Unbiased Analysis of Today's Healthcare Issues
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Did President Biden backtrack on his pledge for increased public access to Medicare data?

The Biden Administration promised more access to Medicare data. Then the reverse happened. ProPublica explains: In January, the Biden administration pledged to increase public access to a wide array of Medicare information to improve health care for America’s most sick and vulnerable. Some Medicare plans’ lack of transparency “deprives researchers...

Wed Feb 21, 2024 02:01
How will Medicaid pay for cell and gene therapies?

One approach CMS has is the Cell and Gene Therapy (CGT) Access Model. Under the CGT Access Model, CMS (at the federal level) will negotiates outcomes based agreements (OBAs) with manufacturers, which will include pricing terms and outcomes to be evaluated. Then states can elect to participate in the contract terms negotiated by CMS or they can opt...

Tue Feb 20, 2024 08:33
Friday Links

Impact of the Great Recession on health.A loneliness epidemic?Medicaid’s increasing pressure on state budgets.Physician reimbursement to decline 3.4%.Are children spending too much time on enrichment activities?

Fri Feb 16, 2024 16:41
Why Does the United States Pay, by Far, the Highest Prices in the World for Prescription Drugs?

That is the topic of a U.S. Senate hearing last week. One person testifying was an economist, USC Professor Darius Lakdawalla. While his full testimony is here, his key points of contention are worth reading. These include: The challenge for public policy is to sustain the pace of medical innovation while ensuring that valuable new technologies...

Fri Feb 16, 2024 09:34
Utilization management for biosimilars

When we think of utilization management (e.g., prior authorizations, step edits), we often think payers only use these for higher cost branded products including biologics. Generic drugs should have low cost sharing and limited utilization management. One question, however, is whether payers’ utilization management practices for biosimilars mirror...

Thu Feb 15, 2024 01:23
How do HEOR studies handle missing data?

That is the questioned answered in a paper by Mukherjee et al. (2023). The authors define an “HEOR study” for this paper as …real-world evidence studies that conducted a secondary/post-hoc analysis using randomized controlled trial (RCT) data, and a within-trial cost-utility analysis in which the outcome of interest was costs or PROs including...

Tue Feb 13, 2024 03:19

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