Category Archives: Health care reform

SCOTUS strikes down Roe as expected; half of states likely to ban abortion

Photo by Elvert Barnes via Flickr.

The U.S. Supreme Court (SCOTUS) handed down its expected decision in the highly anticipated Dobbs v. Jackson Women’s Health Organization case Friday morning, finding no constitutional basis for abortion.

The court, voting 6-3, now leaves the issue to state governments. Missouri was the first state to execute its trigger ban, prohibiting all abortion in the state.

The decision to overturn the right to abortion upends a precedent established in 1973 and re-affirmed in 1992, as Amy Howe reported for SCOTUS blog. “In one of the most anticipated rulings in decades, the court overturned Roe, which first declared a constitutional right to abortion in 1973, and Planned Parenthood v. Casey, which re-affirmed that right in 1992.”

Journalists should note that Howe reported the vote as 5-4, writing this: “The vote to overturn Roe was 5-4.  Justices Clarence Thomas, Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett joined Alito’s opinion. Chief Justice John Roberts did not join the opinion. He agreed with the majority that the Mississippi abortion restriction at issue in the case should be upheld, but in a separate opinion, he argued that the court should not have overturned Roe.”

At The New York Times, Adam Liptak wrote that the decision will transform American life, reshape the nation’s politics and lead to all but total bans on the procedure in about half of the states. “The ruling will test the legitimacy of the court and vindicate a decades-long Republican project of installing conservative justices prepared to reject the precedent, which had been repeatedly reaffirmed by earlier courts,” he added. Also, the decision will be one of the legacies of former President Donald J. Trump, who named three justices who were in the majority, he noted.

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The Federal Trade Commission launches probe into pharmacy benefit managers

The average annual prices of brand name drugs have risen faster than general inflation since at least 2006, according to data from The Rx Price Watch Report, 2021, from AARP, “Trends in Retail Prices of Brand Name Prescription Drugs Widely Used by Older Americans, 2006 to 2020.” Reprinted with permission.

Noting that so many companies in the prescription drug supply chain are vertically integrated, the Federal Trade Commission voted unanimously on Tuesday to investigate the role pharmacy benefit managers (PBMs) have on consumers’ costs and access to prescription drugs.

Given that health insurers own most of the largest PBMs and therefore own their affiliated mail-order and specialty pharmacy companies, the FTC ordered six PBMs to comply with requests for information on their operations: CVS Caremark (which owns Aetna), Express Scripts (a division of Cigna), OptumRx (a UnitedHealth Group unit), Humana (an insurer), Prime Therapeutics (which contracts with multiple Blue Cross Blue Shield plans) and MedImpact Healthcare Systems (which contracts with employers and government and commercial health insurers).

PBMs are middlemen that negotiate rebates and fees with drug manufacturers, create drug formularies and reimburse pharmacies for patients’ prescriptions.

For four years, Darrel Rowland (@darrelbrowland) has covered PBMs closely for The Columbus Dispatch in Ohio. The headline on his story about the FTC decision focused on the potential benefit of such a probe on consumers’ costs: “FTC agrees to ‘shine a light’ on how drug middlemen impact your prescription prices.”

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With Roe likely in its final days, experts say reporters should sharpen focus on abortion as a health issue

Photo by Erica TricaricoSophie Novack (on the left) and Crystal S. Berry-Roberts, M.D. (on the right)

Pregnancy is a medical condition and abortion is an intervention for it, so journalists writing about the topic should take the same approach they would when writing about cancer, diabetes, and other conditions and treatments: focus on mortality risks, patients’ rights to care and bodily autonomy.

Reporters should also step up their game to explain what the medical community has known for decades: that abortion is a safe health care procedure.

These were among the topics covered by women’s reproductive health experts who participated in a round table discussion moderated by Brenda Goodman of CNN Health, about abortion on Saturday, April 30, at Health Journalism 2022 in Austin. The conversation took place two days before what appeared to be a leak of the Supreme Court’s opinion in Roe v. Wade was published by Politico. The opinion would overturn abortion protection under Roe v. Wade.


