Tag Archives: pricing

Ohio Medicaid program demands new payment strategy after journalists explain how PBMs use ‘spread pricing’

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Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo: afagen via Flickr

Over the past six months, journalists for the Columbus Dispatch have written more than 40 articles about the murky world of pharmacy benefit managers (PBMs) in Ohio. This week, they wrote one of the most important stories in this ongoing series, “Ohio firing pharmacy middlemen that cost taxpayers millions.”

In this article, they explained that the Ohio Department of Medicaid was changing the way it pays for prescription drugs by, “giving the boot to all pharmacy middlemen” because the Medicaid program wants to shift away from what’s called the “spread pricing” practice. Continue reading →

How Trump’s new drug proposal may impact older adults

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Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo: Jen R via Flickr

Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services Director Seems Verma are crisscrossing the country to tout the Trump administration’s plan to combat prescription drug prices. They promise that America’s Patients First, released by the president and HHS on May 11, will address significant roadblocks to lowering drug costs.

People age 65 and older account for 34 percent of all prescription medication use and 30 percent of all over-the-counter drugs purchased, according to this Medscape article. Azar, a former drug company executive, recently spoke with reporters and other stakeholders to promote the plan, saying that high prescription costs seriously threaten too many Americans’ health and wellbeing. Continue reading →

What’s next for drug costs? #AHCJ17 hears from the experts – including a patient

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Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

President Donald Trump has spoken about the cost of drugs frequently. Though not always clearly and consistently, he has called for government negotiation of prices. Drug prices also have caught Congress’s eye, although we’re not quite sure what (if anything) legislators are willing to do about it.

But patients are fed up, as David Mitchell, founder of Patients for Affordable Drugs reminded us last week during a Health Journalism 2017 session in Orlando. Continue reading →

Is value-based pricing doomed? #AHCJ17 session to address this question

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Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Paul Levy, former chief executive of Boston’s Beth Israel Deaconess Medical Center, recently made a compelling argument in a blog post about why value-based pricing for hospital services ultimately will fail.

In “The Game That Shows Why Value-Based Pricing Is Doomed” on AthenaInsight, Levy argues that the incentives in value-based pricing are all wrong. As a payment model, value-based pricing promotes selfishness but at the same time requires all parties to cooperate, he writes.

It’s not often that anyone criticizes value-based care, and why would they? That would be like opposing the use of grocery coupons. Continue reading →

Journalists learn about intricacies of prescription drug pricing

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Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News, the Connecticut Health I-Team and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo: Phillip Bradshaw via Flickr

Many Americans think they pay too much for their prescription drugs, especially those who need life-saving medications for cancer and hepatitis C. Why are drug costs so high in the United States? How can reporters better explain the cost squeeze to their audiences?

These were among the questions that Sarah Emond, M.P.P., executive vice president at the Institute for Clinical and Economic Review (ICER) in Boston and Peter Bach, M.D., director of the Memorial Sloan Kettering’s Center for Health Policy and Outcomes in New York City addressed at the Feb. 15  meeting of AHCJ’s New York chapter. Dan Goldberg of Politico moderated the session. Continue reading →

AHCJ webcast to examine drug prices, other cost challenges

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Susan Heavey

About Susan Heavey

Susan Heavey, (@susanheavey) a Washington, D.C.-based journalist, is AHCJ’s topic leader on social determinants of health and curates related material at healthjournalism.org. She welcomes questions and suggestions on resources and tip sheets at determinants@healthjournalism.org.

Photo" Phillip Bradshaw via Flickr

Photo” Phillip Bradshaw via Flickr

Mylan’s price hike for its EpiPen allergy medication fueled an Internet storm this week, with consumers and U.S. legislators expressing outrage over its decision to raise the price about 400% since 2007 to as much as $500 or more. The backlash appeared tied in part to timing as U.S. children head back to school, with parents of those needing EpiPens to treat allergic reactions coming to grips with the hefty price tag.

The incident brought echoes of another drug price hike – the 2015 increase by Turing Pharmaceutical’s malaria and HIV medicine Darapim, another move that brought scrutiny by the House Oversight and Government Reform Committee of the company’s chief executive officer. Continue reading →