Recent months have seen a flood of stories about drug prices, from Martin Shkreli’s dramatic price hikes on generic drugs to Sovaldi's eye-watering introductory price. But woven within these stories are different storylines, each with its own set of complications and policy solutions. Here we present five distinct drug pricing storylines.
December 8, 2016 [This blog originally appeared on the PolicyLab at Children’s Hospital of Philadelphia blog. View the original blog post here]
Nearly half the patients I see are covered by Medicaid or the Children’s Health Insurance Program (CHIP), both of which have comprehensive sets of benefits and are historically thought of as safety nets for the unemployed. However, you might be surprised to learn that the fastest growing users of these public health insurance programs for their children are employed and unable to afford or receive health insurance for their children through their employer health plans.
In a recent paper, Mark Pauly and Vivek Nimgaonkar take a 20-year look at the relationship between growth in the share of the workforce in medical care and changes in the unemployment rate, and offsetting effects on jobs in other sectors such as education or public services. They find that when economy-wide unemployment is high, growth in medical employment reduces the unemployment rate significantly, without crowding out jobs in other services or government. When the share of medical jobs grow, so does the rest of the services sector. When the unemployment rate is low, however, growth in medical sector jobs does not reduce unemployment. It draws jobs away from other industries, but does not draw disproportionately from education or public services.
The election of Donald Trump has ushered in an uncertain future for the Affordable Care Act (ACA), from modification to total repeal. While many policy experts are concerned about people losing the coverage they gained through the ACA, other aspects of the ACA are also under threat: specifically, provisions that address the social determinants of health.
At a recent campus-wide opioid task force at Penn, one noted researcher and clinician pointed out a painful truth: “We know how to treat addiction; it’s the systems that aren’t responding to the need.”Last week, the nation took two important steps to helping our systems respond to this public health crisis: the first-ever Surgeon General's Report on Alcohol, Drugs, and Health, and an announcement that allows physician assistants (PAs) and nurse practitioners (NPs) to prescribe medication-assisted treatment.
[This blog originally appeared on the PolicyLab at Children’s Hospital of Philadelphia blog. View the original blog post here]
The presidential election evoked strong reactions from all sides, but regardless of where you landed, one thing we can all agree on is that a seismic shift occurred on election day. That said, we cannot allow the election and its potential repercussions for the health care system to move our focus away from protecting programs and policies that affect children’s health and welfare.
In two recent JAMA Viewpoints, Amol Navathe and colleagues point to the potential of social comparisons to motivate physicians to improve the care they provide. Fulfilling this potential, however, will take careful attention to how these comparisons are designed and delivered.
Americans visit a public library over one and a half billion times each year. In contrast, Americans visit a physician's office just over 928 million times annually. What if library visits could be leveraged as opportunities to promote health? In Health Affairs, colleagues and I analyze the ways in which the Free Library of Philadelphia already promotes better health, and suggest what more it could do.
Emerging value-based policies are no doubt well-intentioned efforts to achieve better outcomes at lower costs. However, missing from many initiatives seems to be clear recognition about whose value ought to be prioritized -- that of individual patients or society overall.
Medicare Part D beneficiaries can face as much as 33% coinsurance for some drugs listed in a “specialty tier,” which can result in thousands of dollars in out-of-pocket costs. The concern, of course, is that this level of cost-sharing creates a barrier that may put patients at risk for poor outcomes because they cannot afford the drugs they need. Jalpa Doshi and colleagues have looked at this issue in three studies of patients with very different conditions, and found that cost sharing was associated with reduced or delayed initiation of a drug, low adherence to a prescribed drug regimen, or interruptions in treatments. We’ve put this evidence together in a handy one-pager.
A new multidisciplinary consortium of more than 20 experts and stakeholders has come together at Penn to address the promise and challenges of precision cancer medicine. Through multiple conference calls culminating in a conference in May 2017, the group will tackle the hard questions that precision medicine raises for patients, providers, and payers. This is the first in a series of posts on the consortium’s work.