last week, President Joe Biden announced the re-launch of his "Cancer Moonshot" initiative, a project he created in 2016 while serving as Vice President in the Obama administration. The ambitious effort aims to "end cancer as we know it today" by, among other things, halving the death rate from the disease by 2047. That goal is laudable. It will also be impossible to achieve if the president continues to make prescription drug price controls a top administration priority. The only way to spur the...

February 8, 2022 Issues, Price and Costs

According to a new Bureau of Labor Statistics report, consumer prices across a range of goods and services rose 7% between December 2020 and December 2021. It's the largest annual inflation growth in more than 40 years. But the BLS data did reveal one surprising finding. There was zero prescription drug price inflation last year. Yet, as part of their moribund Build Back Better Act, Democrats are continuing to propose price controls on drugs. It makes no sense. Prescription drugs were an outlier in the BLS report....

February 7, 2022 Blog, Industry Trends

Upon facing declining revenue prospects, physicians are shuttering their private, independent practices to partner up with larger hospitals that have near-monopolies on care in the regions they serve. This trend is depressing news for most Americans. Further concentration of market power in these health systems ultimately results in less personalized care and higher overall costs for patients. The effect of the decrease in independent medical practice Medicare physician’s pay has increased by 11% over the past 20 years. The overhead costs of operating an independent medical...

February 1, 2022 Innovation

By Henry Miller and Kathleen Hefferon Much of the world is preoccupied with the ongoing coronavirus pandemic, but there are other global challenges, including climate change, food security, and degradation of the environment. Interestingly, and perhaps ironically, there is some good news regarding the latter three from a recent breakthrough in microbiology.   Plants depend upon beneficial interactions between roots and root-associated microorganisms for growth promotion, disease suppression, and nutrient availability. Crops require nitrogen to grow, and although there is an abundance of...

January 27, 2022 Innovation, Issues

Gene editing, which allows precise edits to the genome, has been widely used for a variety of applications in laboratories worldwide since its discovery a decade ago. It has tremendous potential: Researchers hope to use it to alter human genes to eliminate diseases; improve the characteristics of plants; resist pathogens; and more. The two scientists who discovered the iconic gene editing technology, the CRISPR-Cas9 system, were awarded the 2020 Nobel Prize in Chemistry. In spite of the fact that gene editing is...

January 12, 2022 Briefs, Industry Trends, Price and Costs

BY WAYNE WINEGARDEN AND CELINE BOOKIN Part 1 of the Coverage Denied series documented how distortions in the U.S. healthcare system turned the important financial risk management service of health insurance into a barrier to care and an important driver of health care inflation. The insurance industry’s adverse impact on costs is ironic given its current focus on implementing cost control measures.  Unfortunately, the problems of increasing obstacles to care and decreasing health care affordability are the expected outcomes from the current...

January 3, 2022 Blog, Policy Proposals

Imagine you’re walking the aisles of your local supermarket, on the hunt for your favorite cereal. You usually purchase the generic version, since it tastes nearly the same and is much cheaper than the name-brand version. But today, you notice that the price of the name-brand cereal is just a few cents more expensive than the generic version. You remember that Congress just passed a law capping the price of name-brand cereal. Now, with the prices almost equal, you decide to purchase...

December 29, 2021 Industry Trends

Last week, on Dec. 19 specifically, Sen. Joe Manchin, D-W.Va., announced that he would not support the current iteration of the Build Back Better Act. His decision calls the future of the $1.75 trillion spending package into serious question. For this, Democrats have only themselves to blame. After all, Manchin's demands that Democrats scale back their ambitions are more than reasonable — especially at a moment of high inflation and economic uncertainty. Build Back Better employs a host of gimmicks to mask the bill's true cost. Indeed,...

December 29, 2021 Price and Costs

For current and future taxpayers, 2021 was a brutal year—at least when it comes to healthcare spending. Congress and the Biden administration approved tens of billions in new expenditures. Much of that money was, or will be, wasted on inefficient programs and subsidies that do little to improve the quality of care that Americans receive. But the bill will come due regardless. The president kicked off his first term with a massive $1.9 trillion stimulus package, the American Rescue Plan. About $34 billion went to...

December 29, 2021 Blog, Policy Proposals

By Henry I. Miller, M.S., M.D. and Jeff Stier When President Joe Biden nominated Obama-era Food and Drug Administration Commissioner Dr. Robert Califf to return to his old post, he made what is widely seen as a safe, if uninspired, choice. Califf is a distinguished cardiologist and clinical trial specialist, but the day-to-day regulatory decision-making happens at the organizational levels below the commissioner. The FDA, a huge and critically important but dysfunctional organization, now needs a bold, clear-thinking reformer, but Califf, the...

December 29, 2021 Blog, Policy Proposals

It's hard to find a silver lining in a pandemic. But COVID-19 has convinced the medical and policymaking establishments, perhaps unwittingly, that high-quality care can be delivered remotely. The telehealth revolution is upon us. Lawmakers waived numerous arcane and outdated regulations governing the use of telemedicine to make the service more available for everyday patients. Onerous restrictions that required patients to receive telehealth care in medical facilities and barred doctors from conducting appointments across state lines were as nonsensical before the...

December 24, 2021 Blog, Coronavirus - Alternate, Policy Proposals

By Henry I. Miller, M.S., M.D. and John J. Cohrssen Earlier this week, President Biden outlined new steps to confront the growing spread of Covid-19 from the new, more infectious Omicron variant, which, in only a few weeks, has soared from virtually nonexistent to 73 percent of all new cases. Unfortunately, Biden’s plan failed to include what could be the most important action of all: an all-out effort to make safe and effective anti-viral Covid-19 pills available—two of which have now...

December 21, 2021 Industry Trends

Even health care answers to the law of supply and demand. Before the pandemic, demand for care was surging as our nation aged. Supply has not kept up. More than 83 million Americans live in areas where there’s a shortage of primary care health professionals, according to the federal government. Rising demand coupled with limited supply is a recipe for high prices. And now, with a new variant of covid-19 in our midst, demand for care will only increase. Relaxing the laws that limit what...

December 21, 2021 Price and Costs

Wayne Winegarden, PhD, Discusses the Value of an Interchangeable Designation for Adalimumab Biosimilars December 19, 2021 Skylar Jeremias The Center for Biosimilars® interviewed Wayne Winegarden, PhD, senior fellow in business and economics at Pacific Research Institute (PRI) and director of PRI’s Center for Medical Economics and Innovation. Click here to watch. Winegarden talked about how interchangeability designations are more important for biosimilars referencing adalimumab (Humira) because they would not administered by a physician in a clinic, unlike oncology biosimilars, which pharmacists do not interact with...

December 21, 2021 Policy Proposals

A health insurance “public option” is a long-cherished goal for many Democrats. Yet, progress on that goal has stalled at the national level. But three states — Washington, Nevada, and Colorado— have gone ahead with such schemes. Another 16 are considering them. Washington’s public plan is about to complete its first year in business. Colorado officials, meanwhile, have to create their standardized health benefit plan by the end of this year. We can be sure that the White House and Democrats in...