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HEALTH ACTION NETWORK - ADVOCATES FOR BETTER HEALTH CARE SOLUTIONS

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This Week in Health Care Reform - July 29th, 2016

Telehealth looks to make inroads in behavioral health; challenges remain for the exchanges; and, drugmakers deploy new tactics to protect their patents.

Week in Review

Tele-Behavioral Health: Having seen firsthand how readily patients have embraced technology when interacting with their health care, some providers have begun to redesign the point-of-care transaction as a way of leading to an improved patient experience.  And, as our health care system writ large continues to warm to telehealth’s promise, new areas of treatment are also discovering the benefits of its widespread application – one such area being behavioral health.  A recent study examined a new rehabilitation program in San Francisco for drug and alcohol abusers that uses an online portal through which participants can access health education and prevention information and that facilitates communication between patients and care facility staff.  Called LINKAGE, organizers found that those receiving treatment through the program showed greater involvement in managing their health and health care.  In a separate study of military personnel suffering from posttraumatic stress disorder (PTSD) and depression, researchers found that central assistance for a collaborative telecare model (with stepped psychosocial management and pharmacologic treatment), led to modestly improved outcomes for randomized participants.  However, even as stakeholders prepare to introduce new technologies to health care’s next frontier, experts caution that a 21st century framework must first be established in order for behavioral health to fully realize telehealth’s benefits.
                                          
Exchange Challenges:
The insurance exchange marketplaces have faced some considerable challenges since first coming online in 2013.  From technical glitches to political rancor, the exchanges have had to weather their fair share of struggles.  Unfortunately, the latest threat to their long-term sustainability is less practical and more existential – namely, that the nearly $5 billion in early federal grants set aside to help the exchanges get off the ground has nearly run out.  With the 13 states running their own exchanges each being responsible for establishing their own budgets, there’s growing concern that they’ll be unable to raise the requisite money to maintain operations.  In fact, despite a provision requiring self-sufficiency for each state-run exchange by 2015, every one of them depended on some level of federal funding for their activities in 2016 (the cut-off date has since been extended into 2017).  While states’ experiences have helped them map something of a way forward, each still must contend with its own priorities, which are informed by the needs of its population, the number of uninsured remaining, and the resources available. 
                                            
Patent Delay:
A new tactic adopted by drug manufacturers in seeking to protect their products from competition is being called a “lost opportunity” by industry observers in the system-wide effort to reduce health care costs.  At issue, the best-selling drugs Humira and Enbrel, which use biotechnology to treat autoimmune diseases, such as rheumatoid arthritis and psoriasis, have both been shielded behind patents that would make it difficult for their generic equivalents – known as biosimilars – from ever making their way to market.  Biologics are drugs that are derived from living organisms and differ from other drugs, which are essentially chemicals synthesized from other chemicals.  Prior to 2010, biologics were protected from generic competition.  However, passage of the Affordable Care Act granted the FDA the authority to approve biosimilars.  Unfortunately, given the enormous complexity involved in creating these molecules, the FDA has had difficulty establishing the infrastructure and ground rules necessary to oversee these approvals.  In the meantime, makers of these biologics have started developing biosimilars of their own, while simultaneously erecting extensive patent estates.

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