The TNF-α blocker is the world’s top-selling drug, by revenue. It faces biosimilar competition in Europe, but it will be four years before it’s challenged in the U.S.
The price of biologics can ruin cancer patients financially, this leading oncology expert reminds us. Biosimilars may help, but we need more of them on the market.
The FDA commissioner has an 11-step ‘action plan’ to get biosimilars out of a repeat mode of unrealized potential. But issues like interchangeability still need clarifying if biosimilars are to have a major effect on drug expenditures.
They are ‘living’ molecules, and there is variability among lots, even in the reference products. The key issue is whether the variability has any clinical significance. So far, it hasn’t.
Biosimilars are saving money but not in the U.S., where companies have used a variety of stalling tactics. Now Pfizer and others are accusing Johnson & Johnson of withholding rebates to fend off biosimilar competition to Remicade.
Drug manufacturers have relied on coupons to promote access to branded drugs by reducing patients’ out-of-pocket costs. Insurers and PBMs, on the other hand, have opposed coupons because they undermine the effectiveness of cost-sharing requirements and benefit designs that incentivize cost-effective drug prescribing and purchasing choices.
Is MA a ripoff of taxpayers, a godsend for integrated, cost-effective care, or somehow both? You can’t take a stand on this question from 30,000 feet. So let us guide you through the valley of details.
The pendulum has swung back and forth on hormone replacement therapy. Bespoke and supposed more ‘natural’ hormone combinations put together by compounding pharmacists have become popular. Mainstream endocrinologists see compounding as risky, partly because the practitioners who prescribe it may not see the dangers.
In another international comparison, the health status of American women lags behind that of women in other developed countries.
Recent mergers didn’t quiet the growing frustration and concern employers, pharmacists, consumer advocates, state legislators, and some members of Congress have with the PBMs’ lack of transparency. There are still so many questions, and getting answers anytime soon will be a chore.
The Service Employees International Union Local 32BJ three years ago named Mount Sinai Health System as a preferred provider for participants and started a direct contract for those needing hip and knee replacement surgeries. In health care there are not many examples where each party succeeds. This is one of them.
While researchers see flaws in the MA program, the federal government seems content to pay insurers billions of dollars in bonuses each year—at least for now.
Unlike most payer–provider relationships, the parties took a go-slow approach. The plan was offered only to employees who worked in a subset of Walmart and Sam’s Club outlets and lived or worked near Emory providers, and Walmart did not set premium levels to incentivize workers to choose the Emory ACO.
It is a heroic part of the American health system. Lives are saved, the dire consequences avoided. But the air ambulance industry is consolidating, prices are soaring, and insurers and providers continually fight over network issues. One consequence: Surprise billing that leaves patients owing tens of thousands of dollars.
