Weekend Update

Congress will be in session this week according to the Hill’s Floor Action blog. The Senate Health Education Labor and Pensions Committee will hold a hearing on Sylvia Burwell’s nomination to be HHS Secretary on Thursday May 8.  

This coming week also is Public Service Recognition Week,.which is “time set aside to honor the men and women who serve our nation as federal, state, county, and local government employees.” Here is a link to OPM’s press release.

Kaiser Health News reports on the results of a survey commissioned by the medical society lead Choosing Wisely campaign which the FEHBlog has been following. According to the KHN report,

The [Choosing Wisely] campaign focuses on encouraging conversations between patients and doctors about the suspect treatments it identifies. In the survey, 47 percent of doctors said one patient a week requests something unnecessary. While most doctors believe they are most responsible for interceding, 48 percent said that when facing an insistent patient, they advise against it but still order the test. Another 5 percent said they just order the test.

Not surprisingly, few of the doctors agree with health policy analysts who believe that the financial rewards that come from extra procedures are a major reason why they are ordered. Only 5 percent of physicians said they are influenced by the presence of new technology in their offices. Just 5 percent believe the fee-for-service-system of payment, where physicians are paid for each thing they do rather than a lump sum for keeping a patient healthy, plays a role.

It’s difficult for health plans to control these costs which add up.

Then you read the Washington Post’s story today about the expensive Hepatitis C drugs. The article notes that

Sovaldi costs $84,000 for a 12-week treatment, although some patients will need to take the drugs for 24 weeks. Olysio is about $66,000 for a 12-week treatment but is approved for fewer types of patients. Other drugs must often be used with the two new products, adding to the cost.
In the United States, drugmakers set prices based on development costs, as well as on what the market will bear, with companies demanding higher returns for products that have little or no competition. Until they lose patent protection, brand-name drugs in the United States often are able to garner the highest prices in the world. Prices generally fall sharply once generic rivals hit the market.
The drugmakers defend the pricing, saying the drugs are curative and can prevent the need for other costly care, such as liver transplants. “Gilead believes the price of Sovaldi is fair based on the value it represents to a larger number of patients,” Gilead spokeswoman Michele Rest said.

Is this the same way that penicillin was priced?

At the recent OPM AHIP FEHBP carrier conference, speakers stressed the importance of considering community health values to the performance of the health care system. In that regard, the Commonwealth Fund last week issued  the results from a scorecard of state health plan performance over the period 2007-2012.