By Michelle Leeds
Congress returned from summer recess this week and some policymakers showed up ready! There are a lot of moving pieces on the healthcare front that may start picking up steam, including some glimpses of House Speaker Nancy Pelosi’s long-awaited proposal to give Medicare negotiating power. While there was much swirl around a draft plan earlier this week, the alleged “real” plan could be released as soon as next week.
What has legs?
There are multiple potential bills and proposals emanating from Senate Committees, the Administration and Presidential candidates, but what is a real signal versus noise? We believe the following will rise to the top:
International reference pricing: Speaker Pelosi's latest draft includes a pricing cap linked to an average price of therapies from six other “wealthy” nations. This may be a carrot for President Trump who is also supportive of an International Pricing Index.
Capping price increases to not exceed rates of inflation: The Pelosi bill includes a claw-back provision that would require drug makers who have raised prices faster than inflation (since 2016) to lower prices or pay the difference to the federal government in a rebate. A Senate Finance bill also includes an inflationary cap on drugs covered under both Medicare Parts B and D.
PBM Rebate Reform: It’s not in Pelosi’s plan, but the Senate Finance Committee may revisit legislation to change the way PBMs receive rebates, after the Trump administration withdrew its proposed rule earlier this year.
No targeted limitations on launch prices: All of the proposals in play target steep price increases, but none specifically prohibit a new drug from launching with a high list price.
Stay tuned to The Week That Was for progress updates.
Taking home tests, compromising care
By Olivia Rothseid
We’ve seen the emergence of at-home genetic tests and HIV tests. Now, two companies have taken the concept to a new level: rape kits. The at-home kits are designed to allow survivors of sexual assault to gather evidence in privacy, rather than going to the hospital. The makers of the "PRESERVEkit" and “MeToo Kit” (yes; that is the actual name) say they’re responding to barriers that survivors of sexual assault and abuse face when seeking treatment. These include feelings of not being believed by medical practitioners, facing privacy concerns, apprehensions related to documentation or insurance, and discrimination for sexual or gender identity. The kit manufacturers claim to give people autonomy over their own care – arming them with information they can then bring to a physician if they choose. The MeToo Kit founder further extrapolates that “the predatory nature of parties on college campuses would change if everyone knew that everyone had a kit.” We’re not so sure about that.
These kits raise big issues and shortcomings such as:
- Compromising complete care. The kits do not provide survivors with the medical resources that a hospital environment does, such as referrals to counseling and continued care services, antibiotics and anti-retrovirals that prevent sexually transmitted infections, and a professional physical examination.
- Misleading claims. There is also the question of whether these kits are admissible in court, should charges be pressed. Could defendants claim user-error or tampering if a kit is not completed by an impartial medical practitioner? Concerns surrounding the kits led to several attorneys general issuing cease-and-desist letter to the Preserve Group and the MeToo Kit. New York’s Attorney General Letitia James has remarked “companies selling kits… purport to collect evidence without knowing whether the evidence will be admissible in court."
Although marketed as a solution, these kits bring more harm than good to patients who may already be in an intense period of crisis. Prioritizing convenience over complete care, could further harm survivors by circumventing appropriate medical and mental health care, advising safety practices and plans, and offering admissible legal aid. The problems the manufacturers are hoping to circumvent will not be solved by keeping kits at home, but rather by making systemic changes within the hospital setting.
While the Preserve Group has had 40 sales on Amazon within one month, we will need to wait and see if the MeToo Kit ever meaningfully makes it into homes. