Weekend Update

Congress is in session this coming week as the Hill’s Floor Watch blog reports. The Medicare Part B fix expires at the end of this month unless Congress takes action before then. Upon expiration, Medicare Part B payments to doctors will drop by around 20%.  There is a bipartisan fix on the table but how to pay for the fix remains an open question. The Congress always can kick the can down the road so the issue can be taken up in a lame duck session following the mid-term elections in early November. The Medicare Part B fix has a big FEHBP impact for two reasons. One, there is a large cadre of FEHBP annuitants with primary Medicare Part B coverage, and two, fee for service plans under the FEHB Act pay doctors for services rendered to annuitants over age 65 who have declined Medicare Part B using the Medicare schedule.

Drug Channels.net has an interesting report on the specialty pharmacy business. Specialty pharmacy are biologic or large molecule drugs that require special pharmacy handling because, for example, they often are injectables.  Biologic drugs are more expensive than small molecule / traditional drugs because the FDA still has not created a regulatory pathway for the approval of bio-similar drugs akin to small molecule generics. Drug Channels research

research shows a booming market:

  • In 2013, retail, mail, and specialty pharmacies dispensed about $63 billion in specialty pharmaceuticals.
  • Specialty drugs accounted for 22% of total pharmacy industry revenues.
  • Three companies—Express Scripts, CVS Caremark, and Walgreens—accounted for 63% of revenues from pharmacy-dispensed specialty drugs. The next three largest players had a combined share of about 5%.

Specialty drugs also are dispensed in doctors’ offices and clinics.

Here are a couple of tid bits that caught the FEHBlog’s attention:

  • Two major drug manufacturers — Ranbaxy in India and Pfizer here in the good old USA — have recalled drugs due to distribution mix-ups. How often does that happen?
  • Healthday is reporting that  “A blood test has been developed that can predict with 90 percent certainty whether a senior will suffer from dementia within the next few years, researchers report.” Fingers crossed that the blood test could help researchers determine the cause of this disease. The Washington Post reported last week that “Alzheimer’s disease likely plays a much larger role in the deaths of older Americans than is reported, according to a new study that says the disease may be the third-leading cause of death in the United States.”