News & Information
'Big Pharma' Is Now in Insurance Industry Crosshairs
Written by Editor   
Wednesday, July 02, 2014 07:30 AM

The health insurance industry has seen the enemy and it's not big government -- it's big pharma and its ally big hospitals.

This may come as somewhat of a surprise to those who remember predictions of a collapse of the insurance market issued by America's Health Insurance Plans (AHIP, the insurance industry trade group) in the many months leading up to the rollout of the Affordable Care Act.  

For the last few weeks, AHIP has been filling my mailbox (and, I am guessing, the mailbox of every other journalist on its media contact list) with press releases, surveys, and forwarded articles assailing the two-barreled threat of big pharma and big hospitals to the American way of life.

Here's one example:

 

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Trend in Health Spending is Global
Written by Editor   
Wednesday, July 02, 2014 07:25 AM

Other industrialized countries have been experiencing the same variations in health spending growth over the past 30 years as the U.S., a new analysis found, suggesting that the factors driving these ups and downs are not unique to the U.S.

In every period since 1980 during which growth in U.S. healthcare spending dramatically outpaced the rest of the economy, the same thing was happening in most other countries belonging to the Organization for Economic Cooperation and Development (OECD), which represents the world's major industrial powers.

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What Is the Public-Private Bridge?
Written by Editor   
Tuesday, July 01, 2014 10:41 AM

Bridging the gap between the U.S. public health system and private healthcare is a key mandate of the Affordable Care Act (ACA) that has gone largely unrecognized.  Few so far have described the potential effects of the this mandate on prevention and public health. The public and private health sectors have operated with very little interaction for almost a century.  The ACA's Prevention and Public Health Fund, or Prevention Fund, aims to change that by calling for alignment, coordination, and integration between the two entities.

"Due to the Affordable Care Act, Medicare is now providing coverage for evidence-based preventive services with no copayments."  "We are testing new payment and service delivery models focused on prevention and population health."

Such collaborative care could be a "game-changer that improves the health of the U.S. population." Better integration may prove to be the most radical change through the Prevention Fund as it will allow public health systems to bill insurers for some services, such as immunization.Coordination between the two systems will mean that private clinical providers will be able to refer patients to community programs.  

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Med Student Exposure to Marketers Affects Prescribing
Written by Editor   
Thursday, June 26, 2014 12:00 AM

Physician trainees who spend more time with pharmaceutical marketing representatives are less likely to make evidence-based prescribing choices.  

The authors say their data add to literature showing that pharmaceutical marketing is linked to prescribing choices that are more likely to favor brand names over generics or nondrug treatment options that have the same or comparable effectiveness.  The study found that a 10-point higher industry relations index was associated with 15% lower odds of prescribing based on evidence. There was also a significant link between the industry relations index and greater odds of choosing to prescribe brand-name drugs.

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Drug Discounts Have Pharma Crying Foul
Written by Editor   
Wednesday, June 25, 2014 02:40 PM

In 1992, the federal government told drug manufacturers they had to give steep discounts to hospitals that treat a large percentage of poor patients.  The law got bipartisan support, and it was a boon for hospitals and the federal government. In the decades that followed, the drug discount program has grown in leaps and bounds. But this spring as the feds have been drawing up new rules for the program, a pitched battle has broken out between hospitals and drug manufacturers.

But here's the rub. Sometimes, instead of passing on drug discounts to patients, hospitals sell the medicines at higher prices to their insured patients. The hospitals use the proceeds to fund clinics, staff, and other services that the hospitals say benefit everyone. The law allows them to do that, the hospitals say, because it's a way to stretch "scarce federal resources" -- a phrase that is in the law.

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