Simulated Medicare Drug Price Negotiation Under the Inflation Reduction Act of 2022

JAMA Health Forum, Journal Year: 2023, Volume and Issue: 4(1), P. e225218 - e225218

Published: Jan. 27, 2023

Importance The Inflation Reduction Act of 2022 gives Medicare the authority to negotiate prices for certain prescription drugs. Which drugs will be selected and how negotiated remain unclear. Objective To simulate drug selection minimum savings that would have been achieved at statutory ceiling if price negotiation had implemented from 2018 2020. Design, Setting, Participants In this cross-sectional study, a policy simulation analysis high-spending in Part B D were eligible January December 2020 was performed August 5 November 20, 2022. Exposures Eligibility criteria discounts afforded by negotiation. Main Outcomes Measures main outcomes characteristics subject estimated through spending compared with existing net accounting concessions. Results Among 40 drugs, 35 primarily reimbursed 10 biologics. most common therapeutic classes endocrine (11), neurologic or psychiatric (5), pulmonary (4), rheumatologic immunologic cardiovascular (4). Median time US Food Drug Administration approval 12 years (IQR, 10-14 years). Three faced generic competition 2 between For remaining 37 $55.3 billion; reduced an $26.5 billion, which represented 5% during those 3 years. Conclusions Relevance simulating provisions revealed important limitations, including strict potential become ineligible taking effect. Despite these still delivered substantial because offered steep discounts, part, erasing excess increases faster than inflation.

Language: Английский

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Medicare price negotiation and pharmaceutical innovation following the Inflation Reduction Act

Nature Biotechnology, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 31, 2024

Language: Английский

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Projected Savings for Generic Oncology Drugs Purchased via Mark Cuban Cost Plus Drug Company Versus in Medicare

Journal of Clinical Oncology, Journal Year: 2023, Volume and Issue: 41(29), P. 4664 - 4668

Published: June 8, 2023

Self-administered oncology drugs contribute disproportionately to Medicare Part D spending; prices often remain high even after generic entry. Outlets for low-cost such as Mark Cuban Cost Plus Drug Company (MCCPDC) offer opportunities decreased Medicare, D, and beneficiary spending. We estimate potential savings if plans obtained those offered under the MCCPDC seven drugs.Using 2020 Spending dashboard, Q3-2022 formulary prices, self-administered drugs, we estimated by replacing unit costs with plan.We of $661.8 million (M) US dollars (USD; 78.8%) studied. Total ranged from $228.1M USD (56.1%) $2,154.5M (92.4%) compared 25th 75th percentiles plan prices. The median were abiraterone $338.0M USD, anastrozole $1.2M imatinib 100 mg $15.6M 400 $212.0M letrozole $1.9M methotrexate $26.7M raloxifene $63.8M tamoxifen $2.6M USD. All 30-day prescription drug generated cost except three at percentile pricing: anastrozole, letrozole, tamoxifen.Replacing current pricing could yield significant drugs. Individual beneficiaries save nearly $25,200 per year or between $17,500 $20,500 imatinib. Notably, cash-pay catastrophic phase coverage still more expensive than baseline

Language: Английский

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Use and Costs of Supplemental Benefits in Medicare Advantage, 2017-2021

