News from Thursday, November 7, 2024
Articles
What Happens to Medicare Price Negotiations Under Trump?
(11/7, Shannon Firth, MedPage Today) reports “...‘Our research suggests the IRA may delay the launch of new medicines, reduce the number of subsequent indications approved, and limit post-approval research used to establish treatment guidelines, while encouraging insurance plans to limit access,’ [NPC president and CEO John O'Brien, PharmD, MPH] told MedPage Today. Moreover, it's NPC's job to produce high-quality evidence to help the next administration understand the laws' ‘unintended consequences’ and to ‘protect patient access to innovation,’ he said.” Full
Fate Of IRA Negotiations Uncertain After Trump Election Victory
(11/6, Gabrielle Wanneh, InsideHealthPolicy) reports “...Trump has spoken out against other aspects of the IRA, such as the climate change provisions, but has not stated whether he supports rescinding the law’s drug price negotiation provision, even though that is what the vast majority of his party in Congress wants to do. He also hasn’t vocalized whether he will rescind the IRA’s cost-capping policies, the inflation rebate policy or the Part D redesign.” Subscription Required
With Trump's Return, Pharma Trades Disagreeable Knowns For Uncertainty
(11/6, Jessica Merrill, Pink Sheet) reports “...When Trump was president from 2017-2021, drug prices were a policy priority. Among the many ideas the administration considered were rebate reform and calculating Medicare drug reimbursement based on an index of lower prices paid by European countries, Japan and Canada. Industry scorned the proposal known as the ‘most favored nation’ approach. How Trump will address drug pricing or the changes to the Medicare drug negotiation program remains unclear, but the topic could remain a hot button issue for pharma.” Subscription Required
The Critical Role of Patient Engagement in Patient-Centered Outcomes Research and Health Technology Assessment of Rare Disease Treatments
(11/7, YuanYuan Michelle Cheng, The American Journal of Managed Care) comments “...Early and continuous patient engagement is not just a beneficial addition to HTA, it is a necessity. Engaging patients ensures the identification and capture of outcomes that truly matter to those affected, leading to more comprehensive assessments of treatment value. While progress has been made, more work remains to be done. By prioritizing patient-centered input—especially for rare diseases, which present unique challenges for HTA—researchers can ensure that HTA frameworks evolve to deliver more inclusive and effective health care solutions.” Full
California Voters Say Yes to Restrictions Around 340B Spending
(11/6, Nicole DeFeudis, Endpoints News) reports “...According to unofficial results, 51.5% of voters said yes to the measure, which calls for rules that limit how certain entities can spend revenue from the program...‘Unfortunately, some safety net health care providers have manipulated the program to receive enormous markups on the discounted prescription drugs they receive and then stick taxpayers with the added cost,’ the proposition states.” Full
Opportunities To Enhance Design And Implementation Of ACO REACH’s Core Payment Model Design Elements
(11/7, Rachel Bonesteel, Sara Debab, William K. Bleser, Frank McStay, Robert S. Saunders and Mark B. McClellan, Health Affairs Forefront) comments “...CMS recently announced changes for PY2024 in response to stakeholder experiences to improve the program. To augment these changes and the limited existing evidence, we present timely guidance and recommendations for CMS on the design and implementation of REACH, informed by literature review and conversations with REACH participants and other expert stakeholders about successes, challenges, and opportunities for improvement. This piece focuses on recommendations to improve REACH’s core payment model design components specifically, and an upcoming piece will then address REACH’s equity-focused components.” Full
Press Releases
Study Finds ICER’s Shared Saving Methods Reduce Incentives for Rare, Severe, and Pediatric Disease Treatment Innovation
(11/7, National Pharmaceutical Council Press Release) “A new study published in Value in Health assessed the potential impact of the shared savings methods developed by the Institute for Clinical and Economic Research on the value of a hypothetical cure for various diseases, finding that rare, severe, and pediatric diseases face the highest level of ‘value-based price’ reduction...‘ICER's shared savings approach risks stifling innovation for our most vulnerable patients. By disproportionately impacting treatments for rare, severe, and pediatric diseases, we are potentially limiting the very cures that society values most. We must ensure that health economics frameworks prioritize and reward advances in these critical areas,’ said Jon Campbell, NPC Chief Science Officer.” Full
ISPOR Releases Emerging Good Practices Guidance on Quantifying Specialized Knowledge in Healthcare
(11/6, ISPOR Press Release) “ISPOR—The Professional Society for Health Economics and Outcomes Research announced today the publication of an ISPOR Good Practices Report that identifies existing structured expert elicitation protocols that can support healthcare decision making and provides important insights on how to choose which protocols may be the most appropriate for different scenarios, such as time-constrained decisions, early-stage technology assessments, and public health policies. The report, ‘Recommendations on the Use of Structured Expert Elicitation Protocols for Healthcare Decision Making: A Good Practices Report of an ISPOR Task Force,’ was published in the November 2024 issue of Value in Health.” Full
Journals
Will the Institute for Clinical and Economic Review’s Shared Savings Approach Decrease Value-Based Prices Most for the Most Severe Diseases?
Jason Shafrin, PhD, et al.
September 30, 2024, Value in Health
Recommendations on the Use of Structured Expert Elicitation Protocols for Healthcare Decision Making: A Good Practices Report of an ISPOR Task Force
Marta Soares, PhD, et al.
November 2024, Value in Health
Primary Care Practice Telehealth Use and Low-Value Care Services
Terrence Liu, MD, MS; Ziwei Zhu, MS; Michael P. Thompson, PhD, MPH; et al
November 7, 2024, JAMA Network Open