The Drug Pricing Maze (Axios)
November 11
TL;DR
- The drug pricing system contains a plethora of trade secrets and “hush-hush” deals
- Generic drug sales are split between manufacturers, pharmacies, wholesalers, and insurance drug benefit plans
- Non-generic drug prices are hiked to unbelievably, and seemingly artificially high levels. Insurance plans “negotiate” these drugs down for consumers to a more “reasonable” level. However, some of the “discount” is pocketed by the insurance company.
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- The entire drug pricing system is shrouded in mystery; there is little transparency in pricing for the consumer.
- Pharmacy Benefit Managers in particular find themselves in the rare spotlight.
- Unprecedented levels of lobbying spending are stemming from the pharmaceutical industry, exemplifying the pressure, whether real or fake, that the industry thinks it is facing.
- The white house is not fond of drug prices either
- Several non-profit health systems have banded together to combat drug prices (one of the largest expenses in hospitals), forming Civica Rx, another signal that prices, or the schemes behind the prices, may be getting out of hand
- Seems like the drug industry from top to bottom has some issues with transparency, and we’re not sure that’s going to change any time soon…
Walgreens, Humana Partnership Could Escalate To Investment Stakes (Forbes)
November 20
TL;DR
- Walgreens and Humana allegedly have plans to invest in each other, following the CVS-Aetna deal that is expected to close this year.
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- This news follows along with the vertical integration strategy in healthcare.
- Cigna/Express Scripts, CVS/Aetna, UnitedHealth, and earlier this year, Wal-Mart/Humana were all announced or rumored at some point.
- Vertical integration is a savvy strategy to control costs and maintain market share and leverage in the healthcare space. Economically speaking, firms that are vertically integrated more easily pass on costs one direction (consumers) or the other
- Watch for continued progression with mega-mergers, as big tech (hello, Amazon) tries to disrupt healthcare
- Related: How Senior Care Clinics are Bringing Humana and Walgreens Closer
10 health IT happenings we’re thankful for in 2018
November 21
TL;DR
- Healthcare IT News gives thanks to important progression in the IT space
- Big trends include the centralization of electronic health records, advancement of care through better, faster technology, more productive clinicians, more convenient avenues to care, and the emergence of big data
- Interesting to note is the call for an overhaul to HIPAA, as many of the policies are outdated and holding healthcare back
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- It all sounds very promising, but may be a bit of a pipe-dream article. Healthcare seemingly moves pretty slowly. Perhaps these changes will take effect more quickly as the industry continues to consolidate.
- I’m personally waiting for Apple to continue its health integration – with the most prevalent communication device in history and a growing population of Apple Watch users, physicians will be able to access patients’ health records through Apple’s devices – all while focused on privacy.
- This plan is already unfolding, as Apple seeks to integrate the Department of Veterans Affairs’ health records into its health app
Medicaid buy-ins offer states a new way to expand health coverage (Axios)
November 19
TL;DR
- Several states are attempting to draft legislation to allow people to “buy” in to Medicaid, even if they aren’t eligible for the program
- There are several issues that swirl around the Medicaid buy-in, including the fact that the program already reimburses providers at extremely low levels, and deciding what price point to set for this Medicaid “premium”
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- Although there are several kinks to iron out, this initiative seems like a promising solution to expand basic coverage to low-income individuals without breaking the public bank. A tricky issue appears to be exactly where to draw the line on who exactly should be eligible to pay into Medicaid under this new idea.