Mid-week update

The FEHBlog recently noted a New York Times article on efforts to improve medication adherence by patients / us.  This week, CVS Caremark’s institute published a research study concluding that narrow pharmacy networks can improve medication adherence by encouraging the creation of pharmacy homes for plan members. 

Also on the Rx front and at the risk of belaboring the obvious, a non-profit independent research institute has concluded that the new PCSK9 statin inhibitors are too darn expensive. Reuters reports that

The Boston-based Institute for Clinical and Economic Review (ICER) said its analyses indicated “that the price that best represents the overall benefits” the drugs may provide patients would be between $3,615 and $4,811 a year, a 67 percent discount off the list prices. “Even if these drugs were used in just over 25 percent of eligible patients, then employers, insurers, and patients would need to spend on average more than $20 billion a year for these drugs,” ICER president Steven Pearson said in a statement.

Price of course is an independent variable that bears no necessary relation to cost or value to consumers.  Of course, while jawboning can be helpful, the existence of competitive PCSK9 specialty drugs will be most helpful to prescription drug managers and health plans trying to control specialty drug costs.

This also comes as no surprise to the FEHBlog –the American Medical Association is warning that large health insurance mergers will reduce competition particularly in certain geographies.

“A lack of competition in health insurer markets is not in the best interests of patients or physicians,” said AMA President Steven J. Stack, M.D. “If a health insurer merger is likely to erode competition, employers and patients may be charged higher than competitive premiums, and physicians may be pressured to accept unfair terms that undermine their role as patient advocates and their ability to provide high-quality care. Given these factors, AMA is urging federal and state regulators to carefully review the proposed mergers and use enforcement tools to preserve competition.”

Note to Dr. Stack, whom the FEHBlog admires, your warning overlooks the fact that health insurer profits are capped by the ACA’s minimum loss ratio

Finally, Modern Healthcare in an interesting development reports that health care companies — on both the provider and payer sides — are now more willing to rate doctors on-line, and doctors prefer these ratings to Yelp and Angies’ List.

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