Author Interviews, Cost of Health Care, Diabetes / 01.06.2020

MedicalResearch.com Interview with: Amir Meiri, MD MPH Atrius Health/Department of Population Medicine (DPM) | Delivery System Science Fellow HMS and HPHCI, DPM | General Internal Medicine Fellow Atrius Health Kenmore | Urgent Care Physician VA Boston Healthcare | Attending in Internal Medicine and Emergency Medicine MedicalResearch.com: What is the background for this study? Response: There has been significant media reporting about rising insulin prices and the health impacts of those exorbitant prices. However, it was not clear how these insulin prices may impact out-of-pocket costs among commercially insured patients; though it is clear that those without insurance are affected per previous media reports. Our study examines the difference between insulin manufacturer-set prices and what patients actually pay, the out-of-pocket cost, in the context of the type of insurance patients have. (more…)
Author Interviews, Cost of Health Care, JAMA / 19.05.2020

MedicalResearch.com Interview with: James D. Chambers, PhD, MPharm, MSc Associate Professor of Medicine Tufts Medical Center Institute for Clinical Research and Health Policy Studies MedicalResearch.com: What is the background for this study? Response: We know that biosimilars have not had the same uptake in the US as they have had elsewhere. We know that this is in part due to reference product manufacturer tactics to delay biosimilar market entry and patent disputes. In this study we examined whether lack of preferred coverage by commercial health insurers may also play a role. (more…)
Author Interviews, Cost of Health Care / 10.03.2020

MedicalResearch.com Interview with: Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy London School of Economics and Political Science London MedicalResearch.com: What is the background for this study? Response: Although both Democrats and Republicans consider lowering prescription drug prices a priority, lobbyists and campaign donors in the pharmaceutical industry may counteract efforts by federal and state governments to decrease these costs. In this study, I tracked every dollar spent by the pharmaceutical and health product industry on lobbying and campaign contributions in the US from 1999 to 2018. These data were obtained from the Center for Responsive Politics and the National Institute on Money in Politics—two non-profit, non-partisan US organizations. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 04.03.2020

MedicalResearch.com Interview with: Olivier Wouters, Ph.D. Assistant Professor of Health Policy Department of Health Policy (COW 2.06) London School of Economics and Political Science MedicalResearch.com: What is the background for this study? What are the main findings? Response: Drug companies often point to high research and development costs as justification for the rising prices of new medicines. Yet most prior analyses of research and development costs have been based on confidential data voluntarily supplied by drug companies to researchers with financial ties to the industry. Independent teams have not been able to verify those findings. (more…)
Author Interviews, Cost of Health Care, JAMA, University of Pittsburgh / 04.03.2020

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy MedicalResearch.com: What is the background for this study? Response: Prior research found that list prices of drugs more than doubled in the last decade. However, because prior research was based on list prices, it did not account for manufacturer discounts, which have also increased in the past few years. We leveraged net pricing data from the investment firm SSR health to estimate increases in drug prices after accounting for discounts. (more…)
Author Interviews, Cost of Health Care, Emergency Care / 22.02.2020

MedicalResearch.com Interview with: Collin Tebo BA Georgetown University School of Medicine Washington, DC Collin Tebo BA Georgetown University School of Medicine Washington, DC MedicalResearch.com: What is the background for this study? Response: The growing cost of pharmaceuticals is an issue of increasing concern in the United States where a large portion of the nation’s Gross Domestic Product is health care spending. During the past decade, visits to Emergency Departments (EDs) have increased considerably. Pharmaceutical drugs are utilized in the care of most patients who visit the ED therefore, rising drug prices are a concern for emergency medicine physicians, administrators, and patients throughout the US. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Dermatology, JAMA, Rheumatology / 09.11.2019

