Midweek Update

Rx coverage

Midweek Update

David Ermer–Rx coverage, SCOTUS–

The FEHBlog wishes to remind his loyal readers that you may subscribe to FEHBlog emails which arrive with the full posts the morning after the post goes live. A subscription box prominently appears on the right margin of the FEHBlog page at ermersuter.com

Has any law generated more litigation in a short period of time than the Affordable Care Act??? Katie Keith in the Health Affairs blog provides a lengthy status report on the major ACA cases pending in the U.S. Supreme Court and the U.S. Court of Appeals.

In other judicial news, the U.S. District Court for the District of Columbia ruled yesterday that the Department of Health and Human Services failed to follow the Administrative Procedure Act in certain respects with respect to its 2013 and 2016 rule makings on access to medical records by patients and third parties such as lawyers and insurers. The details are explained in this Health Security IT article. Due to the importance of this issue to HHS, the FEHBlog expects the agency to take remedial administrative action quickly.

In good prescription drug news:

  • Healthcare Dive reports that pharmaceutical manufactures finally are rolling out biosimilar drugs which action will lower the cost of expensive specialty drugs over time.
  • CVS Health announced today “a new solution eliminating member out-of-pocket costs associated with all diabetes prescription medications, including insulin. Offered through the company’s pharmacy benefit manager (PBM), CVS Caremark, RxZERO enables employers and health plan sponsors to leverage formulary and plan design approaches to offer all categories of diabetes medications at zero dollar out of pocket for their members without raising costs for the plan sponsor or increasing premiums or deductibles for all plan members.”

Thursday Miscellany

David Ermer–CDC, Federal employment benefits, Rx coverage–

At last year’s OPM AHIP FEHBP Carrier Conference, a Centers for Disease Control scientist announced that the U.S. Surgeon General soon would be issuing a new comprehensive report on tobacco use in the U.S. That report was issued today. It

  • Examines the effectiveness of various smoking cessation tools and resources;
  • Reviews the health effects of smoking and catalogues the improvements to health that can occur when smokers quit;
  • Highlights important new data on populations in which the prevalence of smoking is high and quit rates are low; and
  • Identifies gaps in the availability and utilization of programs, policies, and resources that can improve cessation rates and help smokers quit.

Here’s a link to OPM’s Quit Smoking website which discusses the FEHBP generous tobacco cessation benefits.

The CDC updated the public on its important antibiotic resistance solutions initiative.

CDC’s AR Solutions Initiative invests in national infrastructure to detect, respond, contain, and prevent resistant infections across healthcare settings, food, and communities. CDC funding supports all 50 state health departments, six local health departments, and Puerto Rico and the U.S. Virgin Islands.  Through these investments, CDC is transforming how the nation and world combat and slow antibiotic resistance at all levels.

Good luck.

The FEHBlog has discussed the relatively new, cooperative effort of hospitals to create a public asset, known as Civica Rx, to help solve drug shortages and lower the cost of generic drugs. Today, Civica Rx and the Blue Cross Blue Shield Association announced

their partnership to create a new subsidiary dedicated to lowering the cost of select generic drugs. The subsidiary is being formed in response to the impact of high drug costs on the health of Americans and the overall affordability of health care. Other health plans, employers, retail partners and health care innovators who share the belief that patients and their needs come first are invited to join the initiative.

The subsidiary will acquire and develop Abbreviated New Drug Applications (ANDAs) for select generic drugs and partner with Civica and manufacturing partners to bring more affordable generic drugs to uncompetitive markets in exchange for aggregated volume and multiyear purchasing commitments. Initially, several generic medications identified as having high potential for savings will be prioritized by the partnership and will evolve into a platform that can be used to enhance competition for additional generic drugs.

The new operation expected to start delivering product in early 2022. Strong move.

The American Hospital Association now offers a webpage with updates and resources concerning the Wuhan coronavirus.