The Rundown | Week of 3.11.2019

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Study: Prescription Drug Costs Up 25 Percent

Evidence from Pew suggests spending on retail prescription drugs has risen by more than 25 percent between 2012 and 2016. Pharmacy benefits received a larger portion of insurance premiums. Pharmacy revenue rose 150 percent, from $30.8 to $76.9 billion, during the same period while net spending for retail prescription drug coverage rose from $250.7 to $314 billion. Manufacturer rebates also doubled and partially offset the increases in list prices, which rose at a greater rate than overall retail prescription drug spending. Pharmacy benefits managers (PBMs) passed 78 percent of these manufacturer rebates to health plans in 2012 and 91 percent in 2016. “Policies with capped out-of-pocket expenses and cost-sharing assistance from manufacturers helped shelter patients from rising drug costs throughout the study period,” researchers noted. On April 3, leading PBMs will testify before the Senate Finance Committee about drug pricing to give “patients and taxpayers an explanation of their role.”
>> Read More: The Prescription Drug Landscape, Explored

No Link Between Diet and Dementia

A recent study published in JAMA concluded there is not a direct link between diet and dementia risk. Researchers tracked the self-reported diets of more than 8,200 middle-aged adults for 25 years and found that participants who consumed more fruits and vegetables did not have a lower risk for dementia. While many studies have correlated heart-healthy diets with reduced cognitive decline, the duration of this new study was particularly long. Among the 344 participants who were diagnosed with Alzheimer’s disease over the course of the study, the diagnostic rates were similar for the healthiest third and unhealthiest third. Peers have questioned the study’s criteria and definitions for “healthy” foods. However, diets that benefit cardiovascular health can lower the risk of other cognitive or psychological conditions, such as depression. A recent study from the National University of Singapore found consuming more than two portions of mushrooms weekly may halve the odds of developing mild cognitive impairment.
>> Read More: Association of Midlife Diet With Subsequent Risk for Dementia

Sharpless to Replace Gottlieb at FDA

Ned Sharpless, MD, will serve as acting commissioner of the Food and Drug Administration (FDA) following the resignation of Scott Gottlieb, MD. Sharpless is the head of the National Cancer Institute as well as a cancer researcher and physician. He has supported Gottlieb’s challenge to and investigation of Big Tobacco as well as e-cigarette and vaping products and their marketing to minors. Commissioner Gottlieb announced his resignation last week. In his role, he was championed by his peers for advancing generic drugs, confronting the opioid crisis, and other public health initiatives. However, critics such as Michael Carome, MD, director of Public Citizen’s Health Research Group, claimed Gottlieb’s “tenure as commissioner was marked by regulatory decision making regarding medications and medical devices that tilted further in favor of industry’s financial interests rather than the interests of public health.”
>> Read More: Ned Sharpless To Be Named Acting FDA Commissioner

Trump Slashes Medicare, Medicaid in Unlikely Budget Proposal

President Trump has proposed significant budget cuts to Medicare and Medicaid funding. Trump claims the changes, which include increased auditing of Medicare Advantage payments and altering hospital reimbursement rates, could save $845 billion over the coming decade. The annual White House budget also proposes moving more than $1 trillion in federal Medicaid spending to state-operated block grants. Furthermore, Trump called for a work requirement for low-income adults to receive Medicaid coverage. The budget is unlikely to progress in a Democrat-controlled House. The plan may also draw disapproval from elderly citizens, who comprise a large segment of his base, given the reductions to Medicare.
>> Read More: White House Proposes Deep Cuts to HHS and Medicaid in New Budget

Value- and Risk-Based Contracts Moving Forward Slower Than Expected

Adoption of value-based care continues to lag behind expectations, according to healthcare executives. A report by Numerof & Associates polled more than 500 executives about wide-reaching and diverse population health programs. While most respondents projected their systems would partake in risk-based programs within the next two years, only 61 percent of respondents noted their organizations are average or worse than other organizations’ management of cost variation. Smaller systems were less likely to have risk-based contracts, likely because of precarious finances, which is a common barrier to entry. Overall, the majority of respondents generated less than 10 percent of their revenue from risk-based contracts.
>> Read More: Numerof State of Population Health Survey

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