Check out the full transcript of the round table discussion.

The speakers at the “Women’s reproductive health in a post-Roe world” round table included Crystal S. Berry-Roberts, M.D., an obstetrician and gynecologist in Austin; Lisa Harris, M.D. Ph.D., an associate professor of obstetrics and gynecology at the University of Michigan; Sonja Miller, interim managing director for Whole Woman’s Health Alliance; and Sophie Novack, an independent journalist who has reported on the implications of Texas laws restricting abortions. Continue reading

Rising prescription drug prices: What to know

Madelaine A. Feldman, M.D., F.A.C.R. (Photo courtesy of Paola Rodriguez)

In pharmacies across the country, sticker shock is not uncommon. The high price of prescription drugs is one of the biggest problems facing the nation’s health care system, Joyce Frieden explained on Friday, April 29, during the “Covering the controversy over high prescription drug costs” panel at Health Journalism 2022 in Austin.

Each speaker offered a different perspective as to why prescription medications cost so much. Frieden’s expert panelists included Douglas Holtz-Eakin, Ph.D., the former director of the Congressional Budget Office (CBO) and current president of the American Action Forum, a center-right think tank on fiscal policy; Madelaine A. Feldman, M.D., a clinical assistant professor at the Tulane University School of Medicine, a practicing rheumatologist and president of the Coalition of State Rheumatology Organizations; and Gerard Anderson, Ph.D., a professor of health policy and management and international health at the Johns Hopkins Bloomberg School of Public Health.

“So, what is being done to solve the problem of high prescription drug costs?” asked Frieden, the Washington editor for MedPage Today. “And are there angles to this story that have yet to be fully covered today?”

Distinguishing between brand-name and generic drug prices

Holtz-Eakin began by talking about one of his frustrations with the usual coverage of drug costs. “When we talk about the high cost of prescription drugs, it’s important to be precise about which price we’re talking about,” he said. Too often journalists do not distinguish between the costs of brand-name and generic drugs or between the net price of drugs after rebates and discounts. Also, we often fail to write about the actual cost at the pharmacy counter and what consumers pay out of pocket, he noted. “Being clear about which price you’re trying to keep track of matters a lot,” he said.

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CMS Administrator Brooks-LaSure kicks off AHCJ 2022 in Austin

Photo by Paola RodriguezCMS Administrator Chiquita Brooks-LaSure

Chiquita Brooks-LaSure, administrator for the Centers for Medicare and Medicaid Services (CMS), opened AHCJ’s Health Journalism 2022 conference on Thursday, April 28, with a keynote address highlighting the importance of health care and CMS’s efforts to foster greater equity, access, and value, and how much health care is integrated into the fabric of our society.

Check out the full video of her speech and Q&A.

In her remarks, Brooks-LaSure explained just how much health care is part of the fabric of our society. While many people have been touched by the health system, many are still left out. The Affordable Care Act — in which Brooks-LaSure played a key policy role in developing and implementing — has certainly transformed the health system. However, there’s still too much inequity and multiple challenges to address. Brooks-LaSure has put forth six pillars to guide the agency’s thinking about their work and to ensure CMS measures results to ensure they are pursuing initiatives that address underlying disparities in the health system.

 

Following her brief opening remarks, Brooks-LaSure answered questions from the audience. Reporters took advantage of the opportunity to probe issues including Medicaid expansion, maternal mortality and CMS’s controversial decision to cover the newly approved Alzheimer’s drug Aduhelm only for those enrolled in clinical trials. 

 

“I think it’s really important for people to understand that this was unique,” she said, referring to the Aduhelm decision. Normally, coverage decisions are made at a local level, but in this instance, CMS was asked to make a broader decision on this particular drug.

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