Seven out of 10 consumers would prefer a drug that had been on the market for 10 years or more, compared to a newer drug, even if the copayments were equal. Further, 31 percent believe newer drugs are less safe than older drugs, according to the Medco Monitor, a nationwide household survey. The report surveyed 1,092 insured adults.

Formulary decision makers take heart: This could be a sign that consumers are more inclined to start using generic medications.

Ann Smith, a spokeswoman for Medco Health Solutions, says, "Just the idea that these older medications have been on the market for some time — they're tried and proven in the consumer's mind. They see the safety profile and effectiveness. And then you factor in the [usually] lower cost of an older drug. Consumers see that older may be better, or at least safer. If there's a cost savings, they are comfortable choosing an older drug."

Other findings from the survey include:

  • Only 11 percent of adults over age 59 felt that newer drugs were safer than older drugs.
  • One third of respondents felt that newer drugs were more effective than drugs that have been on the market for 10 years or more.
  • Women reported greater knowledge about generic drugs (63 percent) than men (54 percent), and were 20 percent more likely than men to have chosen a generic drug to save money in the past year.
  • Women were more likely than men to question the safety of newer drugs, and were more likely than men to believe that newer drugs were less effective than older drugs.
Would you prefer to take a prescription drug that is new to the market
or one that has been on the market for 10 or more years?
Not sure 16%
New to market 16%
On the market for more than 10 years 68%

Source: The Medco Monitor

Managed Care’s Top Ten Articles of 2016

There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.