MedicalResearch.com Interview with: Emily S. Ruiz, MD, MPH Director, High-Risk Skin Cancer Clinic, Dana Farber/Brigham and Women’s Cancer Center Assistant Professor, Harvard Medical School, Dermatology Brigham And Women's Faulkner Hospital MedicalResearch.com: What is the background for this study? Response: Innovation in oncology has led to increased development and market entry of anticancer drugs. For example, from 2009 to 2013, the US FDA approved 51 oral and systemic anticancer drugs for 63 indications. Prices for anticancer drugs have risen faster than inflation over time, especially for older drugs, and prices in the US have largely been set by market forces rather than novelty or efficacy. Understanding the evolving cancer economic landscape requires consideration of annual and cumulative rates of change for key metrics, such as total spending, drug cost per beneficiary, out-of-pocket cost, and utilization. This study sought to weigh the proportional impacts of rising drug costs and utilization on increased Medicare Part D spending for a cohort of oral anticancer drug utilized from 2013-2017. (more…)
Author Interviews, Cost of Health Care, JAMA / 01.11.2019

MedicalResearch.com Interview with: Rena M. Conti, PhD, Associate Professor Department of Markets, Public Policy and Law Questrom School of Business Boston University Boston, MA 02215 Co-Authors: Sayeh S. Nikpay, PhD Melinda B. Buntin, PhD Vanderbilt University School of Medicine MedicalResearch.com: What is the background for this study? Response: The federal 340B program provides deep discounts on the acquisition cost of prescription drugs for participating hospitals and places no limits on what hospitals charge patients and insurers. Congress intended 340B profits generated from hospital participation to subsidize the provision of safety net care for patients residing in the community. This study is the first to estimate the size of profits hospitals participating in the 340B drug discount program collect from Medicare patients for the outpatient clinic administration of prescription drugs. (more…)
Amgen, Author Interviews, Cost of Health Care, JAMA, Lipids, UCLA / 24.06.2019

MedicalResearch.com Interview with: Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA MedicalResearch.com: What is the background for this study? Response: Last year, Amgen made the PCSK-9 inhibitor evolocumab available at a reduced list price of $5,850 per year This 60% reduction was aimed at improving patient access by lowering patient copays, especially for Medicare beneficiaries. Additionally, the treatment landscape for PCSK9 inhibitors was further defined in 2018 when the American College of Cardiology/American Heart Association Multisociety Clinical Guideline on the Management of Blood Cholesterol recommended PCSK9 inhibitors for, among other patient populations, patients with very high-risk (VHR) ASCVD whose low-density lipoprotein cholesterol levels remain at 70 mg/dL or more despite a heart-healthy lifestyle and treatment with standard background therapy. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmacology / 21.02.2019

MedicalResearch.com Interview with: Jennifer N. Goldstein, MD, MSc Assistant program Director of Internal Medicine Christiana Care Health System Newark, Delaware MedicalResearch.com: What is the background for this study? Response: Human synthetic insulins have been available over-the-counter for nearly a century, and at relatively low cost for around a decade under a Walmart brand name. However, little is known about the frequency of sale of over-the-counter insulin or the reasons why patients use it. While prescription insulins (insulin analogues) are considered by many to be easier to use and more predictable than the over-the-counter versions, the cost of these insulins has skyrocketed. Our study examined the frequency of sale of over-the-counter insulins and whether patients potentially use over-the-counter insulin as a substitute for expensive prescription insulins. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmacology, University of Pittsburgh / 19.02.2019

MedicalResearch.com Interview with: Alvaro San-Juan-Rodriguez, PharmD Pharmacoeconomics, Outcomes and Pharmacoanalytics Research Fellow Pharmacy and Therapeutics School of Pharmacy University of Pittsburgh MedicalResearch.com: What is the background for this study? Response: Before 2009, etanercept (Enbrel®), infliximab (Remicade®), and adalimumab (Humira®) were the only tumor necrosis factor (TNF) inhibitors approved by the FDA for rheumatoid arthritis. Subsequently, 3 therapies gained FDA approval: subcutaneous golimumab (Simponi®) in April 2009, certolizumab pegol (Cimzia®) in May 2009, and intravenous golimumab (Simponi Aria®) in July 2013. All 6 agents are brand-name drugs. Our study aimed to evaluate how the prices of existing TNF inhibitors (Enbrel®, Remicade® and Humira®) changed in response to the market entry of new TNF inhibitors. (more…)
Author Interviews, Cancer Research, Cost of Health Care, JAMA / 08.01.2019

