Some drugs that improve price competition fall through the cracks of the FDA user fees
USC-Brookings Schaeffer on Health Policy
by Marta E. Wosińska, Richard G. Frank
1M ago
By Marta E. Wosińska, Richard G. Frank Generic drugs are essential for bringing price competition to prescription drug markets and providing a moderating force on drug spending.  They make up 92% of prescriptions, but only 16% of invoice-level spending in the US. This price competition relies on a determination by FDA that generic products are therapeutically equivalent to a brand name drug. That determination enables the generic drug to be automatically substituted at the pharmacy counter for the brand-name product. This in turn allows lower priced generics to quickly take market share f ..read more
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Multi-year Medicare physician fee freeze threatens access: Pair relief with reforms
USC-Brookings Schaeffer on Health Policy
by Paul Ginsburg, Steven M. Lieberman
3M ago
By Paul Ginsburg, Steven M. Lieberman Medicare pays for physician services on the basis of a fee schedule.  For many years now, payment rates have not been updated for general inflation. This has left Medicare payment policy vulnerable to the sharp increases in general inflation that are now being experienced.  Physicians have already experienced and are likely to continue to face large and permanent declines in inflation-adjusted payment rates in the absence of legislative relief. These sharp current law reductions in effective payment rates could have several undesirable consequenc ..read more
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Tweaking the Marketplace enrollment process could magnify effects of larger premium tax credits
USC-Brookings Schaeffer on Health Policy
by Matthew Fiedler, Adrianna McIntyre
5M ago
By Matthew Fiedler, Adrianna McIntyre The Inflation Reduction Act included a three-year extension of enhancements to the premium tax credit that were originally enacted in 2021. These enhancements reduced the cost of Marketplace coverage by making the tax credit more generous for people who were already eligible and by extending it to people with incomes that were previously too high to qualify. Consistent with model-based projections that lower premiums would increase coverage, Marketplace enrollment is now around 3 million people (29%) above its 2019 level, which has helped push the national ..read more
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Profits, medical loss ratios, and the ownership structure of Medicare Advantage plans
USC-Brookings Schaeffer on Health Policy
by Richard G. Frank, Conrad Milhaupt
7M ago
By Richard G. Frank, Conrad Milhaupt Introduction There is a great deal of controversy and uncertainty regarding profits in the Medicare Advantage (MA) program. Interest in these issues is growing as the share of beneficiaries grows. The Medicare Payment Advisory Commission, or MedPAC, recently reported that MA enrollment grew 10% from July 2020 to July 2021. This means MA accounted for 46% of all Medicare beneficiaries in 2021, with payments to MA plans totaling $350 billion. A recent visible exchange of facts and interpretations of some data by Berwick and Gilfillan, Halvorson,  Crane ..read more
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To prevent public health crises, we need to update the essential medical product list
USC-Brookings Schaeffer on Health Policy
by Marta E. Wosińska, Richard G. Frank
8M ago
By Marta E. Wosińska, Richard G. Frank The COVID pandemic has disrupted supply chains across the economy. Disruptions have been particularly acute in the health sphere, with COVID tests, vaccines, and treatments in short supply at various points in the pandemic.  But as the baby formula crisis has reminded us, shortages of critical products impacting health are not just tied to pandemics. In this case, the shortage was caused by a shutdown of a key manufacturing facility, following evidence of bacterial contamination in products made at the facility. This facility produced a large share o ..read more
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FDA user fee reauthorization: Contextualizing the VALID Act
USC-Brookings Schaeffer on Health Policy
by Rachel Sachs
8M ago
By Rachel Sachs On Wednesday, June 15, the Senate Committee on Health, Education, Labor and Pensions advanced its version of the must-pass Food and Drug Administration (FDA) user fee reauthorization bill. Previously, I had reviewed several key similarities and differences between the Senate and House bills, with a focus on their impact on reforms to the prescription drug approval process. In this article, I delve deeper into an important aspect of the Senate bill which is not yet present in the House’s version: the Verifying Accurate Leading-edge IVCT Development (VALI ..read more
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5 things to understand about pharmaceutical R&D
USC-Brookings Schaeffer on Health Policy
by Richard G. Frank, Kathleen Hannick
8M ago
By Richard G. Frank, Kathleen Hannick At the heart of the policy debate aimed at controlling the price of prescription drugs is a concern that pricing policies, which would reduce revenues for brand name prescription drugs, would result in fewer “new cures.” The logic underlying this concern is as follows: higher prices equate to higher returns to investors that then bring more capital into drug development, which is the lifeblood of innovation. Therefore, the logic goes, reducing prices will reduce returns, which will reduce the capital invested, thus slowing innovation. More colorful version ..read more
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Tackling unfinished business and taking on current challenges: Putting Biden’s mental health proposals in context
USC-Brookings Schaeffer on Health Policy
by Richard G. Frank, Vikki Wachino, Karina Aguilar
10M ago
By Richard G. Frank, Vikki Wachino, Karina Aguilar President Biden’s State of the Union address brought renewed urgency to the challenges of treating and supporting people with mental illnesses in the U.S. His proposals respond to escalating rates of mental illness in the U.S., address several vexing long-term issues in mental health care, and deal with some contemporary dimensions of mental illnesses. The basis for the mental health policy proposals offered in the State of the Union Address are grounded in a set of core values that started with President Kennedy and were extended by President ..read more
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What does economy-wide inflation mean for the prices of health care services (and vice versa)?
USC-Brookings Schaeffer on Health Policy
by Matthew Fiedler
11M ago
By Matthew Fiedler Consumer prices rose 6.1% over the twelve-month period ending in January 2022, driven by particularly rapid growth in goods prices. In parallel, wage growth has picked up too, with labor costs up 4.0% over the twelve months ending in December 2021. Higher prices for goods and labor translate into higher input costs in the service sector, so it is natural to expect the prices of services to rise in response. Indeed, service sector inflation rose meaningfully over the course of 2021 and is now well above pre-pandemic rates. Thus far, however, health care services are an except ..read more
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Building a sustainable behavioral health crisis continuum
USC-Brookings Schaeffer on Health Policy
by Richard Frank, Vikki Wachino
1y ago
By Richard Frank, Vikki Wachino Too often, the systems that respond to people who are experiencing a behavioral health crisis result in a range of poor health outcomes, including mortality. They also involve people with the criminal justice system unnecessarily. Historically, behavioral health crises, which are emergencies that face people with mental health or substance use issues, have been responded to in a fragmented manner, with default reliance on law enforcement, hospitals, and jails. Available data on the impact of these response systems on people with mental health conditions and peop ..read more
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