Thursday Update

The Senate Finance Committee will be holding a hearing “to consider” the Graham-Cassidy healthcare reform bill (H.R. l628)  on Monday September 25 at 2 pm. Senate Majority Leader Mitch McConnell (R KY) expects to hold a vote on the bill later in the week.

The bill is an interesting policy play because it would devolve healthcare policymaking from Washington, D.C. to the states and do away with the unpopular ACA individual and employer mandates. The bill would not impact the FEHBP.

Although the Graham-Cassidy bill would not repeal the health insurer tax, the FEHBlog expects that Congress will not allow this currently resurrected tax return to life for 2018. However, this action likely will not occur until after the 2018 government contribution is finalized. Nothing is simple.

Bloomberg has an interesting report on the problems in successfully bringing lower priced FDA approved bio-similar drugs to market.  “Because of their complexity, biologic drugs can have more than 100 patents — which can be used to fend off competition.”  For example, as Market Watch reports

When Pfizer Inc. began selling a cheaper [bio-similar] version of Johnson & Johnson’s rheumatoid arthritis therapy Remicade, investors worried about the impact on sales of the blockbuster drug.
But new competition turned out to be more of a nibble. Pfizer PFE, -0.06%  now says there’s a reason for that, alleging that Johnson & Johnson JNJ, -1.10%  negotiated contracts that left Pfizer’s Inflectra biosimilar out in the cold.
In an antitrust lawsuit filed Wednesday, Pfizer alleged that Johnson & Johnson set up “a web of exclusionary contracts” on hospitals and clinics to keep a “stranglehold” on Remicade’s market share.

This lawsuit could have broader ramifications for the drug supply chain over time.

CVS Health announced additional steps to combat the opioid epidemic yesterday. For example

CVS Caremark will roll out an enhanced opioid utilization management approach for all commercial, health plan, employer and Medicaid clients as of February 1, 2018 unless the client chooses to opt out. This program will include limiting to seven days the supply of opioids dispensed for certain acute prescriptions for patients who are new to therapy; limiting the daily dosage of opioids dispensed based on the strength of the opioid; and requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed.

CVS’s Chief Medical Officer also was the lead author of a Health Affairs article on the PBMs’ role in helping resolve this crisis.

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