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(1), P. e2454699 - e2454699

Published: Jan. 14, 2025

Importance Nearly all Medicare Advantage (MA) plans offer dental, vision, and hearing benefits not covered by traditional (TM). However, little is known about MA enrollees’ use of those or how much they cost insurers enrollees. Objective To estimate use, out-of-pocket (OOP) spending, insurer payments for hearing, vision services among beneficiaries. Design, Setting, Participants This cross-sectional analysis used pooled 2017-2021 Medical Expenditure Panel Survey (MEPS) Current Beneficiary (MCBS) data TM beneficiaries (excluding also Medicaid). The was performed from September 10, 2023, to June 30, 2024. Exposures compared with coverage. Main Outcomes Measures main outcome receipt eye examinations, corrective lenses, aids, optometry dental visits, insurers’ spending such services. MEPS MCBS were weighted be nationally representative. Results We included 76 557 non–dually eligible beneficiaries, including 23 404 the 53 153 MCBS. Weighted demographic characteristics similar (54.7% 51.9% female; 39.8% 35.2% older than 75 years, respectively). Only 54.2% (95% CI, 52.4%-55.9%) 54.3% CI 52.2%-56.3%) aware having coverage, respectively. enrollees no more likely receive eyeglasses After adjustment differences, paid OOP $205.86 $192.44-$219.27) $226.12 $212.02-$240.23), respectively, (MA − difference, −$20.27 [95% −$33.77 −$6.77] −9.0% −14.9% −3.0%]); $226.82 $202.24-$251.40) $249.98 $226.22-$273.74) respectively −$23.16 −$43.15 −$3.17] −9.3% −17.3% −1.3%]); less visits durable medical equipment (a proxy aids). Nationwide, plans’ annual on services, totaled $3.9 billion $3.3-$4.4 billion), while spent $9.2 $8.2-$10.2 billion) annually these other private $2.8 $2.7-$3.0 billion). Conclusions Relevance In this study 2 representative surveys, did supplemental possibly because cost-sharing limited awareness benefit

Language: Английский

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Trends in National Pharmaceutical Expenditure in Korea during 2011 - 2020

Infection and Chemotherapy, Journal Year: 2023, Volume and Issue: 55(2), P. 237 - 237

Published: Jan. 1, 2023

This study aimed to identify the trends in pharmaceutical expenditure (PE), share of PE health (HE), and by pharmacological groups (ATC level 1 classification) Korea for a 10-year period (2011 - 2020) compare data with those other Organisation Economic Co-operation Development (OECD) countries. Using findings, we determined current status (PE) management derived implications establishing future macroscopic policies on PE.We analyzed OECD Health Statistics Korean national insurance claims database from January 2011 through December 2020. The outcome measures were HE, PE, sales ATC medicines during As collects limited data, used HIRA PEs level-1 classification, including D, L, P, S.PE increased 38.5% 19.9 billion USD 27.6 2020, whereas HE decreased 6.3%p 26.4% 20.1% In ranked third per capita (760.9 PPP) had highest (20.1%) among 19 countries studied. By class, was A (alimentary tract metabolism) at 4.3 USD, L (antineoplastic immunomodulating agents) increase 13.4%; contrast, J (anti-infectives systemic use) lowest annual average -0.2% 2020 relative 2011. Among 17 countries, third-highest expenditures codes J, respectively.PE has continued between indicating need PE. Our results code may help authorities

Language: Английский

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The Imperative to Enhance Cost-Effectiveness for Cardiovascular Therapeutic Development

JACC Basic to Translational Science, Journal Year: 2024, Volume and Issue: 9(8), P. 1029 - 1040

Published: Feb. 21, 2024

Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Therapeutic agents, such as those that lower low-density lipoprotein cholesterol, have been a critical factor in mitigating CVD event risk and demonstrate important role drug discovery plays reducing morbidity mortality. However, rapidly rising development costs, diminishing returns, an increasingly challenging regulatory environment all contributed to declining number cardiovascular (CV) therapeutic agents entering health care marketplace. For pharmaceutical companies, traditional outcomes trial (CVOT) can be major financial burden impediment CV agent development. They take long decade conduct, delaying potential investment return while carrying failure. patients, lengthy CVOTs delay accessibility. Without cost-effective CVOTs, innovation may compromised, with patients bearing consequences. This paper reviews approaches for making more cost-effective.

Language: Английский

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Pharmaceutical Spending in Fee-for-Service Medicare

JAMA, Journal Year: 2022, Volume and Issue: 328(15), P. 1502 - 1502

Published: Oct. 18, 2022

Our website uses cookies to enhance your experience. By continuing use our site, or clicking "Continue," you are agreeing Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications Network Open Cardiology Dermatology Health Forum Internal Medicine Neurology Oncology Ophthalmology Otolaryngology–Head & Neck Surgery Pediatrics Psychiatry Archives of (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions LibrariansReprints Permissions Terms Use Privacy Accessibility Statement 2023 American Association. All Rights Reserved Search Archive Input Term Sign In Individual inCreate an Account Access through institution Purchase Options: Buy this article Rent Subscribe the journal

Language: Английский

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JAMA Network Call for Papers on Health and the 2024 US Election

