Healthcare System Mergers and Investments Private Equity-Acquired Physician Practices and Market Penetration Increased Substantially, 2012-21 (Health Affairs) Ola Abdelhadi, Brent D. Fulton, Laura Alexander, and Richard M. Scheffler The awareness for private equity’s influence on the healthcare sector continues to grow and be quantified. Generally, there has been concern among parties in the health care system regarding the rate at which private equity firms have been acquiring physician practices, creating antitrust, quality, and pricing concerns within the broader health system. A new Health Affairs study estimated the local market share …

The theme last month in litigation and enforcement action seems to be drug pricing. As the national debate surrounding rising prescription drug prices continues to heat up, we are seeing increasing legal action targeting the cause of such price hikes at the private, state, and federal levels. In our highlights this month, we look at how drug manufacturers and pharmacy benefit managers are coming under fire for their drug pricing practices, and how two states have turned to the Supreme Court to salvage their laws designed to rein in rising …

*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 …

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 …

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, …

By: Katie Beyer, Student Fellow INTRODUCTION It is no secret that drug prices have been rising at an alarming rate. In fact, spending on prescription drugs rose 12.4% in 2014 and 9% in 2015.[1] In 2015, the U.S. spent $457 billion on prescription drugs, which accounted for 16.7% of overall healthcare services.[2] In 2016, Americans filled 4.4 billion drug prescriptions, at a total cost of approximately $400 billion.[3] On average, Americans spend $1,370 out of pocket on prescription drugs per year.[4] With an average annual price increase of approximately 10% over …

By: Katie Beyer, Student Fellow Happy July! In this Roundup of articles from the past month, we cover five articles all published in June. The topics this month include 1) Maryland’s anti-price gouging law|2) the 2018 medical cost trend|3) lowering generic drug costs through effective price transparency|4) state efforts to establish cost sharing standards|and 5) the effects of insurance coverage expansions.    Maryland’s Anti-Price Gouging Law The New England Journal of Medicine published an article titled, Targeting Unconscionable Prescription Drug Prices – Maryland’s Anti-Price Gouging Law by Jeremy Greene, and William …

July 2016 Update: In April, the U.S. Court of Appeals for the 11th Circuit overturned the district court’s February 2015 decision dismissing the class-wide allegations in this case. The case charges certain Florida medical centers and Nashville, Tenn.-based HCA with billing exorbitant and unreasonable fees for emergency radiological services covered in part by Florida Personal Injury Protection (“PIP”) insurance. Under Florida’s No Fault Car Insurance Law, drivers are required to have $10,000 in PIP insurance, and the complaint alleges that patients covered by PIP who received radiological services at emergency rooms following …