Morning Briefing
Summaries of health policy coverage from major news organizations
Medicare Could Save Billions Through Mark Cuban's Generics Pharmacy
Stat: Medicare Could Have Saved Billions On Drugs If It Paid What Mark Cuban Charges At His New Pharmacy
Amid growing anger over the cost of medicines, a new analysis finds that Medicare could have saved billions of dollars if the federal agency had purchased generic drugs directly from the online pharmacy recently launched by billionaire investor Mark Cuban. Specifically, Medicare could have saved up to $3.6 billion in 2020 — or 37% of the $9.6 billion spent on 77 of 89 different prescription medicines. This assumed the health care program had purchased the maximum quantity for each prescription, or a 90-day supply. The Mark Cuban Cost Plus Drug Company did not offer any savings on the other 12 generic medicines. (Silverman, 6/20)
The Wall Street Journal: Buying From Mark Cuban’s Pharmacy Could Save Medicare Billions, Study Says
Mr. Cuban, the billionaire internet entrepreneur and owner of the NBA’s Dallas Mavericks, launched his pharmacy in January with an eye toward disrupting the $365 billion U.S. prescription-drug market by sidestepping health-insurers and selling commonly used generic medicines directly to consumers with a transparent, fixed-rate markup pricing model. A group of Harvard Medical School researchers say that Mr. Cuban’s “cost plus” business model could also benefit health insurers, including Medicare, which spent an estimated $115.6 billion on prescription drugs last year, or nearly a third of total U.S. drug spending. (Walker, 6/20)
NBC News: Medicare Could Save Billions On Generic Drugs Buying At Mark Cuban's Prices
Cost Plus Drug offers certain generic drugs, such as the depression drug fluoxetine or blood pressure medication lisinopril, at discounted prices, by selling medications at a fixed markup of 15% plus a $3 flat fee, according to the company’s website. Cost Plus doesn't offer brand-name drugs or accept insurance, so patients pay for medications out of pocket. The study "does show that Medicare is overpaying for some of the generic drugs," said Dr. Hussain Saleem Lalani, a researcher at Brigham and Women’s Hospital in Boston and the study’s lead author. "And this is a conservative estimate, so the actual savings are likely higher.” (Lovelace Jr., 6/20)
In other news about Medicare —
Modern Healthcare: Hospitals Call Medicare Pay Proposal 'Woefully Inadequate'
The' proposed Medicare payment update for inpatient services is nowhere close to covering hospitals' rising costs, industry groups warn the Centers for Medicare and Medicaid Services in comment letters. Hospitals are calling on CMS to make further upward adjustments to the fiscal 2023 inpatient prospective payment system rule to compensate for underpredictions from this fiscal year's rule and to eliminate a separate negative adjustment for the coming year. (Goldman, 6/20)
And in news about California's Medicaid program —
KHN: Medi-Cal Will Cover Doulas At More Than Twice California’s Initial Proposed Rate
California will cover doula services for low-income residents at more than twice the state’s initial proposed rate under a spending plan lawmakers passed last week. Some advocates welcomed the new benefit in Medi-Cal, the state’s Medicaid health insurance program, as a step toward professionalizing this group of nonmedical birth workers. They say better pay may encourage more people to become doulas. Other advocates, however, called it a partial victory, saying that the rate is still too low for the amount of time and work it takes to ensure healthy deliveries. (Bluth, 6/21)
