CMS May Be Overpaying For Certain Molecular Tests
Read about the biggest pharmaceutical developments and pricing stories from the past week in KHN's Prescription Drug Watch roundup.
Modern Healthcare:
Medicare Lab Payment Analysis Raises Questions About Pricing Transparency
A Medicare administrative contractor has sent a cease-and-desist letter to a well-known diagnostic reimbursement expert containing lab test pricing and coding information that reveals instances where CMS may be overpaying for certain molecular tests. Palmetto GBA sent the letter to Bruce Quinn, asking him to delete information from a public blog and his own files. Palmetto's lawyer asserts that the information was included in a document, known as a master edit file (MEF), that is the contractor's intellectual property. (Ray, 10/13)
Also —
The New York Times:
Covid-19 Vaccines Offer Drug Makers Chance At Salvation, Financial And Beyond
For a long time, drug makers have been the most hated industry in America. Companies are blamed for gouging prices on lifesaving drugs and enriching themselves through the opioid crisis, among other sins. Now, with pharmaceutical companies racing to find vaccines to end the coronavirus pandemic, the industry is hoping to redeem itself in the public’s mind. (Drucker, Gelles and Thomas, 10/13)
Houston Chronicle:
Prescription Drug Costs Take Center Stage In Texas Races For Congress
The cost of prescription drugs has taken center stage in congressional races all over Texas. In battles from Austin to San Antonio to Houston, candidates are insisting they are committed to tackling the high price of prescription drugs while they claim their opponents can’t be trusted on the issue. (Wallace, 10/12)
Barron's:
Pfizer Suit Could Be An ‘Earthquake’ For Drug Pricing
Last year, Pfizer posted a billboard outside its midtown Manhattan headquarters showing a larger-than-life patient smiling at his partner. “Dedicated to the brave of heart,” it read. The patient, Walter Feigenson, 72, of Portland, Ore., says he was paid roughly $1,000 for taking part in the launch of tafamidis—sold by Pfizer (ticker: PFE) under the names Vyndaqel and Vyndamax—a $225,000-a-year treatment for a potentially fatal heart condition. The price, which makes tafamidis the most expensive cardiovascular drug ever launched in the U.S., is “unconscionable” and “completely unjustified,” Feigenson said in an interview with Barron’s. (Lalse, 10/12)
The Salt Lake Tribune:
Older Utah Voters Are Worried About Health Care And Prescription Drug Costs, Survey Shows
The rising costs of prescription drugs and health care could be a potent campaign issue for older voters in Utah ahead of the November elections. And according to a new survey, Utahns age 45 and above expressed support for a number of progressive policies to boost pay and reduce the influence of money in politics. The survey from AARP Utah found 75% of Utahns either “strongly” or “somewhat” support raising the state’s minimum wage to $12/hour over a three-year period. Just 23% were opposed. (Schott, 10/10)
