HEALTHCARE COSTS
Spotlight on 2018 State Drug Legislation: Part 4 – Price Gouging Prohibitions
Katie Gudiksen, Senior Health Policy Researcher September 11, 2018
*Update: This post was written before the end of the 2018 legislative session. For the most recent count of states that passed these legislation, see the Spotlight on 2018 State Drug Legislation Summary: The Year in Review or download our Summary Chart. In this installment of The Source’s Spotlight on State Drug Legislation, we focus on price gouging prohibitions. In 2017, Maryland became a pioneer among states addressing rising drug costs when it passed the first law (HB 631) to prevent price gouging in the pharmaceutical market. At the start …
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Litigation and Enforcement Highlights – August 2018
Amy Y. Gu, Managing Editor August 15, 2018
This month we highlight new developments in several high profile antitrust enforcement cases and pharmaceutical legal actions, including 1) new challenges to the proposed Beth Israel-Lahey merger, 2) expanded probe into generic drugs price-fixing scheme, 3) conclusion to Allergan’s patent saga, and 4) the future of Maryland’s price gouging law. Massachusetts Health System Merger Hits Roadblock, with Rocky Road Ahead We have our eye on the proposed merger of Beth Israel Deaconess Medical Center and Lahey Health, which has been under regulatory review since December 2017. As we covered …
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The Source Roundup: August 2018 Edition
Tiffany Wang, Student Fellow August 1, 2018
Happy August! In this edition of the Source Roundup, we cover four academic articles and reports from June and July. The topics this month include: (1) price transparency as a means to affordable health care; (2) effect of state-based individual mandates; (3) Trump’s 5-Part Medicare Part D plan; and (4) Medicare’s experiment with bundled payments. Price Transparency Goals to Achieve Affordable Health Care Skeptics have questioned whether consumer price transparency initiatives are an effective means of driving down healthcare costs. In the NEJM Catalyst article, “Defining the Goals of …
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California Legislative Beat: Transformative Healthcare Bills of 2018 (Pt. 2)
Sammy Chang, Health Policy Researcher July 23, 2018
Year two of California’s 2017-2018 legislative session continues to be an active one with the introduction of new innovative healthcare bills. As lawmakers work diligently, this month’s California Legislative Beat continues to look at some 2018 bills that can potentially change the California healthcare landscape. AB 2499: This bill would increase the medical loss ratio (MLR) by 5%, from 85% to 90% for a health plan or health insurer in the large group market, and from 80% to 85% for a health plan or health insurer in the individual market. …
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CVS-Aetna Merger: Competition and Patient Care Concerns Raised at CDI Hearing
Source Fellow June 26, 2018
By: Megan O’Leary, Student Fellow CVS Health and Aetna Insurance defended their proposed vertical merger to the California Department of Insurance (CDI) on June 19. The Source attended the hearing and brings this report regarding the prospects and impact of the planned merger. Pursuant to the California Insurance Code, Commissioner Dave Jones was able to call the public hearing as it involves an Aetna subsidiary based in California. While the commissioner does not have direct approval authority over the merger, his input could have an impact on how other states …
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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 …
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Litigation and Enforcement Highlights – June 2018
Amy Y. Gu, Managing Editor June 15, 2018
Pharmaceutical litigation and enforcement actions took the spotlight in the news last month. In this edition, we highlight two high profile enforcement cases and continue to follow the Allergan patent saga. In enforcement, we saw developments in the FTC’s antitrust enforcement against generic drugmaker Impax and the DOJ’s anti-kickback enforcement against brand manufacturer Pfizer. These actions could set important precedents for similar cases and significantly impact price and competition in the pharmaceutical industry. Meanwhile, Allergan continues to defend against attacks of its tribal immunity maneuver in a seemingly losing battle. …
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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 …
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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 …
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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 …
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