Remdesivir powers activate! Wouldn’t it be great if remdesivir magically cured COVID-19? Too bad it doesn’t. So what should we be willing to pay for a drug that shortens hospital stays and might reduce mortality? In this episode of HealthBiz, physician and healthcare executive Surya Singh shares his take on drug pricing, ICER and the future of the pandemic.
Adherence to medication regimens is a huge challenge, with patients failing to get the benefit of their drugs and payers not getting the results they’re paying for. Adherence is also a major opportunity; for example over half of Medicare Star ratings are based on adherence.
In this podcast interview, AdhereHealth CEO Jason Rose offers his perspective:
(0:12) What are the biggest challenges in the pharmacy field? (Here’s the article Jason references in his reply)
(1:52) What does adherence really mean? Is it a big deal?
(6:15) Who has a financial incentive to do something about it?
(8:38) You claim over half of Medicare Star ratings are based on adherence. Is it really true?
(12:18) Is adherence a patient-centric term? It sounds more top down.
(13:58) How do social determinants of health tie in to adherence?
(18:15) What role does AdhereHealth play?
(22:27) Is your Pharmacy at Home program just a mail order pharmacy?
(24:56) Why did your company change its name?
(26:38) Can we expecting sweeping changes in adherence, with the introduction of new tools like AI and wearables?
Pharmacy Benefit Managers (PBMs) claim to keep drug costs under control, but their convoluted business models and tactics don’t always result in the best deal for employers. Reference based drug pricing is an interesting alternative approach. It’s used for drug cost control in other parts of the world and within the US for things like elective surgery.
“Rebates are like crack cocaine…”
In this podcast interview, drug pricing expert David Henka sheds light on the drug pricing world and describes the reference based approach employed by ActiveRADAR, where he is CEO.
Here’s what we discussed:
(0:17) How can we understand the recent dust-up between President Trump and Pfizer’s CEO? What provoked it?
(1:00) Why does Pfizer want to see the “blueprint” unveiled —isn’t that supposed to squeeze the drug companies?
(2:47) Say more about your “balanced billing” analogy.
(4:21) So is Europe like Medicaid, developing countries the uninsured, and the US a commercial payer?
(4:59) Isn’t freeloading just good negotiating?
(7:23) What about someone like Martin Skrelli, who said just push prices to their logical conclusion: instead of 10% why not 100 or 1000%?
(8:52) You mentioned the typical consumer is fairly protected due to fixed deductibles or co-pays. What is the role of PBMs in drug pricing?
(11:07) Would eliminating rebates really drive down costs?
(13:37) What other techniques are PBMs using?
(15:45) ActiveRADAR is involved in reference pricing. What is it? What implications does it have for PBMs? Are their days numbered?
(21:54) Historically generics have helped keep prices under control. How is that working out now? How should we think about “generics” or “similars” for biotech products?
Massachusetts eHealth Collaborative CEO Micky Tripathi has been leading the charge on electronic health records and interoperability for more than 15 years, pre-dating HITECH, meaningful use and the Affordable Care Act. In this podcast, we caught up on the state of play, including :
(0:13) How e-health looks today compared with what was envisioned originally
(3:01) How interoperability has evolved
(11:23) What’s wrong with TEFCA and why he calls it a “regulatory” wet blanket
Wright on Health has posted the Repeal Fatigue Editionof the Health Wonk Review. You’ll find there a roundup of fine posts there, and thankfully they aren’t all about the implosion of repeal and replace. Topics include: vulnerable populations, opioids, workers comp and more.