New National Health Expenditure (NHE) projections released today by the Centers for Medicare & Medicaid Services (CMS) call into question claims that have been made in recent months about the sustainability of prescription drug spending. Even with new treatments and cures for hepatitis c, high cholesterol and cancer, spending on retail prescription medicines is projected to remain approximately 10 percent of U.S. health care spending through 2024 – the same percentage as in 1960.
As health care payers seek to transition to new, value-based payment models, clinical pathways are one strategy payers and providers are using in their efforts to contain costs and promote evidence-based care. New research released this week by Avalere Health examines current practices related to these programs and stakeholder reactions to their growing use.
Last week, we introduced two hypothetical patients, Sheryl and Bill, who are working to get their cholesterol levels under control. Today we highlight George and Betty. George is able to control his cholesterol with better adherence to his statin therapy. In contrast, Betty struggles to control her cholesterol level since she was forced to discontinue her statin therapy due to side effects (i.e., muscle pain and aches). These stories illustrate the different tools patients and physicians can use to bring down cholesterol levels and reduce the risk of dangerous cardiovascular events. They also show the unmet medical need that remains and how important new treatment options could be for some patients.
As Congress considers patent legislation known as H.R. 9, the Innovation Act, and S. 1137, the PATENT Act, health care leaders – from patient groups to Members of Congress to trade associations – continue reminding lawmakers about the critical importance of ensuring a fair and reliable patent system.
In their recent op-ed published in The Hill, John Castellani, president and chief executive officer, PhRMA, and James Greenwood, president and chief executive officer, Biotechnology Industry Organization (BIO), outline a clear path forward for reform: recognize the unique role of patents in the biopharmaceutical industry by exempting certain biopharmaceutical patents from the inter partes review (IPR) process at the U.S. Patent and Trademark Office (PTO). As Castellani and Greenwood write, “patents are the lifeblood of any new medicine. And our industry’s reliance on them is unique; while your cellphone might be protected by hundreds of patents, the new medicine you or your loved ones take is usually only protected by just a handful.”
This Thursday, Medicare celebrates its 50th anniversary! One critical part of Medicare for older Americans and people living with disabilities is the Part D prescription drug benefit that began in 2006. In celebration of Medicare’s birthday, we’re taking a look at medicines in development for older Americans.
More than 9 in 10 older Americans have at least one chronic condition and more than 7 in 10 have at least two. The biopharmaceutical industry is committed to developing medicines that help patients live longer, healthier lives and that includes treatments to manage chronic conditions and some of the most debilitating diseases facing Americans as they age.
The biopharmaceutical industry remains committed to enhancing public health through responsible data sharing that recognizes the importance of protecting patient privacy, respects the integrity of national regulatory systems, and maintains incentives for continued investment in biopharmaceutical research.
Commentary published today in Mayo Clinic Proceedings highlights a critical challenge facing cancer patients: the ability to access the medicines they need. But rather than address this issue directly, the authors outlined a series of proposals that focus solely on the 1 percent of health care spending that goes toward life-saving cancer medicines. And the article ignores the fact that cancer medicines represent only one-fifth of total spending on cancer treatment. The policy proposals they recommend would, if adopted, send a chilling signal to the marketplace that risk-taking will no longer be rewarded, stopping innovation in its tracks and halting decades of progress in cancer care.
After a heart attack at only 39 and subsequent diagnosis of high cholesterol, Doreen was in shock. “That was the beginning of a great challenge for me,” says Doreen.
She knew she had to stay alive for her children and grandchildren, so she immediately adopted a healthy lifestyle. She tweaked her diet, began an exercise routine and started a statin therapy, the most commonly prescribed class of cholesterol-lowering medicines. But her cholesterol levels didn’t change.
Frustrated, Doreen continued this treatment regimen until she developed heart muscle spasms and her doctor advised that she stop taking the cholesterol-lowering medication. Doreen learned that she is part of a small patient population intolerant to statins because of side effects or adverse events.
Even though Sheryl and Bill both have high cholesterol they have two very different stories. Sheryl is able to control her cholesterol level through statin therapy combined with lifestyle changes like a better diet and increased exercise. On the other hand, Bill struggles to control his cholesterol with statins and other cholesterol-lowering medicines. Sheryl’s story reflects the opportunity presented by existing treatment options to achieve better control of high cholesterol; while Bill’s story reflects the significant unmet medical need that remains.
The difference between these stories highlights why every patient is different and only some will benefit from a new class of cholesterol-lowering medicines, PCSK9 inhibitors. These new medicines will not replace existing treatment options that work for millions of Americans and will address a significant unmet medical need in a small subset of people.
Despite claims that tens of millions of Americans could be eligible for treatment with a new class of cholesterol-lowering medications, called PCSK9 inhibitors, the fact is these new medicines will not replace existing treatment options and will address a significant unmet medical need in a small subset of people. PCSK9 inhibitors will help those who cannot be treated with existing cholesterol-lowering medicines and are just one of many opportunities for those with uncontrolled cholesterol.