Drug Makers, Insurers Could Feel Added Marketplace Merger Pressures
The Wall Street Journal notes that changes in the insurance market could lead to new pressures as doctors likely face stingier reimbursements, with cancer treatments a possible target. Meanwhile, Bloomberg reports that insurers, which have been hesitant to cover costly hepatitis C drugs, will also feel a push from a report that finds these therapies cost effective.
The Wall Street Journal's Pharmalot:
Health Insurer Mergers Will Pressure Pharma Over High-Cost Drugs
As the nation’s biggest health insurers jockey for supremacy, drug makers should brace for added pressure because doctors are likely to face stingier reimbursement over the next few years. And cancer treatments, in particular, are expected to be targeted, according to a report from Moody’s Investor Service. (Silverman, 7/13)
Bloomberg:
Gilead Pills Priced At $1,000 A Day Are Found Cost-Effective
Health insurers that have been reluctant to cover hepatitis C drugs with list prices of $1,000 a daily dose will face more pressure after a report concluding the medications are “cost-effective” given their benefits. The report, still in draft form, is by an influential panel of doctors and medical experts that helps insurers set policies. While insurance companies already cover the sickest patients for treatments by Gilead Sciences Inc. and AbbVie Inc., they’ve resisted extending coverage to people who aren’t yet showing damage from the disease. Even with negotiated discounts, the pills can cost hundreds of dollars a day and are taken for eight to 12 weeks. (Bloomfield, 7/13)
Meanwhile, on the biotech front -
CQ Healthbeat:
CMS Pay Proposal On Copycat Biotech Drugs Draws Criticism
Novartis AG, the first company to win United States approval to sell a copycat biotechnology drug, and Amgen Inc., a competitor in the emerging field, are questioning how Medicare officials plan to pay for these products. The Centers for Medicare and Medicaid Services last week said it plans to put products that are approved to deliver the same therapeutic protein in the body into a common group calculation. The approach, known as blended J codes, would make it more difficult to track cases where one manufacturer's version of a biotech medicine may have variations that cause complications, Kimberly Greco, director of research and development policy at Amgen, told reporters Monday after a Capitol Hill briefing. Having distinguishable codes in setting payments would make it easier to track the cause of potential adverse events for patients, she said. (Young, 7/13)
