The Catalyst

ICYMI: New cholesterol-lowering medicines will not be “budget busters”

Posted by Holly Campbell on October 8, 2015 at 4:03 PM

In case you missed it, Express Scripts, the nation’s largest pharmacy benefit manager, announced that it will include two new cholesterol-lowering medicines, called PCSK9 inhibitors, on its national list of covered medicines thanks in part to substantial – and typical – discounts negotiated.  According to the company, “we were able over the course of tough negotiations to get good economics on both products.”

That’s because our nation’s competitive marketplace works to control costs while encouraging the development of new therapies.

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Topics: drug cost, Cholesterol, Hepatitis C, high cholesterol, cost

340B Spotlight: Rapid growth of contract pharmacies

Posted by Rebecca Davison on October 8, 2015 at 2:00 PM

Last week we covered the basics around contract pharmacies in the 340B program. Today we’re taking a closer look at contract pharmacies as a relatively new source of growth in the program.

Contract pharmacies allow hospitals and other 340B entities to capture 340B discounts for prescriptions filled at for-profit, retail pharmacies. While these contract pharmacy arrangements were originally allowed only for entities without an in-house pharmacy, beginning in 2010 HRSA allowed an unlimited number of contract pharmacies for all 340B entities. This policy change was made without any requirement that patients benefit from the 340B discounts at the pharmacy. In fact, recent evidence from government investigators suggests that often hospitals and retail pharmacies split the profits from the 340B discounts, without patients seeing any benefits.

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Topics: 340B, 340B Spotlight

Special Edition Medicare Monday: More context on MedPAC’s analysis of drug costs

Posted by Rick Smith on October 8, 2015 at 10:00 AM

Richard I. Smith is principal, RIS Consulting and a past executive vice president for policy and research of PhRMA.

A few weeks ago, we looked at the Medicare Payment Advisory Commission’s (MedPAC) discussion about drug spending in Medicare and provided some important additional context

Today and tomorrow in our two-part post, we’ll add further context to the information from MedPAC.  We’ll be talking about three topics: 

  • How has the share of Medicare spending on drugs changed between 2007 and 2013?
  • Why is the share of spending on drugs different in Medicare than in the overall National Health Expenditures?
  • What is actually included in Medicare spending on drugs?
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Topics: Part D, Medicare, Medicare Monday

ICYMI: Higher out-of-pocket costs in health insurance exchange plans compared to employer plans for patients managing chronic conditions

Posted by Rachel Licata on October 7, 2015 at 4:00 PM

A recent study published in Health Affairs took a look at estimated out-of-pocket expenses for individuals living with chronic conditions if they switched from average employer-sponsored plans to a silver health insurance exchange plan. The study focused on prescription drug spending and looked at the potential impact of higher cost sharing on medicines and spending on other health care services.

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Topics: Access, ACA, exchanges, ABCs of Coverage

Highlighting innovation during Mental Illness Awareness Week 2015

Posted by Hannah Mooney on October 6, 2015 at 3:00 PM

Each year, during the first full week of October, organizations across the country work to raise awareness for mental health disorders to educate the public, fight stigma and provide support. Mental health awareness is an important topic to address year-round, but Mental Illness Awareness Week is an opportunity to highlight the important work being done to improve the lives of Americans affected by mental health disorders.

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Topics: Medicines in Development, Access, Innovation, Mental Health

4 facts on why importing drugs is bad for patients

Posted by Holly Campbell on October 6, 2015 at 2:07 PM

Ensuring patients have access to needed medicines is critical, but importing medicines, whether from Canada or elsewhere in the world, is the wrong answer .

Due to the U.S. Food and Drug Administration’s (FDA) comprehensive drug approval process, medicines on the U.S. market are widely regarded as the safest in the world. The U.S.’s relatively closed distribution system plays a critical role in helping to keep the global proliferation of counterfeit medicines from infiltrating the U.S. prescription medicine system.

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Topics: drug cost, imported Drugs, drug supply, cost

Medicare Monday: Who Benefits from Part D Extra Help?

Posted by Allyson Funk on October 5, 2015 at 9:00 AM

We’ve talked before about Medicare Part D’s Extra Help program – also known as Low-Income Subsidies (LIS)—a program designed to help Medicare beneficiaries with limited incomes afford needed medicines.

Learn more about Part D Extra Help in our new video

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Topics: Part D, Medicare, Medicare Monday

Week in Review: The Latest from PhRMA

Posted by Tina Stow on October 2, 2015 at 10:14 AM

340B Spotlight:  The latest 340B Spotlight explores contract pharmacy arrangements. Learn more about the history of contract pharmacy arrangements and why a policy change in 2010 led to a dramatic increase in the volume of contract pharmacies.

ICYMI: Dr. Murray Stewart, Chief Medical Officer of GSK, explains why clinical data transparency is the right thing to do and how it can benefit patients. Check it out here

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Topics: heart health, Week in Review, Clinical Trials, 340B, Rx Response, Medicare, Conversations

340B Spotlight: What are contract pharmacy arrangements?

Posted by Allyson Funk on October 1, 2015 at 11:31 AM

We’ve been covering 340B a lot in recent weeks, including areas of needed reform: how discounts work, levels of charity care among 340B hospitals and the relatively high rate of 340B hospitals acquiring physician practices.

Another aspect of 340B that deserves a closer look is contract pharmacy arrangements. But what are contract pharmacies and how do they work?

Contract pharmacy arrangements enable covered entities to contract with multiple independent retail pharmacies to dispense drugs receiving 340B discounts. The original purpose of these arrangements was to help small clinics who did not have their own in-house pharmacy. But a policy change in 2010 allowed all 340B entities – including large non-profit hospitals – to have an unlimited number of contract pharmacies. This change dramatically increased the number of contract pharmacies, but did nothing to ensure that patients either receive or benefit from the 340B discount.

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Topics: 340B, 340B Spotlight, community pharmacies

Clinical trial data transparency is the right thing to do

Posted by Guest Contributor on September 30, 2015 at 12:00 PM

By Dr. Murray Stewart, Chief Medical Officer, GSK

At times, there can be a huge gulf between principle and practice. For example, eating healthy foods and getting lots of exercise are clearly beneficial, but they require commitment and hard work and are not sustained by many people.

Expanding access to clinical trial information is another principle that attracts widespread support, but in practice, it takes a lot of commitment and hard work by many across the health care network. Despite the challenges, there have been significant strides made by the biopharmaceutical industry in putting this principle into practice.

Researchers can now access detailed trial data from many companies to support their own research and, hopefully, benefit medical science and patients. GSK and 11 other companies provide access to data through a common online website ( Other companies have created their own systems consistent with the PhRMA-EFPIA Principles for Responsible Clinical Trial Data Sharing.

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Topics: Clinical Trials, transparency, data sharing

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