BACK of the BOOK
Heard in the Blogosphere
Can Washington Ever Hope to Negotiate
Drug Prices?
It sounds like a simple solution to the problem of skyrocketing drug
prices in the United States: Let Medicare negotiate drug prices and
help bring down prices for consumers. In Stat News, experts discuss
whether this dream will ever become a possibility – and what’s standing in the way.
“There’s a huge gulf between the political talking points and the practical execution. It’s extremely difficult to structure the program so the
negotiations desired by Congress would be productive.”
—Dan Mendelson, president of the Avalere Health consulting firm
“To negotiate, you have to have a credible threat of saying no. Without
a stronger ability to say no, the office wrote in its most recent analysis,
the savings would be negligible. But if Congress takes the handcuffs
off of the private plans and lets them use formularies that are more
like large companies’ health plans, that would save billions.”
—Kevin Outterson, co-director of the health law program at Boston University
Medicare could press for rebates similar to the kind Medicaid gets
for drug coverage for low-income people. Of course, this is not a true
negotiation. It’s more the government using its executive authority to
say, ‘We will get this discount or walk away.’”
—Jack Hoadley, a Medicare Part D expert at Georgetown University
Your Cells. Their Research. Your
Permission?
“How people feel about [the use of their anonymous
clinical biospecimens in research] varies depending
on everything from their relationship to their DNA
to how they define life and death. People have told
me by the thousands, and numerous public opinion
studies find the same: They want to know if their
biospecimens are used in research, and they want to
be a sked first. Most will probably say yes, because
they understand it’s important. They just don’t want to find out later. That damages their trust in
science and doctors. It makes them wonder, what else are you hiding from me?”
—Rebecca Skloot, discussing the patient perspective on the recent changes
to the Common Rule in The New York Times
The Consequences of a Lack of Clinical Trial Diversity
“Only 2 percent of cancer studies and less than 5 percent of pulmonary studies have studied
enough minorities to provide useful information. We’ve known for years that certain drugs don’t
work on parts of our population. You begin to wonder, well, why is this the case? And part of that
reason might be because our studies in the past have not recruited as heavily in those populations. It’s also really important when you want to do science in diverse communities you have a
scientific team and a scientific staff that is also diverse.”
The Mall-ification of Medical Care
There are nearly 2,000 retail clinics in the United States, and between
2007 and 2009, the number of visits to retail clinics quadrupled. In
The New York Times, physicians discuss the rise of the retail clinic, and
the potential benefits and drawbacks for patients and the health-care
system.
“Typically, [retail clinics] are staffed with nurse practitioners or physician assistants. For patients, the convenience of easy location, afterhours availability and walk-right-in policies are appealing. It’s hard
to argue with this, since traditional doctors’ offices fail miserably on
these measures. There’s also an actual price list.”
–Danielle Ofri, MD, associate professor of medicine
at New York University
“For the minor conditions treated by retail clinics, the quality is generally as good as the care at regular doctors’ offices. Or should I say ‘as
poor as’ because these clinics overprescribe antibiotics as much as
doctors do. There is a problem, though: When we make things more
convenient people use them more.”
–Ateev Mehrotra, MD, associate professor of medicine
at Harvard University
“Retail clinics have the potential to disrupt longitudinal doctor-patient
relationships and undermine the ‘medical-home’ model of primary
care. Nevertheless, a number of large health systems have adopted
the if-you-can’t-beat-‘em-join-‘em attitude and are partnering with,
purchasing, or creating retail health clinics. The benefits of such an arrangement could be extending the medical home into a more convenient setting for patients.”
–Dave Chokshi, MD, MSc, assistant professor of medicine
at New York University
—Sam Oh, PhD, MPH, epidemiologist at University of California, San Francisco, on NPR’s “All Things Considered”
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FDA Regulator, Widowed by Cancer, Helps Speed Drug Approval
“I have a much greater sense of urgency these days. I have been on a jihad to streamline the
review process and get things out the door faster. I have evolved from regulator to regulatoradvocate.”
—Richard Pazdur, MD, on how the death of his wife from cancer affected his priorities as the
U.S. Food and Drug Administration’s Office of Oncology Drug Products in The New York Times
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February 2016