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March 8, 2022 Issues, Price and Costs

Late last month, the Federal Trade Commission announced it would seek public comments on the ways pharmacy benefit managers distort the prices of prescription drugs. PBMs deserve the scrutiny, as they're to blame for much of the rise in prescription drug costs. Insurers hire PBMs to negotiate drug prices with manufacturers and determine which medicines end up on a plan's formulary. To guarantee their drug has a spot on the list, pharmaceutical firms routinely offer these gatekeepers deep discounts on medications. Savings on...

March 7, 2022 Issues, Value

In his last blog post before resigning as director of the National Institutes of Health in December 2021, Francis Collins touted many of the important areas of research NIH conducted or funded in his more than 12 years leading the organization, “from innovative immunotherapies for treating cancer to the gift of mRNA vaccines to combat a pandemic.” He could have added to this list other frontiers of medicine explored by NIH-supported researchers: how the human brain works; the health benefits of the trillions of microbes that call our bodies...

March 4, 2022 Coronavirus, Issues

‘Test to Treat’ ignores the significant risk of drug interactions with the Pfizer pill. President Biden touted a new anti-Covid initiative in his State of the Union address Tuesday. “We’re also ready with antiviral treatments. If you get Covid-19, the Pfizer pill reduces your chances of ending up in the hospital by 90%,” he said. “And we’re launching the ‘Test to Treat’ initiative so people can get tested at a pharmacy, and if they’re positive, receive antiviral pills on the spot at no...

March 2, 2022 Innovation, Issues

“That morning I squeezed every orange and it felt like a wet sponge – I knew I lost the whole crop,” said Natalia Derevianko, a small farmer in the tiny Florida town of Archer, somewhere in the void between Orlando and Tallahassee.   Florida’s peninsular climate offers farmers an opportunity to grow high-value fruit crops in the winter months when much of the rest of the country is blanketed in snow. On Jan. 30, this season’s valuable crop of citrus, peaches, and avocados was...

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...