Another Legal Challenge to the ACA
July 26th 2022The plaintiffs in Kelley v. Becerra are arguing that the Affordable Care Act’s requirement that preventive services be covered without cost sharing is unconstitutional. In a factsheet published yesterday, the Urban Institute says that the ACA requirement has had an especially a large effect on women, partly because contraception is among the services covered by the no-cost-sharing rules that apply to private insurers.
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Pandemic Mortality Rate Much Lower in Canada Than in the US. Why?
July 13th 2022Some researchers have pointed to the benefits of a single-payer system such as the one in Canada. But the author of the PNAS commentary, David Fisman, say it may be trace back to the more communitarian outlook of Canadians
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The BA.5 Variant Is Now Dominant: What News Outlets, Social Media Are Saying
July 11th 2022White House COVID-19 coordinator Ashish Jha tweeted last week that “we know how to manage this moment.” News coverage and social media posting about the BA.5 variant crested as the variant became the dominant strain circulating in the U.S.
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Specialty Pharmacy Has Won Lawsuit Against CVS Caremark
July 6th 2022The case concerns the controversial direct and indirect remuneration (DIR) fees that pharmacy benefit managers (PBMs) collect from pharmacies. Meanwhile, a separate whistleblower lawsuit has been filed against CVS Caremark, its parent company and SilverScripts, its Part D plan, accusing them of blocking customers from getting cheaper generic drugs.
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Researchers to Medicare: Mark Cuban Prices Could Have Saved You $3.6 Billion
June 24th 2022Harvard researchers calculated that buying 77 generic drugs at prices being charged by Mark Cuban’s online pharmacy prices would have lowered Medicare spending on those drugs from $9.6 billion to $6 billion.
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Paxlovid Rebound: Rare But Real
June 14th 2022Mayo Clinic researchers reported today in the journal Clinical Infectious Diseases that less than 1% of patients at high risk for experiencing severe COVID-19 who were treated with Paxlovid (nirmatrelvir and ritonavir) experienced a second bout of COVID-19.
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FTC Launches Inquiry Into PBM Industry
June 7th 2022The Federal Trade Commission says its inquiry “will shed light on” clawbacks, potentially unfair audits, rebates and other business practices of the pharmacy benefits management (PBM) industry. Today’s announcement says the commission will be requiring information from the six largest PBMs.
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The Long COVID's Long Shadow: CDC Researchers Document Health Conditions After Acute Phase Is Over
May 30th 2022One in 4 COVID-19 patients in the 18-64 age group experienced at least one of the 26 conditions that may be associated with COVID-19, according to CDC researchers. However, the study did not differentiate the risk by vaccination status or SARS-CoV-2 strain, both of which may affect the risk of post-acute conditions and symptoms.
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Some Perils of Medicare Advantage Growing, Traditional Medicare Shrinking
May 24th 2022Traditional Medicare has been an important proving ground for U.S. healthcare for decades, and Medicare reimbursement has been used to support rural healthcare and medical education. In an opinion piece published by JAMA, Gretchen Jacobson and David Blumenthal of The Commonwealth Fund discuss some of the pitfalls of shrinking enrollment in traditional Medicare as the proportion of beneficiaries in Medicare Advantage plans grows.
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KFF Drug Cost Panelists Discuss Rebates, Compulsory Licensing and COVID-19 Vaccine Development
May 23rd 2022Kirsten Axelsen, Richard Frank and Rachel Sachs agreed that the rapid development of the COVID-19 vaccines was a government-business success story. There was less to celebrate as the Kaiser Family Foundation panelists also unpacked the legal issues and economic consequences of drug rebates, international reference pricing, high deductible health coverage and compulsory licensing.
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Patterns in New Formulation Approvals Suggest “Evergreening” by Drugmakers, Researchers Report
May 23rd 2022Findings in JAMA Health Forum show that new formulations were more likely for blockbuster drugs and drugs that received accelerated approval. Proxy measures of clinical usefulness and other elements of therapeutic value were not associated with new formulations.
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Vaccination Could Have Prevented Half of U.S. COVID-19 Deaths, Research Model Suggests
May 13th 2022It is a statistical model not actual data. But calculations by Brown University School of Public Health and Microsoft researchers show that 318,000 of the 641,305 deaths from COVID-19 between Jan. 1, 2021, and April 30, 2022, might have been prevented if vaccination coverage among U.S. adults had reached 100%.
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Removing Subset of T Cells Reduces Chronic Graft-Versus-Host Disease
May 10th 2022Findings from phase 2 trials reported in Journal of Clinical Oncology seed hopes that winnowing out certain types of T cells from peripheral blood stem-cell transplants will make chronic graft-versus-host disease less common. Randomized trials are underway to test the proposition.
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At the 2022 Asembia Specialty Pharmacy Summit, healthcare policy experts at Avalere shared insights into the politics of a less ambitious Build Back Better bill and the healthcare provisions it might include. If a "skinny bill" doesn't get passed, the healthcare action of the Biden administration might shift to CMS Innovation Center and payment models, including a successor to the Oncology Care Model, they said.
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Biden Administration’s Healthcare Priorities and the Build Back Better Act, per Ryan Urgo of Avalere
May 6th 2022Ryan Urgo, Managing Director, Health Policy at Avalere addressed the Biden administration’s healthcare priorities and if the Build Back Better legislation will include provisions that deal with drug prices? Urgo spoke at this year's annual Asembia Specialty Pharmacy Summit in Las Vegas on the subject, as well.
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For New Drugs, Manufacturers are Becoming Payers: 2022 Asembia Specialty Pharmacy Summit
May 3rd 2022IQVIA’s Lucas Greenwalt says manufacturers need to provide patient assistance if they want their new brands to meet sales goals as payers devise strategies to cope with cost and the increasing number of ultra-expensive medications skyrockets.
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