PHARMACEUTICALS
Recent lawsuits focus on key competition issues
Bruce Allain, Managing Editor April 16, 2024
This spring, court cases are dealing with a variety of issues relevant to healthcare marketplace competition issues. These include a Federal Trade Commission’s (FTC’s) action to block a sale of hospitals in North Carolina, examining the fiduciary duties employer-sponsored health plans have in selecting drug plans, and looking at the acceptability of non-compete clauses in physician contracts. FTC Files suit in North Carolina In February, the FTC authorization of a suit to block Novant Health’s proposed acquisition of two hospitals owned by Community Health Systems (CHS) in North Carolina. On …
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The Source Roundup: January 2024 Edition
Dilani Logan, Student Fellow January 2, 2024
Healthcare Costs and Spending Arriving at a Fair Price in the Medicare Drug Price Negotiation Program: Considerations from Other Countries (Health Affairs Forefront) John K. Lin, James I. Barnes, Jalpa A. Doshi, Salah Ghabri, Peter Kolominksy-Rabas, Brian O’Rourke The Centers for Medicare and Medicaid Services (CMS) are slated to begin negotiating drug prices for a subset of Medicare drugs soon, due to the Inflation Reduction Act (IRA) of 2022. Recognizing the subjectivity involved in determining fair drug prices, this article highlights the authors’ perspectives on CMS’ current strategic shortcomings and analyzes …
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Recapping the 2023 California Legislative Session (Part 2): Healthcare Services and Pharmaceutical Costs
Dilani Logan, Student Fellow December 14, 2023
In the last issue of California Legislative Beat, we examined some significant bills from year one of California’s 2023-2024 legislative term. Specifically, we focused on legislation that sought to make changes in healthcare competition, consolidation, and system reform. In part 2 of the 2023 session recap, we turn our attention to bills that aimed to tackle healthcare service and pharmaceutical costs, coverage, and price transparency. Healthcare Costs and Coverage Californians can expect to be protected from surprising dental or emergency ground medical transportation bills soon. The legislature approved and …
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The Source Roundup: December 2023 Edition
Bruce Allain, Managing Editor December 1, 2023
Healthcare Prices and Cost In An Era Of Premium And Provider Price Increases, State Employee Health Plans Target Key Cost Drivers (Health Affairs Forefront) Sabrina Corlette, Karen Davenport Employer-sponsored health insurance premiums have outpaced inflation and are poised for significant rate hikes this year. State Employee Health Plans have been in a prime position to address health care costs. Administrators of these plans identified reference pricing, tiered network plans, and multi-payer purchasing initiatives as having promising results in addressing cost drivers. The Joint Distribution Of High Out-Of-Pocket Burdens, Medical Debt, …
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The Source Roundup: November 2023 Edition
Dilani Logan, Student Fellow November 1, 2023
Healthcare Costs and Spending A Study of the Cost of Care Provided in Physician Owned Hospitals Compared to Traditional Hospitals (Physician’s Advocacy Institute and the Physicians Foundation) Robert H. Aseltine and Gregory J. Matthews The Physician’s Advocacy Institution and the Physicians Foundation released a new technical report summarizing their findings from an investigation comparing the cost of care patients across Medicare’s 20 most expensive conditions in 2019 in physician owned hospitals (POHs) and traditional hospitals. The authors assessed the statistical similarities in cost, patient demographics, and comorbidity levels between hospitals in …
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The Source Roundup: October 2023 Edition
Amy Y. Gu, Managing Editor October 2, 2023
Consolidation and Competition A Doctrine in Name Only — Strengthening Prohibitions against the Corporate Practice of Medicine (NEJM) Jane M. Zhu, Hayden Rooke-Ley, and Erin Fuse Brown The NEJM perspective examines state corporate practice of medicine laws that prevent ownership or control of physician practices by corporate entities. In an accompanying audio interview, Erin Fuse Brown discusses the role of these laws, including the usefulness and how they could be strengthened. Competition in Commercial PBM Markets and Vertical Integration of Health Insurers with PBMs: 2023 Update (American Medical Association) José R. …
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Supreme Court Upholds State Regulation of Pork: What Does it Mean for the Pharmaceutical Industry?
Amy Y. Gu, Managing Editor June 15, 2023
In a recent Supreme Court decision, the high court upheld a California ballot initiative that bans the sales of certain type of pork in the state. While the challenge of the law is specifically focused on the state pork law, it has significant legal implications for industries beyond the meat industry. The Pharmaceutical Research and Manufacturers of America (PhRMA), representing many biopharmaceutical and biotechnology companies, filed an amicus brief opposing the law due to its potential application to the state regulation of prescription drug prices. In this post, we take …
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The Source Roundup: June 2023 Edition
Stephen Cosenza, Student Fellow June 1, 2023
In the past month, newly released publications have chronicled how partnerships, alternative payment models, and insurer market power affect competition and consolidation. Separately, researchers examined Affordable Care Act developments in terms of its impact on coverage and costs of health care. Moreover, as more and more price data are made publicly available, researchers studied how that data is presented, utilized, and what is reveals. Competition and Consolidation Since 2005, over 190 rural hospitals have closed across the US, and today, 600 more (the nearly one third that remain) are …
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2023 California Healthcare Bills Part 2: System Reform, Transparency, and Prescription Drug Costs
Rachel Ng, Student Fellow May 12, 2023
In the previous issue of the California Legislative Beat, we examined healthcare bills introduced in the 2023-2024 legislative term that target healthcare consolidation and competition in California (see 2023 California Healthcare Bills – Part 1). In this second part of the two-part series, we explore some newly proposed bills that seek to increase access to care, control costs, and improve transparency in data and prices. System Reform and Access California is a leader in innovative healthcare policy and initiatives, particularly to increase patients access to care while lowering overall …
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Recapping the 2022 California Legislative Session: What Was and What Wasn’t – Part 2: Promoting Telehealth and Tackling Out-of-Network Costs and Prescription Drug Prices
Amy Y. Gu, Managing Editor November 13, 2022
In the previous issue of the California Legislative Beat, we recapped noteworthy bills from year two of California’s 2021-2022 legislative term, specifically legislation that sought to regulate healthcare competition and ensure affordable access (see Recapping the 2022 California Legislative Session – Part 1). In this second part of the two-part series, we turn to bills that aimed to eliminate surprise out-of-network costs, advance telehealth, and rein in prescription drug prices, including ones that were signed into law and some important ones that didn’t make the cut. Surprise Out-of-Network Costs …
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