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HEALTH ACTION NETWORK - ADVOCATES FOR BETTER HEALTH CARE SOLUTIONS

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This Week in Health Care Reform: May 17th, 2019

A rule is finalized requiring drugmakers to list their prices in ads; meanwhile, nearly a quarter of new drugs approved last year come with hefty price tags; patients cite convenience in their embrace of telehealth – which is to say nothing about the cost savings; and, unmet social needs are shown to have a deleterious effect on whole-person health.

Week in Review

Drug Ad Rule Finalized: Last week, the Centers for Medicare & Medicaid Services (CMS) finalized a proposed rule requiring pharmaceutical manufacturers to post the list prices of their products in direct-to-consumer ads, including television commercials.  That policy, aimed at increasing transparency in drug pricing, was vehemently opposed by drugmakers.  Specifically, the rule, which takes effect in 60-days, applies to drugs with price tags greater than $35 for a month’s supply.  Despite skepticism that the rule would do anything to lower the price of prescription drugs, and concern that sticker shock could actually result in patients going off their medications, there was general consensus amongst stakeholders that this injection of transparency into the murky world of drug pricing would better empower patients in making health care decisions.

Pricey New Drugs: Separately, a new analysis shows just how important rules like the one CMS finalized last week are in the ongoing efforts to combat rising drug prices.  Compiled by GoodRx, that analysis shows that, of the nearly 100 prescription drugs approved in 2018, 23 had list prices over $30,000 per year for a course of treatment.  In fact, prices for those drugs range from over $35,000 to as high as approximately $574,000.  And, of the top 10 drugs on that list, none has a list price under $177,000.

Telehealth Benefits: While there’s a lot recommending the widespread integration of telehealth services into our evolving health care delivery model, our understanding of patients’ expectations and satisfaction with these tools is only slowly beginning to come into focus.  A new study suggests that patients who have engaged in real-time video visits with providers, rather than in-person exams, are generally satisfied with both the quality and the convenience of their digital checkups.  Among the reasons cited by participants in the study for utilizing video visits was the added convenience, in addition to just not being sure they needed to see a doctor in person.  After the exams, the vast majority of patients not only felt that the checkup met their needs, but were confident in the quality of the care they’d received, as well.  These findings are only amplified by new research reinforcing the cost-saving potential of telehealth.  Essentially, that data points to cost savings being generated mainly by diverting patients away from more costly care settings.  Specifically, patients utilizing telehealth services instead of seeking care from emergency departments can save more than $1,500 per visit.  And, a new government report expands the reach of those savings into the increasingly popular Medicare Advantage (MA) program.  That analysis, provided by the Government Accountability Office, estimates that MA plans could save enrollees more than $500 million by promoting greater use of telehealth services
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Social Needs and Health:
Our understanding of how social determinants of health (SDoH) impact whole-person health is also evolving.  This has led to greater insights into the nature of that intersection, in particular, how SDoH affects patient care quality, including health care utilization and patient-reported health status.  A new survey examines that interplay, observing trends in patient experiences.  Overall, more than half of respondents reported having at least one unmet social need – from food insecurity to safe housing.  Researchers went on to establish that experiencing one or more of these SDoH factors had a considerable impact on patient reports of their own health status.      

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We encourage you to stay involved as implementation efforts surrounding health care reform progress.  Visit the Health Action Network and be sure to let us know what's on your mind.


 

Spotlight

A new infographic from the Campaign for Sustainable Rx Pricing breaks down how drugmakers spend each dollar they collect, including just 22 cents on research and development, less than half of the 46 cents that goes to corporate overhead and profits.
                                            
                                            

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