Fertility Patient Wrestles With Unclear Prices, Surprise Bills
Read about the biggest pharmaceutical developments and pricing stories from the past week in KHN's Prescription Drug Watch roundup.
Business Insider:
Fertility-Benefits Conundrum: High Medication Prices, Cigna
Andrea decided last year that she wanted to freeze her eggs. At 36, she wished to relieve some of the pressure of having kids before she was ready. Andrea, who works at a major tech company, knew the process would be lengthy and expensive, but she figured the $20,000 fertility benefit provided by her company would cover most of the cost, leaving her on the hook for, at most, $4,000. (Lydia Ramsey Pflanzer, 7/30)
Health Affairs:
Compared With Other Countries, Women In The US Are More Likely Than Men To Forgo Medicines Because Of Cost
Cost-related nonadherence to prescription medicines is a common problem with important implications for population health. Relative to men, women may be more vulnerable to cost-related nonadherence because of higher health needs and lower financial resources. Using data from the Commonwealth Fund International Health Policy Survey, we compared cost-related nonadherence among younger (ages 18–64) and older (ages 65 and older) women and men in eleven high-income countries. (Daw and Law, 8/1)
Salon:
Pharma CEOs Privately Scoff At Trump’s Drug Pricing Orders: “Not Expecting Any Impact”
Pharmaceutical executives have publicly spoken out against President Trump's executive orders aimed at reducing drug prices, but several CEOs in the industry have told shareholders that they are "not expecting any impact" from the president's largely symbolic moves. (Derysh, 8/5)
Modern Healthcare:
Here's A Peek At The White House's Unreleased Drug-Pricing Order
Partial text of an executive order the White House has refused to make public indicates the White House is using a more aggressive version of a payment demonstration for outpatient drugs to try to pressure drugmakers to the negotiating table. President Donald Trump signed four drug-pricing executive orders on Friday, but the White House has refused to release the text of the most controversial order that aims to reduce the amount Medicare pays for some high-cost outpatient drugs. Trump said during the White House event that the order would go into effect a month after signing. (Cohrs, 7/29)
FiercePharma:
Trump And Big Pharma Tussle Over Drug Price Proposal With 3 Months Until Election
It’s been a busy week in the world of drug pricing, but not because of any major changes to the industry’s pricing power or legislation. Instead, drugmakers and President Donald Trump exchanged barbs over a group of executive orders and the president's aim to lower prices. The latest back-and-forth started at the end of July, when Trump rolled out executive orders to create discounts for insulin and epinephrine, eliminate rebates, allow drug imports from Canada and other countries and create an index linking U.S. prices to those elsewhere. The industry hit back quickly, but experts said the measures wouldn’t likely bring real change—at least not right away. (Sagonowsky, 8/3)
Health Affairs:
Medicare Part D Plans Rarely Cover Brand-Name Drugs When Generics Are Available
Recent press reports and other evidence suggest that Medicare Part D plans may be encouraging the use of brand-name drugs instead of generics. However, the scope of such practices is unclear. We examined Medicare Part D formulary coverage and tier placement of matched pairs of brand-name drugs and generics to quantify how often preferred formulary placement of brand-name drugs is occurring within and across Part D plans and to assess the cost implications for Medicare and its beneficiaries. We found that in 2019, 84 percent of 4,176,772 Part D plan-product combinations had generic-only coverage (that is, the brand-name counterparts were not covered). (Dusetzina et al, 8/1)
Columbus Dispatch:
Ohio Medicaid Officials Misled Public On Drug Spending Study
As Ohio struggled to escape the grip of pharmacy benefit managers that were reaping close to a quarter-billion dollars a year from the state’s Medicaid program, an assessment by a Columbus consultant of newly implemented reforms was eagerly awaited last summer.But several times in the months after the study was due, the Ohio Department of Medicaid’s top spokesman denied it had been submitted. He also said repeatedly that there were no earlier versions of the study to view. (Rowland, 8/2)
