Headlines in the News

ACA Premiums Rising Beyond Reach of Older, Middle-Class Consumers

March 5, 2019

The sweeping health-care law created nearly a decade ago to put insurance within reach of more Americans has left significant holes in the ability of older, middle-class people to afford coverage, particularly in rural areas, according to a new analysis.

The sweeping health-care law created nearly a decade ago to put insurance within reach of more Americans has left significant holes in the ability of older, middle-class people to afford coverage, particularly in rural areas, according to a new analysis.

Sixty-year-olds with a $50,000 income must pay at least one-fifth of what they earn for the least expensive premiums for health plans in Affordable Care Act marketplaces across a broad swath of the Midwest, the analysis shows. In much of the country, those premiums require at least one-sixth of such people’s income.

The findings, issued Tuesday by the Kaiser Family Foundation, underscore why the Trump administration and other Republicans are pushing inexpensive insurance that bypasses ACA rules and protections — and why Democrats are pursuing strategies to make ACA plans more affordable….

Read the full The Washington Post article

Lilly Will Sell a Version of Its Popular Insulin at Half the Price, but Will This Appease Critics?

March 4, 2019

As drug makers come under increasing pressure to lower prices, Eli Lilly (LLY) is trying to thread a needle by introducing a new version of insulin at half the list price.

Specifically, the product is a so-called authorized generic version of the Humalog insulin, which means the medicine is identical to the brand-name treatment and will be made at the same plant, but carries a different label. Known as Lispro, the medication will sell for $137.35 a vial, while the list price of a five-pack of KwikPens will be $265.20.

As drug makers come under increasing pressure to lower prices, Eli Lilly (LLY) is trying to thread a needle by introducing a new version of insulin at half the list price.

Specifically, the product is a so-called authorized generic version of the Humalog insulin, which means the medicine is identical to the brand-name treatment and will be made at the same plant, but carries a different label. Known as Lispro, the medication will sell for $137.35 a vial, while the list price of a five-pack of KwikPens will be $265.20.

The move reflects growing anger at the pharmaceutical industry, although insulin has been a particular focal point among patients and, subsequently, lawmakers. The average list price for insulin nearly tripled between 2002 and 2013, according to the American Diabetes Association. More than 30 million Americans have some form of diabetes….

Read the full Stat article

Big Pharma Gave Money To Patient Advocacy Groups Opposing Medicare Changes

March 4, 2019

Dozens of patient advocacy groups, like the Bonnie J. Addario Lung Cancer Foundation and the National Coalition for Cancer Survivorship, recently appeared in national advertisements objecting to a Trump administration proposal that could limit drugs covered by Medicare providers.

But a Kaiser Health News analysis found that about half of the groups representing patients have received funding from the pharmaceutical industry.

Dozens of patient advocacy groups, like the Bonnie J. Addario Lung Cancer Foundation and the National Coalition for Cancer Survivorship, recently appeared in national advertisements objecting to a Trump administration proposal that could limit drugs covered by Medicare providers.

But a Kaiser Health News analysis found that about half of the groups representing patients have received funding from the pharmaceutical industry.

Drugmakers funneled more than $58 million to the groups in 2015 alone, according to financial disclosures in KHN’s “Pre$cription for Power” database, which tracks the little-publicized ties between patient advocacy groups and drugmakers. As patient organizations gain ground lobbying Congress and the administration, experts have begun to question whether their financial ties could push them to put drugmakers’ interests ahead of the patients they represent….

Read the full Kaiser Health News article

Congress Squares Off With Pharma CEOs In Showdown Over High Drug Prices

February 26, 2019

Expect sparks to fly Tuesday as senators get a rare chance to grill the heads of seven major pharmaceutical companies under oath about the budget-busting prices of prescription drugs.

Expect to hear more from this committee in the coming months, including inquiries to pharmacy benefits managers, as lawmakers seek legislation to ease health care costs. But first, here’s what you should know before the hearing.

Expect sparks to fly Tuesday as senators get a rare chance to grill the heads of seven major pharmaceutical companies under oath about the budget-busting prices of prescription drugs.

Expect to hear more from this committee in the coming months, including inquiries to pharmacy benefits managers, as lawmakers seek legislation to ease health care costs. But first, here’s what you should know before the hearing.

1. Most lawmakers have taken money from drugmakers — including the senators on this committee.

The Senate Finance Committee will host executives from Pfizer, Merck, AbbVie and other drugmakers. Sen. Chuck Grassley (R-Iowa), the chairman, said he hopes the hearing will pull back the curtain on how drugmakers set prices — and how they justify the culture of secrecy surrounding those decisions….

Read the full Kaiser Health News article

Measles Outbreaks Lead States to Reconsider Vaccine Exemptions

February 26, 2019

Measles outbreaks across the nation are prompting state lawmakers to consider eliminating vaccination exemptions for religious and personal beliefs that have been claimed by the parents of some children.

Public health experts and officials blame the exemptions as one reason why states are seeing an increased number of cases of measles.

Measles outbreaks across the nation are prompting state lawmakers to consider eliminating vaccination exemptions for religious and personal beliefs that have been claimed by the parents of some children.

Public health experts and officials blame the exemptions as one reason why states are seeing an increased number of cases of measles.

“What you see as religious choice could possibly cause negative health outcomes for other members of your community and society,” said Pat Burke, a Democratic state lawmaker in New York who is pushing to eliminate the state’s religious exemption.

Laws allowing parents to opt out of vaccinations were created by states trying to strike a delicate balance between religious freedom, personal choice and public health….

Read the full The Hill article

Anthem Says Bid to Save $49 Billion Deal Was ‘Cut Off at Knees’

February 25, 2019

Cigna Corp. officials did everything they could to sabotage a $48.9 billion merger with Anthem Inc., including refusing to consider divestitures that would have helped the deal win regulatory approval, Anthem’s general counsel told a judge.

Cigna refused to turn over data Anthem executives needed to convince U.S. Justice Department attorneys of the merger’s value to customers, Thomas Zielinski, Anthem’s top lawyer, testified Monday in the opening of a damages trial tied to the transaction’s collapse.

Cigna Corp. officials did everything they could to sabotage a $48.9 billion merger with Anthem Inc., including refusing to consider divestitures that would have helped the deal win regulatory approval, Anthem’s general counsel told a judge.

Cigna refused to turn over data Anthem executives needed to convince U.S. Justice Department attorneys of the merger’s value to customers, Thomas Zielinski, Anthem’s top lawyer, testified Monday in the opening of a damages trial tied to the transaction’s collapse.

After Cigna Chief Executive Officer David Cordani expressed unhappiness with his role in the combined company, Cigna “cut us off at the knees’’ in their joint effort to fend off antitrust concerns, Zielinski told Delaware Chancery Court Judge Travis Laster.

Cigna, which Anthem would have acquired, is seeking more than $16 billion in damages and termination fees. Anthem, which runs Blue Cross and Blue Shield plans in more than a dozen states, claims it’s owed $20 billion in damages because of Cigna’s intransigence in turning over information to push the merger forward….

Read the full Bloomberg article