Cost Containment
The Source Roundup: December 2018 Edition
Source Fellow December 3, 2018
By: Leah S. Gray, Student Fellow Happy December! ‘Tis the season for curling up next to the fire and catching up with what’s happening in the world of health policy. In this December Roundup, we highlight (1) effect of disclosing prescription drug price in advertisements, (2) a systematic review of cost-saving literature, (3) employer alliances for health plans, (4) how to decrease the cost of care for Alzheimer’s patients, and finally, already gearing up for the next election, (5) what types of health policies the Democratic and Republican 2020 presidential nominees …
Continue Reading Download PDF
The Source Roundup: November 2018 Edition
Source Fellow November 1, 2018
By: Swaja Khanna, Student Fellow Happy November! We hope you are enjoying football season and preparing for turkey! In this edition of the Source Roundup, we cover five academic articles and reports from October. The topics this month include (1) the popularity of telemedicine for employers and employees, (2) an integrated health care system that combines ACO and bundled payment, (3) health spending growth in the coming years, (4) Maryland’s new initiative reduced hospital utilization and costs, and (5) how to remedy recent generic drug price hikes. Telemedicine Is …
Continue Reading Download PDF
The Source Roundup: October 2018 Edition
Source Fellow October 1, 2018
By: Jake Winton, Student Fellow Welcome to October! We hope you are getting your costumes picked out and finding those deals to stock up on trick-or-treat candy. In this edition of The Source Roundup, we review five academic articles and reports from September that stood out to us. This month we look at (1) price inflation in the California fully-insured large group market, (2) forward motion in drug price transparency laws, (3) the future of pharmaceutical reference pricing in the U.S., (4) lessons learned from California’s competitive healthcare model, and (5) …
Continue Reading Download PDF
California Legislative Beat: Transformative Healthcare Bills of 2018 (Pt. 1)
Sammy Chang, Health Policy Researcher June 21, 2018
Year two of California’s 2017-2018 legislative session has been an active one. As lawmakers work diligently, The Source will take a brief look at some 2018 bills that can potentially change the California healthcare landscape. SB 1021: This bill removes the sunset provision for AB 339 (2015), which was enacted to cap cost sharing for a covered outpatient prescription drug at $250/$500 per 30-day supply.[1] Furthermore, the bill codifies the regulation that “prohibits an enrollee or insured from being charged more than the retail price for a prescription drug …
Continue Reading Download PDF
Reference Pricing: When Transparency Is Not Enough
Katie Gudiksen, Senior Health Policy Researcher June 12, 2018
In most markets, consumers can compare prices and shop for the items they want. For example, to buy a new pair of shoes, a consumer can typically drive to a shopping mall and choose from a number of stores. Each store typically carries a number of different styles and brands. The consumer might choose to pay $500 for a designer pair of heels or $25 for an inexpensive pair of tennis shoes. The consumer can also shop online and have the shoes shipped to his or her home. Regardless of …
Continue Reading Download PDF
The Source Roundup: June 2018 Edition
Source Fellow June 1, 2018
By: Megan O’Leary, Student Fellow Happy June! In this edition of the Source Roundup, we cover five academic articles and reports from April and May. The topics this month include: 1) barriers for generics to lower specialty drug prices, 2) a call to reform pharmaceutical systems in the United States and Canada, 3) efforts by states to stabilize the individual market, 4) Vermont’s push for community-driven health care reform, and 5) antitrust lawsuits in the pharmaceutical industry. Barriers for Generics to Lower Specialty Drug Prices The Health Affairs article Generic …
Continue Reading Download PDF
Will Putting “American Patients First” Result in Lower Drug Prices?
Katie Gudiksen, Senior Health Policy Researcher May 30, 2018
On May 11, 2018, the Trump Administration released American Patients First, a blueprint to lower drug costs (the blueprint). The report details four challenges with the prescription drug market, including high list prices for drugs, high and rising out-of-pocket costs for patients, government programs that overpay for drugs due to the lack of negotiation tools, and foreign governments “free-riding” off of American investment in innovation. To address these challenges, the report also lays out four key strategies for reform, including a list of more than fifty recommendations with both immediate and …
Continue Reading Download PDF
California Legislative Beat: Noteworthy 2017 Bills Still Pending That Should be Passed
Sammy Chang, Health Policy Researcher May 24, 2018
As year two of the California legislative session goes into full swing, a couple of bills introduced in 2017 are still active and waiting to be passed. This month’s post will look at four active 2017 bills that should be considered for passage. SB 199: This bill authorizes the creation of an advisory committee to research and develop recommendations on the creation of a database to be titled California Health Care Cost, Quality, and Equity Atlas. This bill is the first step to creating a statewide database that would collect …
Continue Reading Download PDF
Litigation and Enforcement Highlights – May 2018
Amy Y. Gu, Managing Editor May 15, 2018
Several major court decisions were handed down last month that may leave lasting impacts in terms of price and competition in the healthcare industry. Specifically, the 4thCircuit Court of Appeals ruled Maryland’s Price Gouging Law unconstitutional, while the Supreme Court upheld inter partes review, a controversial patent review process. In antitrust enforcement, the Justice Department began its review of the Cigna-Express Scripts merger. 4thCircuit Strikes Down Maryland Price Gouging Law In a significant victory for the pharmaceutical industry, the 4thU.S. Circuit Court of Appeals found Maryland’s landmark 2017 law, …
Continue Reading Download PDF
State Medicaid Programs are a Tool to Address Rising Drug Costs
Katie Gudiksen, Senior Health Policy Researcher May 8, 2018
Rising prescription drug prices concern nearly all Americans, with 80% reporting that drug prices are “unreasonable”. The problem of rising drug expenditures is particularly acute for state Medicaid programs, which provide health coverage for low-income and disabled Americans. Medicaid serves nearly one in five Americans including many with chronic conditions, and purchases about 10% of total prescription medications dispensed in the U.S.[1] Furthermore, Medicaid’s nationwide drug spending increased almost 50% between 2013 and 2016 (from $22.4 billion to $33.4 billion).[2] In a survey of Medicaid programs, 36 states reported increased cost containment efforts for prescription drugs …
Continue Reading Download PDF