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This Week in Health Care Reform - August 26th, 2016

A life-saving allergy medicine finds itself at the roiling center of the ongoing drug pricing issue; while, a new report from CMS highlights the threat to taxpayers from escalating drug costs; and, HHS issues a report on the state of telehealth.

Week in Review

EpiPen Spike: A critical life-saving medicine has become the latest drug to spark outrage amongst a frustrated public after steep increases to its wholesale price came to light.  That drug, EpiPen, an emergency injection device for people with severe allergies, has seen its price go up by 500% since 2009.  In fact, when the decades-old product was first acquired by current pharmaceutical manufacturer Mylan back in 2007, pharmacies paid less than $100 for a two-pen set.  However, after years of steady increases, this May that price spiked again to $609.  Further compounding the issue for allergy sufferers and their families is the recommendation that patients carry two EpiPens on them at all times, prompting many to keep multiple sets in their homes, cars, and at school – and, that’s not even factoring in that the devices need to be replaced, often annually, depending on their expiration date.  Given the enormous burden this has placed on consumers, lawmakers have demanded an investigation into what’s driving these price hikes.  In response to the firestorm it generated, Mylan announced yesterday that it would be offering discounts on EpiPen going forward.  But, not before it was reported that the company had likely raised the price of its medicine in anticipation of a generic competitor’s product making its way to market.
Part D Spending:
Late last week, the Centers for Medicare & Medicaid Services (CMS) released a report on prescription drug spending in its Medicare Part D drug benefit program.  Experts quickly seized upon the analysis, focusing on the drugs with the highest spending.  Their concern, that the costliest medicines have undergone repeated price hikes over the years without either improvements or justification.  And, with prescription drug prices rising faster than inflation year-to-year, taxpayers are the ones footing the bill, whether or not they even take these medications.  A separate analysis doesn’t offer much hope either, in terms of price relief.  Compiled by pharmacy benefits manager Express Scripts, their report shows that prices for brand-name prescription drugs soared by 16 percent last year alone.  And, more alarmingly, between 2008 and 2015, the prices for these medicines rose 164 percent, putting many of these drugs out of reach.  And, finally, a new study published in the Journal of the American Medical Association (JAMA) shines a light on the high cost of prescription drugs in the United States.  Their findings point to the prices of brand-name drugs as being the primary reason per capita prescription drug spending in this country far exceeds that in all other countries.  Their conclusions about what might be done to mitigate the escalating trend may also sound familiar: More stringent requirements regarding exclusivity rights; enhanced competition through generic drug availability; and more evidence-based, cost effectiveness comparisons between alternative therapies. 
Telehealth Report:
Stakeholders continue to leverage technology in their ongoing efforts to improve the patient experience.  Regardless of their respective constituencies, organizations are looking to innovate.  For instance, federal agencies are investing more resources in providing telehealth to veterans.  Meanwhile, retailer Walmart has partnered with health insurer Anthem to install new health risk assessment kiosks in their pharmacies in Indiana as a way of identifying Medicaid members that might suffer from a chronic disease in order to enroll them in a wellness program that could potentially help them manage their condition.  As these advances continue to make their way to market, the transition to a more integrated, technology-enhanced health care system has become less a question of if, than when.  In an effort to better understand what the federal government is currently doing in the telehealth space, last year, Congress directed the Department of Health & Human Services (HHS) to perform an assessment report on federal efforts.  Their report, released earlier this month, highlights, amongst other things, programmatic grants supporting various telehealth initiatives; recommendations for designing models to boost adoption of telehealth services; and, some of the challenges still impeding broader telehealth implementation.      

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