Author's posts
Cigna And Express Scripts Deal: Virtues Of Vertical Integration
Vertical integration, as entailed by the Cigna-Express Scripts merger, may help contain cost growth and improve health outcomes. Such mergers may signal a move away from siloed budgets in healthcare, as PBMs would no longer be incentivized to focus sol…
Why Payers Sometimes Restrict Access To Single Tablet Regimens For HIV Patients
Payer restrictions on HIV patient access to single tablet regimens may be based on cost but not cost-effectiveness considerations. Reforms to the healthcare system should include policies conducive towards incentivizing payers to incorporate a longer-t…
To Include Or Not Include Drug Prices In DTC Ads
The debate on inclusion of drug price information in DTC ads points to a much larger problem surrounding transparency. A free, competitive prescription drug market is not simply a market without price controls. It is also a market with relevant compara…
Will CVS Caremark Make ICER The American NICE?
CVS Caremark intends to institute a $100,000 per QALY threshold for drugs, above which it would deny patient access. However, without an empirically determined threshold, pricing and formulary decisions contingent on an arbitrarily defined threshold ca…
Medicare Advantage Plan Proposed Use Of Step Therapy For Part B Drugs
Policymakers should proceed with caution in allowing Medicare Advantage plans to use step therapy for physician-administered Part B drugs: First, due to variability in patient response to drugs in the same therapeutic class; second, the lack of evidenc…
The Curious Case Of Gleevec Pricing
As a branded drug, Gleevec’s price increases were the target of criticism by oncologists, payers, and patients. Yet, its price was more reflective of value than many other cancer drugs. What is problematic is the fact that generic imatinib’s list price…
Belviq Study Results May Improve The Fortunes Of Weight-Loss Drugs
Findings from a recently released post-marketing study on Belviq may remove some of the doubts concerning adverse events. And, effectiveness data lend support to the notion that Belviq in combination with behavioral therapies may be worth the money.
Tanezumab’s Phase 3 Results: A Promising Sign For Non-Opioid Pain Treatments
As the opioid crisis has unfolded concerns have grown about dependency and the potentially addictive nature of opioid-based pain treatments. Having satisfactory non-opioid treatment alternatives will need to be an integral part of effective pain manage…
Medicaid To Introduce Value-Based Drug Pricing
States have often been an incubator for innovative ideas in health technology pricing and reimbursement. the Medicaid drug pricing initiatives put forward by Oklahoma and Massachusetts may give impetus to an uptick in value-based pricing agreements thr…
Where Medication Therapy Management/Telehealth Services Deliver Value
A reasonable question regarding use of healthcare technologies, from medication therapy management/telehealth services to prescription drugs, is whether the healthcare system is gettingvalue for money.In many instances such technologies are cost-effect…