MedicalResearch.com Interview with: Kiu Tay-Teo, PhD World Health Organization Geneva, Switzerland MedicalResearch.com: What are the main findings? Response: High costs and high risks of R&D for drugs have been presented to justify high drug prices, especially for cancer drugs. However, it is unclear whether prices are in fact justifiable compared to the overall return on R&D investment. In this paper, we systematically compared incomes from the sales of cancer drugs with the R&D costs. We quantified the incomes generated from the sales of 99 cancer drugs approved by FDA from 1989–2017. This was based on sales figures reported in the originator companies’ annual financial reports, and where necessary, estimates deduced from the reported figures. The sales incomes were net of rebates and discounts, but without accounting for expenses and taxes. For the R&D costs of bringing one new cancer drug to the market, the literature reported a typical costs of between $219 million and $2.9 billion, after accounting for the costs of failed products that were investigated but not marketed and the opportunity costs. For the main analysis, we used a median cost of $794 million, as reported in the literature. To be clear, this analysis did not estimate profit return because we do not have information about the costs and year-to-year variations in costs (i.e. expenses and taxes) specific to cancer drugs. (more…)
Author Interviews, Cost of Health Care, University of Pittsburgh / 08.01.2019

MedicalResearch.com Interview with: Inmaculada Hernandez, PharmD, PhD Assistant Professor of Pharmacy and Therapeutics University of Pittsburgh School of Pharmacy MedicalResearch.com: What is the background for this study? What are the main findings? Response: The objective of our study was to answer a research question of high policy relevance: to what extent are rising drug costs due to inflation in the prices of existing products versus the market entry of new, more expensive drugs. We found that rising prices of brand-name drugs are largely driven by manufacturers increasing prices of medications that are already in the market rather than to the entry of new products. In contrast, increases in costs of specialty and generic drugs were driven by the entry of new drugs. (more…)
Author Interviews, Cost of Health Care, JAMA, Pharmaceutical Companies / 26.09.2018

MedicalResearch.com Interview with: Thomas J Moore AB Senior Scientist Institute for Safe Medication Practices Lecturer, Department of Epidemiology and Biostatistics The George Washington University Milken Institute of Public Health Alexandria, VA 22314 MedicalResearch.com: What is the background for this study? What are the main findings?
  • The study provides realistic cost estimates of pivotal clinical trials that establish drug benefits to support FDA approval of 59 new drugs released for marketing in 2015-2016.
  • The median estimated cost was just $19 million, with half of the 138 trials studied clustered between $12 million and $33 million.
  • The highest cost trials–with estimates up to $345 million–were for new drugs that were similar to drugs already available and already proven in treating serious illnesses.
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Author Interviews, Cancer Research, Cost of Health Care, JAMA, Pharmacology / 12.10.2016

MedicalResearch.com Interview with: Dr. Sham Mailankody, MBBS Memorial Sloan Kettering Cancer Center MedicalResearch.com: What is the background for this study? Response: The high price of older drugs has been increasingly criticized in part because of recent dramatic price hikes. There are some well known examples like pyrimethamine and more recently EpiPen. Whether and to what degree examples like pyrimethamine represent a common problem or exceptional cases remains unknown. Using Medicare data available for Part B, we sought to analyze the change in average sales price of cancer drugs between January 2010 and January 2015, and whether older drugs were more likely to undergo price increases than newer drugs. (more…)
Author Interviews, Cost of Health Care, Pharmacology / 04.10.2016

MedicalResearch.com Interview with: Kevin Bowen MD MBA Senior Health Outcomes Researcher Prime Therapeutics LLC 1305 Corporate Center Drive Eagan, MN 55121 MedicalResearch.com: What is the background for this study? What are the main findings? • Autoimmune specialty drugs now account for about one of every 10 dollars of combined drug expense through the medical and pharmacy benefits in a commercially insured population. • The autoimmune drug class is one of the fastest growing, with this study finding a doubling in autoimmune drug expenditures and a 38 percent increase in utilization, in the most recent four years. • Integrated analysis of medical and pharmacy claims is essential for this category of drugs because more than 25 percent of autoimmune specialty drug use is paid through the medical benefit and medical claims diagnosis coding provides a means of determining what conditions were treated with drugs covered by pharmacy claims. (more…)