JAMA Health Forum, Journal Year: 2023, Volume and Issue: 4(8), P. e233014 - e233014

Published: Aug. 18, 2023

Nationally and globally, health will continue to be one of the most important policy issues for 2024 US election.Information about these is critical decision-making answer pressing public global questions affecting world. 1,2US elections are not only domestic; they affect world politics, economies, security, welfare, health. 3,4er last few years, a number new have captured political attention.For example, recent health-related misinformation, coupled with uncertainty during COVID-19 pandemic, has heightened need high-quality, objective evidence. 5In US, clinicians, policymakers, continued deliberate many long-standing issues, including costs care prescription drugs 6,7 ; disparities racial, ethnic, gender inequities [8][9][10][11] opioid epidemic 12 Medicaid Affordable Care Act 13 access abortion reproductive services 14 clinician workforce well-being. 15,16Controversies also arisen over previously established standards like vaccinations drug approvals. 17,18rldwide, attention been drawn humanitarian emergencies related ramifications, such as equitable responses pandemic effective networks systems needed detect respond infectious diseases, war in Ukraine, refugee crises, effects climate change, drought food insecurity horn Africa. 19e increasing interconnectedness science society requires that we consider research across range disciplines both outside medicine within worldwide.7][28] The economy, always priority voters, on mental well ability afford meet other essential needs education, housing, sanitation, food, water social drivers 29,30Moreover, stagnated investments health, care, worldwide portend failure Sustainable Development Goals. 31 Across this disciplines, populations, outcomes policies contribute or mitigate pervasive disparities.JAMA 10 participating JAMA Network journals, Health Forum, issuing Call Papers solicit rigorous empirical election-year populations medical specialties represented by journals.Of greatest interest studies influence debates, news stories, candidate platforms, discourse run-up election, topics overlooked campaigns. 2,32A goal provide actionable evidence candidates, international influencers identify ineffective solutions problems.Just ask candidates propose rather than merely criticizing status quo, hope receive reports test evaluate existing proposed strategies interventions simply describing problems solved.

Language: Английский

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Association between changes in prices and out‐of‐pocket costs for brand‐name clinician‐administered drugs

Health Services Research, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 21, 2024

Abstract Objective To determine whether annual changes in prices for clinician‐administered drugs are associated with patient out‐of‐pocket costs. Data Sources and Study Setting National commercial claims database, 2009 to 2018. Design In a serial, cross‐sectional study, we calculated the percent change manufacturer list net after rebates. We used two‐part generalized linear models assess relationship between price (1) percentage of individuals incurring any costs (2) median non‐zero Collection/Extraction Methods created cohorts privately insured who one 52 brand‐name drugs. Principal Findings List increased 4.4%/yr (interquartile range [IQR], 1.1% 6.0%) 3.3%/yr (IQR, 0.3% 5.5%). The patients from 38% 48% 2018, by 9.6%/yr 4.1% 15.4%). There was no association individual Conclusions From increased, but these were not directly related This may be due insurance benefit design private insurer drug reimbursement rates.

Language: Английский

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Treatment sequences and drug costs from diagnosis to death in multiple myeloma

European Journal Of Haematology, Journal Year: 2023, Volume and Issue: 112(3), P. 360 - 366

Published: Oct. 11, 2023

Abstract Novel therapies for multiple myeloma (MM) have improved patient survival, but their high costs strain healthcare budgets. End‐of‐life phases of treatment are generally the most expensive, however, these may be less justifiable in context a pronounced clinical benefit. To manage drug expenses effectively, detailed information on end‐of‐life administration and crucial. In this retrospective study, we analysed sequences from 96 MM patients Netherlands who died between January 2017 July 2019. Patients received up to 16 lines therapy (median overall survival: 56.5 months), with average lifetime €209 871 (€3111/month; range: €3942–€776 185) anti‐MM drugs. About 85% last 3 months before death, incurring €20 761 (range: €70–€50 122; 10% total). Half 14 days, mainly fully oral regimens (66%). substantial despite limited survival benefits. The use expensive options is expected increase further. These data serve as reference point future cost studies, further research needed identify factors predicting efficacy benefit continuing therapy.

Language: Английский

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