PHARMACEUTICALS
Spotlight on 2018 State Drug Legislation: Part 1 – Drug Importation: The Next Frontier for State-action to Control Prescription Drug Costs
Katie Gudiksen, Senior Health Policy Researcher July 27, 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 the most recent legislative sessions, states have demonstrated they are increasingly willing to use their power to target prescription drug prices. In 2018, only two states with active legislative sessions, North Carolina and Alabama, did not consider legislation with the aim of reducing prescription drug costs. Of …
Continue Reading Download PDF
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. …
Continue Reading Download PDF
Litigation and Enforcement Highlights – July 2018
Amy Y. Gu, Managing Editor July 16, 2018
June has been a busy month in terms of healthcare litigation and enforcement action. In this issue, we highlight 1) implications of the AT&T-Time Warner merger for vertical mergers in healthcare, 2) FTC’s big win in a pharmaceutical pay-for-delay case, and 3) constitutional challenges against state drug pricing laws. AT&T-Time Warner Merger Encourages Healthcare Vertical Mergers but May Mean Little Last month, a federal court approved AT&T and Time Warner’s $85 billion merger without condition, setting off a wave of speculation on how the decision could impact pending healthcare …
Continue Reading Download PDF
Update on Massachusetts’ Waiver Request to use a Drug Formulary for Medicaid
Katie Gudiksen, Senior Health Policy Researcher July 9, 2018
On June 27, 2018, the Centers for Medicaid and Medicare Services (CMS) denied Massachusetts’ request to implement a closed drug formulary in its Medicaid program. In a previous post, the Source described the request and explained why it has the potential to save the state millions of dollars every year. In denying the request, CMS said that it would consider the waiver if Massachusetts no longer used the federal Medicaid Drug Rebate Program in which manufacturers give the state rebates when the state purchases a drug to ensure that Medicaid …
Continue Reading Download PDF
The Source Roundup: July 2018 Edition
Source Fellow July 2, 2018
By: Megan O’Leary, Student Fellow Happy July! In this edition of the Source Roundup, we cover six academic articles and reports from May and June. The topics this month include: (1) the drug rebate system, (2) provider-payer integration as model for healthcare reform, (3) anticompetitive behaviors that delay generic drug competition, (4) short-term insurance plan expansion increases 2019 ACA marketplace premiums, and (5) competition concerns of healthcare consolidation. The Drug Rebate System is Not the Villain in Rising Health Care Costs There are plenty of reasons health care price …
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
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. …
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