Saturday December 7, 2019

Trump’s Chief Heath Officials Urges Congress to Pass Prescription Drug Discount Plan

Consumers are worried about prices for brand-name drugs, particularly new medications that promise breakthrough results.

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In this Oct. 26, 2018, file photo Health and Human Services Secretary Alex Azar speaks about proposed reforms to Medicare Part B drug pricing policies at the Brookings Institute in Washington. VOA

The Trump administration’s top health official asked Congress on Friday to pass its new prescription drug discount plan and provide it to all patients, not just those covered by government programs like Medicare.

The plan would take now-hidden rebates among industry players like drug companies and insurers and channel them directly to consumers when they go to pay for their medications.

Patients with high drug copays stand to benefit from the proposal, while people who take no prescription drugs, or who rely on generics mainly, would probably pay somewhat more, since premiums are expected to rise.

A day after unveiling the plan as a proposed regulation, Health and Human Services Secretary Alex Azar raised the stakes by calling on Congress to make it law and broaden it to include people covered by employer health insurance, not just Medicare and Medicaid beneficiaries.

“Congress has an opportunity to follow through on their calls for transparency … by passing our proposal into law immediately and extending it into the commercial drug market,” Azar said in a speech at the Bipartisan Policy Center think tank.

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U.S. President Donald Trump leads a discussion on immigration proposals with conservative leaders in the Cabinet Room of the White House in Washington, Jan. 23, 2019. VOA

Trump under pressure

Ahead of next week’s State of the Union speech, President Donald Trump is under political pressure to show results for his promise to slash prescription drug costs. Data show that prices for brand-name drugs have continued to rise, though at a somewhat slower pace. Polls show consumers across the political spectrum want government action.

Democrats say the administration’s plan doesn’t go far enough because it still leaves drug companies free to set high list prices. They say drug pricing is like a black box, and it’s impossible to tell if prices reflect actual costs or if companies are charging what they think the market will bear.

House Speaker Nancy Pelosi, D-Calif., says she’s also worried that the plan would raise premiums. HHS acknowledges Medicare prescription premiums would go up $3 to $5 a month.

Proposal draws interest

Nonetheless, the administration’s proposal appears to be in the mix as Congress gears up to craft legislation addressing prescription drug costs. Friday evening, the Republican chairman of the Senate Health, Education, Labor and Pensions Committee, expressed his support. Rebates “ought to lower costs to patients, and this is a good first step towards that goal,” Sen. Lamar Alexander, R-Tenn., said in a statement.

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Speaker of the House Nancy Pelosi talks to reporters during a news conference at the Capitol in Washington, Jan. 31, 2019. VOA

The complex plan would work by doing away with an exemption from federal anti-kickback rules that currently allows drugmakers, insurers and middlemen called pharmacy benefit managers to negotiate rebates among themselves.

Drug companies pay rebates to make sure their medications are covered by insurance plans that are the intermediaries between them and patients. HHS says hidden rebates can amount to up to 30 percent of a drug’s list price. Insurers say they use the money from rebates to hold down premiums for all consumers.

Under the plan, the current anti-kickback exemption for industry rebates would be replaced with a new one for discounts offered directly to consumers.

Azar said the idea would reshape the drug pricing system, shifting it away from hidden rebates to upfront discounts, creating pressure on drugmakers to keep prices down. The proposal was co-authored with the HHS inspector general’s office.

Potential consequences

Experts say it will take time to sort out all the potential consequences.

Peter Bach, director of the Center for Health Policy and Outcomes at New York’s Memorial Sloan Kettering Cancer Center, said the current system of rebates harms patients who take costly drugs with high copays.

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A mural honoring the late Prince adorns a building in the Uptown area of Minneapolis, Aug 28, 2016. The rock star died of an overdose at the age of 57. VOA

Think people with cancer, patients with intractable illnesses such as multiple sclerosis or rheumatoid arthritis, and those who take brand-name medicines with no generic competition. Patients’ cost sharing is often based on list prices, not the cost of the drug after rebates.

