Issues

The Biden administration claims to support price transparency in healthcare. The Centers for Medicare and Medicaid Services has formally warned hundreds of hospitals to comply with federal rules requiring them to post their prices publicly. And the agency just rolled out a new rule designed to “advance prescription drug transparency in Medicaid.” But that drug pricing rule has little to do with transparency. It’s an opaque bid by the White House to impose price controls on drug makers. If implemented, it...

Who says bipartisanship is dead? In the House and Senate, members of both parties are advancing legislation to check the power of pharmacy benefit managers (PBMs), the self-dealing middlemen in the drug supply chain that inflate Americans' spending on prescriptions by billions of dollars a year. By shining a light on PBMs' questionable business practices, and potentially cracking down on some of their anticompetitive behavior, lawmakers can help patients fill their prescriptions without breaking the bank....

President Joe Biden just announced a new effort that he hopes will spur the development of better, more precise cancer surgery technologies. The program is part of his administration's "Cancer Moonshot," which aims to halve cancer death rates in the United States by 2047. Ironically, one of the biggest obstacles to achieving that goal might be Biden himself — or more specifically, his policies. The prescription drug price controls Biden signed into law as part of last year's Inflation Reduction Act (IRA) have...

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...

Congress is looking to narrow our nation's doctor shortage. After introducing legislation that would reform our primary care system, Senate Health, Education, Labor, and Pensions Committee Chairman Bernie Sanders (I-VT) said last month , "Tens of millions of Americans live in communities where they cannot find a doctor while others have to wait months to be seen." The Vermont socialist is right. Too many people do struggle to find a doctor. But his preferred solution — spending tens of billions of taxpayer dollars to recruit and train...

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 nonprofit group Patient Rights Advocate just published its fifth report exploring how hospitals are complying with federal price transparency requirements. About two-thirds are still flouting the rules. That's unacceptable. Noncompliant hospitals are preventing patients and payers from shopping around for high-value care — and inflating healthcare costs in the process. The price transparency regulations went into effect in January 2021. Hospitals are now required to publish the prices they have negotiated with each insurer for every service they provide. They must also display the cost of 300 "shoppable"...

The last few months have seen a flurry of activity on Capitol Hill regarding prescription drug reform, with a particular focus on pharmacy benefit managers, or PBMs. The U.S. Senate Finance Committee is set to markup a bipartisan PBM reform bill within the next few days. The House Energy and Commerce Committee and the House Committee on Education and the Workforce are weighing PBM reform legislation of their own. All these efforts have an eye on reducing drug costs for patients. Click to read the full article in...

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...

It’s been less than a year since Democrats enacted the Inflation Reduction Act, which gives Medicare the power to set the prices of certain medicines. Those price controls have yet to go into effect. But Democrats already want more. They’ve introduced new legislation that would amp up those price controls — and even permit the government to refuse to cover drugs in order to drive a harder bargain with pharmaceutical companies. As for the patients who would benefit from those drugs —...

A new Senate bill takes aim at one of the chief drivers of the high out-of-pocket drug costs that many consumers are experiencing — middlemen known as "pharmacy benefit managers." Introduced in mid-June by a bipartisan group of senators including Finance Committee Chair Ron Wyden, D-Ore., and Ranking Member Mike Crapo, R-Idaho, the Patients Before Middlemen Act — or PBM Act, for short — would shed some much-needed light on a part of the pharmaceutical market that has been in the shadows for too long. Few companies exert...

Hundreds of lifesaving therapies will never be invented, and as many as 1.1 million jobs will be lost if Senate Democrats successfully expand their prescription drug price-fixing program, according to a major new study. The study, conducted by the research group Vital Transformation, modeled the effects of the SMART Prices Act. Sponsored by 28 Democratic senators including Amy Klobuchar, D-Minn., Peter Welch, D-Vt., and Elizabeth Warren, D-Mass., the bill would expand the price-control scheme approved last year for certain drugs under Medicare as part...

Pharmaceutical giant Merck announced last week that it is taking the federal government to court over the Inflation Reduction Act's drug pricing reforms. The lawsuit alleges that the law's Medicare price negotiation program violates some of the most fundamental rights guaranteed by the U.S. Constitution. "This is not 'negotiation,'" the company says in its official complaint. "It is tantamount to extortion." Such strong language is justified. The IRA's price controls represent an unprecedented act of government intervention into the prescription drug market — one that...

Patients in several states could soon find it easier to access life-saving medical care, if state legislators and executive officials eliminate so-called certificate-of-need restrictions for new acute-care hospitals in rural areas. Certificate-of-need laws require health care providers to get a state government’s sign-off before building new facilities, expanding existing ones, or even purchasing new equipment. These laws are currently on the books in nearly three dozen states. It makes little sense to artificially restrict the supply of medical care when our nation...

America is facing a chronic doctor shortage. Solving that problem will require not just more doctors but a much bigger role for advanced-practice nurses in our healthcare system. A 2021 report found that the United States will need nearly as many as 48,000 more primary care doctors by 2034 to meet patient demand. It’s infeasible to train that many more new doctors over the next decade. We need to make better use of the supply of healthcare professionals we have. In nearly...

New research into COVID-19 has revealed some troubling findings. Even mild cases can lead to lasting heart complications. Comparing test data collected before and after a group of patients in their mid-30s contracted mild cases of COVID, researchers noticed an increase in arterial stiffness and cardiovascular inflammation. That means they may face "a widespread and long-lasting pathological process" that places them at elevated risk of cardiovascular issues. Heart disease is already America's leading cause of death, claiming roughly 700,000 lives per year. Add to that potentially increased risk...

The price of a COVID-19 shot will soon go up. The federal public health emergency ended this month, and the government will stop providing COVID vaccines to all Americans free of charge. Moderna and Pfizer have both signaled that they plan to raise the prices of their shots once the vaccines move to the commercial market. And that's prompted outrage from some of the drug companies' typical foes. Vermont Senator Bernie Sanders castigated Moderna CEO Stéphane Bancel at a recent hearing...

Today , Sen. Bernie Sanders, I-Vt., will haul executives from three insulin manufacturers and three pharmacy benefit managers before the Senate Health, Education, Labor and Pensions Committee for a hearing on "the need to make insulin affordable for all Americans." Sen. Sanders is sure to call the pharmaceutical executives — who represent Eli Lilly and Company, Novo Nordisk, and Sanofi — greedy, as he has repeatedly during his tenure atop the HELP Committee. This time, though, PBMs will get some heat, too. Good....

President Biden’s Inflation Reduction Act is just eight months old. It hasn’t yet slayed inflation. But it’s already gutting drug research and development. The law gives Medicare the power to impose price controls on certain prescription drugs for the first time. By September, federal officials will select the first 10 medicines subject to price-setting from those covered by the Medicare Part D prescription drug program. The price caps for these drugs will go into effect in January 2026. In the months leading...

The Biden administration is in the midst of setting the terms for its program of price controls on prescription drugs dispensed through Medicare. The first 10 medicines subject to the price caps will be selected by the end of this year. That prospect is already chilling investment in drug research, particularly in small-molecule drugs. This category of medicines, which are generally chemically synthesized, includes everything from aspirin to certain cancer drugs. The implications of this slowdown in research and development could be...