Consumers Could Be On Hook For More Health Costs Under Trump Proposal To Incentivize Generic Drugs
The proposal would allow insurers to only credit the cost of a generic drug -- if one exists -- toward the annual limit for cost-sharing. So if a consumer filled a prescription with a $25 brandname drug, but there was a generic on the market that cost $5, the consumer might get credit for only $5 in out-of-pocket spending.
The New York Times:
Trump Proposals Could Increase Health Costs For Consumers
Consumers who use expensive brand-name prescription drugs when cheaper alternatives are available could face higher costs under a new policy being proposed by the Trump administration. The proposal, to be published this week in the Federal Register, would apply to health insurance plans sold under the Affordable Care Act. Health plans have annual limits on consumers’ out-of-pocket costs. Under the proposal, insurers would not have to count the full amount of a consumer’s co-payment for a brand-name drug toward the annual limit on cost-sharing. Insurers would have to count only the smaller amount that would be charged for a generic version of the drug. (Pear, 1/21)
In other national health care news —
The New York Times:
For Trump Administration, It Has Been Hard To Follow The Rules On Rules
Ever since President Trump took office, his appointees have directed federal agencies to draft regulations meant to delay or reverse policies of the Obama administration. Nearly all the proposals have been tripped up by the same arcane 1946 law governing administrative policies. Just last week, two signature administration actions — to add a question about citizenship status to the 2020 census, and to allow employers to avoid covering birth control for their workers if they object to it — have been stymied by rulings under the law. (Sanger-Katz, 1/22)
The New York Times:
Shutdown’s Pain Cuts Deep For The Homeless And Other Vulnerable Americans
Ramona Wormley-Mitsis got welcome news in December: After years of waiting, the federal government had approved a subsidy that allowed her to rent a three-bedroom house, bracketed by a white picket fence to keep her two autistic sons from bolting into traffic. A few days later, the dream was deferred. The Department of Housing and Urban Development — one of the federal agencies hit hardest by the shutdown — would not be able to pay her new landlord until the government reopened. (Thrush, 1/21)
Reuters:
CVS, Walmart Resolve Pharmacy Contract Impasse
Walmart Inc, the world's largest retailer, will remain part of CVS Health Corp's network for commercial and Medicaid pharmacy customers, the companies said on Friday, breaking a contract impasse disclosed earlier this week. The companies did not provide financial terms of the new contract.
The New York Times:
Study Links Drug Maker Gifts For Doctors To More Overdose Deaths
A new study offers some of the strongest evidence yet of the connection between the marketing of opioids to doctors and the nation’s addiction epidemic. It found that counties where opioid manufacturers offered a large number of gifts and payments to doctors had more overdose deaths involving the drugs than counties where direct-to-physician marketing was less aggressive. The study, published Friday in JAMA Network Open, said the industry spent about $40 million promoting opioid medications to nearly 68,000 doctors from 2013 through 2015, including by paying for meals, trips and consulting fees. (Goodnough, 1/18)
Politico:
‘I’m Trying Not To Die Right Now’: Why Opioid-Addicted Patients Are Still Searching For Help
The Trump administration, Congress and states are pouring billions of dollars into addiction treatment to fight the opioid crisis, but accountability for the burgeoning industry hasn’t kept pace with those efforts — leaving patients vulnerable to ineffective care, fraud and abuse. Interviews with patients in recovery and nearly two dozen advocates, officials and public health and addiction experts in and out of government reveal a fragmented addiction care industry, with a patchwork of state regulations and spotty oversight. (Ehley and Roubein, 1/20)