Stop the presses! The Centers for Disease Control and Prevention want you to know that being obese or overweight is definitely not good for you. Why point out the obvious? Because it turns out that a recent CDC study that indicated that overweight people might live longer than normal weight people may have been based on skewed data. Hence, the counterintuitive results. Critics pointed out that the normal-weight group contained people with heart disease and cancer who weigh less because of those diseases. CDC Director Julie Gerberding held a news conference in which she apologized for any possible confusion and added that obesity is indeed a "serious epidemic" in this country.... Who's pointing fingers? The AMA called on state attorneys general to require health insurers to provide patients with updated and accurate physician listings. Managed care companies must provide patients with a realistic choice of network physicians that offer services in a broad array of locations and specialties."Physicians are concerned that managed care companies are misleading patients with erroneous or artificially inflated lists of participating physicians," said AMA President-elect William Plested, MD, during the annual meeting.... Tough times at General Motors. The auto manufacturer lost $1.3 billion on North American operations in the first quarter of 2005. The company plans to cut 25,000 jobs by 2008, and close some factories. CEO Rick Wagoner pins much of the blame on escalating health care costs. GM wants its unionized workers to pay a bigger share of health care costs. The United Auto Workers responds by saying that any unilateral action by GM to reduce benefits would be a "huge mistake." Stay tuned.... Profits are surging at the nation's HMOs, according to Weiss Ratings. HMOs earned $8.9 billion during the first three quarters of 2004. That's an increase of $2.3 billion, or 33.6 percent, over the $6.7 billion earned in the same period in 2003.
House Republicans come out with their ACA alternative. A continuous coverage surcharge replaces the individual mandate. But where’s the CBO score?
The biosimilar segment of the pharmaceutical industry is on fire. Some 700 biosimilars are at some stage of development, and more than 660 companies are involved in some way in the biosimilars land rush. Still, only a handful may get on the market in the next few years.
No one knows how much of an effect biosimilars will have on oncology expenditures. Pricing and market share are in a large, opaque “to be determined” cloud. But there’s certainly potential for a major impact that could lower oncology expenditures by millions, if not billions.
The future of biosimilars in this country is nothing if not uncertain. Most immediately, the U.S. Supreme Court is hearing a case that will determine the timing of the 180-day waiting period before a biosimilar can go on the market. But there are larger and longer-term issues at play as well.
While coupons help individual consumers, they are also having a major impact on the insurance industry and anyone responsible for paying health care bills. Insurers and pharmacy benefit managers complain that they foil formularies and other pricing strategies designed to steer consumers to less-expensive drugs.
The hard truth is that telehealth’s future—its size, its contours—will depend a lot on what payers will be willing to pay for. Currently, commercial plans cover only a limited number of services. In addition, research suggests that there may be quality and utilization problems.
Insurers should consider covering new drug-delivery devices that can improve outcomes while lowering disease-specific pharmacy and long-term overall health care costs. Managing these devices in the pharmacy benefit will consolidate volume-based purchasing and capitalize on PBM strategies for improving adherence.
Basaglar is coming on the scene during tumultuous times for insulin products. Manufacturers are under attack for price hikes. There are allegations of backroom rebate deals. And a class-action lawsuit has been brought on behalf of uninsured patients, charging insulin makers with setting artificially high prices.
Evaluating the quality of telemedicine care is about as easy as evaluating the quality of health care, period, and researchers are still ironing out the methodological kinks. That may be one reason research results are all over the place. This article involved reviewing nine such studies, and the findings are a mixed bag.
If millions of Americans lose Medicaid or private health insurance coverage because of the unACAing of American health care, telehealth may seem like a gimmicky sideshow rather than a good-faith effort to bring health care into the digital century.