Late last year, we highlighted a study published in in the New England Journal of Medicine that found many nonprofit hospitals were not complying with the charity care requirements laid out in the Affordable Care Act (ACA). Now, a new report released by the Alliance for Integrity and Reform of 340B (AIR340B)—of which PhRMA is a member—expands on this research and compares charity care compliance rates at 340B and non-340B hospitals. The report from the Berkeley Research Group (BRG) found 340B and non-340B hospitals had similar charity care compliance rates, even though in 2015 alone 340B hospitals received almost $4 billion in additional financial benefits through access to discounted medicines.
Clinical trials are the most effective way to find new, innovative treatments for illnesses patients may face. But misconceptions and lack of awareness about this important research often keep people from participating. In fact, two thirds of trials fail to enroll enough participants.
Next week, we celebrate Clinical Trials Awareness Week (May 2-6) to help people better understand clinical trials and feel empowered to get involved in the process.
Topics: Clinical Trials
In recent weeks, providers and stakeholders across the health care system have raised concerns that the Part B Drug Payment Model proposed by the Centers for Medicare & Medicaid Services (CMS) lacks needed safeguards to protect patients from access barriers and reduced quality of care. A new issue brief released by Discern Health last week builds on these concerns, finding CMS has not yet presented a monitoring and evaluation plan for the Part B Drug Payment Model to mitigate the risk of harm to Medicare beneficiary access and quality of care.
Today is World Intellectual Property Day, a celebration across the globe of the protections that allow creativity, risk-taking and innovation to thrive. America has long been the world’s innovation center – whether that is in manufacturing, technology or biopharmaceuticals. And it has been shown time and time again that strong protection of intellectual property (IP) is good for patients as it leads to the creation of innovative medicines and lifesaving cures.
The government is proposing dramatic changes to Medicare Part B, including possible cuts to physician reimbursement for many innovative treatments based on the government’s decisions about which treatments are most valuable for seniors. Unfortunately, these decisions would be based on average results across broad populations, ignoring individual patient needs.
These so-called market-based proposals are nothing more than a litany of new government regulations and mandates that would undermine the competitive market and empower government bureaucrats and insurance companies to make one-size-fits-all treatment decisions for patients.
Over the last two and a half decades the world’s life expectancy has grown from 65 to 71 years. This life-changing advance is due in no small part to the creation of new drugs, therapies and treatments that have mitigated and even cured a variety of diseases and conditions that once may have been chronic or even fatal. The development of new generations of treatments is, in part, a result of nations around the globe understanding the importance of supporting intellectual property policies that encourage innovation and risk-taking.
Despite warnings from the Centers for Medicare & Medicaid Services (CMS) that requiring high cost sharing for all or most medications to treat a condition may be discriminatory, new data from Avalere show some health plans are continuing to engage in this practice. While the share of plans with this type of formulary design has generally decreased, we are still seeing some plans placing all medicines for some conditions on the specialty tier or on a tier with high coinsurance. Surprisingly, this is sometimes occurring even in drug classes where there are generics available. Placing all medicines on the highest cost-sharing tier—a practice known as adverse tiering—can lead to thousands of dollars in additional out-of-pocket costs even for patients taking generic medicines.
Two recent studies add to a growing body of research on how consolidation is driving up treatment costs. More and more cancer treatments are being administered at hospital outpatient facilities rather than physician offices, and this has real implications for costs.
For Matt, today is a great day to be alive. And if you ask him why today is possible for him and why tomorrow is possible, too, he will tell you: Innovative medicines saved his life. When he was diagnosed with advanced non-small lung cancer, he was given a slim chance of living five more years. But let him tell you what it’s like to be alive and thriving nearly seven years later – and why.