“Simply put, those on no medications at all will just see their premiums go up and see no savings because they don’t take any medicine,” said Bach. “Those on generics only may be essentially in this category (as well).

“But those on expensive medications … they will see savings in total,” he added. More than half a million people filled at least $50,000 in prescriptions in 2014, according to an Express Scripts report.

Insurers and pharmacy benefit managers like Express Scripts and CVS oppose the administration plan, saying it will undercut their ability to bargain with drugmakers for lower prices.

Companies please with plan

Drugmakers have applauded the administration’s action.

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Consumers are worried about prices for brand-name drugs, particularly new medications that promise breakthrough results. Generics account for nearly 90 percent of prescriptions filled, but brand-name drugs account for more than 70 percent of the spending.

Azar contends that under the current system everybody but the patient benefits from high prices. A high list price makes room for bigger negotiated rebates for insurers and middlemen. And drugmakers then merely build that expectation into their prices.

Before joining the Trump administration, Azar was a top executive for drugmaker Eli Lilly. That led to criticism that he would be an industry pawn. But the drugmakers vehemently disagree with some of his other ideas, including an experiment using lower international drug prices to cut some Medicare costs. (VOA)

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Reduction in Air Pollution May Increase Life-Expectancy: Study

Findings of a Research indicate almost immediate and substantial effects on health outcomes followed reduced exposure to air pollution

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Fortunately, reducing air Pollution can result in prompt and substantial health gains. Pixabay

Reductions in Air Pollution yielded fast and dramatic impacts on health-outcomes, as well as decreases in all-cause morbidity, a new study suggests.

The study, published in the journal Annals of the American Thoracic Society, reviewed interventions that have reduced air pollution at its source. It looked for outcomes and time to achieve those outcomes in several settings, finding that the improvements in health were striking.

Starting at week one of a ban on smoking in Ireland, for example, there was a 13 per cent drop in all-cause mortality, a 26 per cent reduction in ischemic heart disease, a 32 per cent reduction in stroke, and a 38 per cent reduction in chronic obstructive pulmonary disease (COPD). Interestingly, the greatest benefits in that case occurred among non-smokers.

“We knew there were benefits from pollution control, but the magnitude and relatively short time duration to accomplish them were impressive,” said lead author Dean Schraufnagel from the American Thoracic Society in the US.

“Our findings indicate almost immediate and substantial effects on health outcomes followed reduced exposure to air pollution. It’s critical that governments adopt and enforce WHO guidelines for air pollution immediately,” Schraufnagel added.

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Reductions in Air Pollution yielded fast and dramatic impacts on health-outcomes, as well as decreases in all-cause morbidity, a new study suggests. Pixabay

According to the researchers, In the US a 13-month closure of a steel mill in Utah resulted in reducing hospitalisations for pneumonia, pleurisy, bronchitis and asthma by half.

School absenteeism decreased by 40 per cent, and daily mortality fell by 16 per cent for every 100 µg/m3 PM10 (a pollutant) decrease.

Women who were pregnant during the mill closing were less likely to have premature births.

A 17-day ‘transportation strategy,’ in Atlanta, Georgia during the 1996 Olympic Games involved closing parts of the city to help athletes make it to their events on time, but also greatly decreased air pollution.

In the following four weeks, children’s visits for asthma to clinics dropped by more than 40 per cent and trips to emergency departments by 11 per cent. Hospitalizations for asthma decreased by 19 per cent.

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Findings of the Study indicate almost immediate and substantial effects on health outcomes followed reduced exposure to air pollution. It’s critical that governments adopt and enforce WHO guidelines for air pollution immediately. Wikimedia Commons

Similarly, when China imposed factory and travel restrictions for the Beijing Olympics, lung function improved within two months, with fewer asthma-related physician visits and less cardiovascular mortality.

“Fortunately, reducing air pollution can result in prompt and substantial health gains. Sweeping policies affecting a whole country can reduce all-cause mortality within weeks,” Schraufnagel said.

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Local programmes, such as reducing traffic, have also promptly improved many health measures, said the study. (IANS)