Men carry a higher average account balance ($1,525) in their health savings accounts and health reimbursement accounts compared to women ($1,321), says the Employee Benefit Research Institute’s “Health Savings Accounts and Health Reimbursement Arrangements: Assets, Account Balances, and Rollovers, 2006–2010.” EBRI attributes this to the fact that men use less health care than women, allowing them to maintain higher account balances.… More than 25 percent of women diagnosed with early ovarian cancer do not receive lymph node biopsies — disheartening because lymph node biopsies can lead to improved survival, say researchers at the University of California–Davis Cancer Center and the California Cancer Registry. They found that 72 percent of patients with early-stage disease had diseased lymph nodes in the pelvis and abdomen. Five-year survival for women who had a node biopsy was 84 percent, compared with only 69 percent of those who did not have the tests. Findings were published in the journal Gynecology Oncology.… The percentage of adults 45 years and older who use a statin to control their cholesterol increased from 2 percent in 1988–1994 to 25 percent in 2005–2008 according to “Health, United States, 2010,” a report prepared by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Half of men ages 65–74 had taken a statin drug in 2005–2008, compared with over one third of women in the same age group.
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.