The cumulative costs of care for people with Alzheimer’s disease will exceed $20 trillion (today’s dollars) from 2010 to 2050, assuming the absence of disease-modifying treatments (therapies that affect the disease, rather than just the symptoms). These daunting data are presented in the Alzheimer’s Association’s “Changing the Trajectory of Alzheimer’s Disease: A National Imperative.” The report also shows that the number of Americans age 65 and older who have this condition will increase from the 5.1 million today to 13.5 million by the middle of the century.... “Workers appreciate the value of the health care coverage their employers offer to them and their families,” says the National Business Group on Health’s president, Helen Darling. But more than a third would consider dropping that coverage if cheaper but similar coverage were to become available through other avenues, according to a survey conducted jointly by the NBGH and Hewitt Associates, involving more than 3,000 American workers. The survey found that 61 percent of Americans use employer-sponsored health care coverage and participate in healthy living and wellness programs. Nearly half plan or hope to continue to do so in the next three to five years.... Osteoporosis screening increased to 64 percent for women age 65 and over, according to the latest numbers in the “2009 National Healthcare Disparities Report” from the Agency for Healthcare Research and Quality (AHRQ). Back in 2001, it was only 34 percent. Two-thirds of the estimated 34 million Americans at risk of developing osteoporosis are women. The latest numbers from the agency indicated that Hispanic women had the most dramatic increase in screening, going from 22 percent to 55 percent, with African-American women also experiencing a significant increase in osteoporosis screening from 16 percent to 38 percent. The report also suggests that income is a factor in screening for osteoporosis, with only 46 percent of poor women having a screening test, compared to 80 percent of high income women in 2006.
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.
The results can be tragic. Patients with addictions are unlikely to wait the hours or days it takes health insurers to approve the medications they need. Insurers are changing their practices, but not without some outside pressure.