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May 27, 2015

Today's Featured Story

S&P Sees Market Unease Heading Into ’16 as Plans Weigh Risk of Exchange 3R Hole
Reprinted from Health Plan Week

The likelihood CMS will not be able to make good on 100% of the risk corridors payments owed to health plans that lost significant amounts of money on Affordable Care Act (ACA) exchanges in 2014 will create market instability in 2016, a new report by Standard & Poor’s Ratings Services says. Market consultants say the lack of certainty about these payments, from the so-called 3Rs (reinsurance, risk corridors and risk adjustment) risk-mitigation programs under the ACA, will lead plans to hike exchange-based premiums next year as aggressive pricing gives way to the hard realities of the marketplace.... Read Full Story


Quote of the Day

“A flourishing pharmaceutical industry provides invaluable benefit to society by developing new drugs to combat disease and alleviate suffering. The success of the pharmaceutical industry in bringing new therapies to market for the treatment of MS has improved the care of people with MS. However, the unbridled rise in the cost of MS drugs has resulted in large profit margins and the creation of an industry ‘too big to fail.’ It is time for neurologists to begin a national conversation about unsustainable and suffocating drug costs for people with MS — otherwise we are failing our patients and society.”

— Oregon State researchers who published the article “The Cost of Multiple Sclerosis Drugs in the U.S. and the Pharmaceutical Industry,” which appeared in the April 24 issue of Neurology.

Click here to read the SPECIALTY PHARMACY NEWS article in which this quote appeared. (Free for SPN subscribers; $17 for non-subscribers).


Today's Datapoint

$11.9 billion ... was the reduction in U.S. spending on prescription drugs in 2014 as a result of patent expirations, the lowest impact of expirations in five years, according to a new report, Medicines Use and Spending Shifts, from the IMS Institute for Healthcare Informatics.



Today from Washington

People on the Move

Richard Gibson, M.D., joined PeraHealth as physician executive. Gibson was most recently chief of health care intelligence at Providence Health & Services....Ann & Robert H. Lurie Children’s Hospital of Chicago named Kary McIlwain vice president of marketing. She was previously president and North American managing partner of Y&R....Sarcos Corp. named Preston Woo chief financial officer and head of corporate development. Woo was formerly head of corporate development at Pendrell Corp.


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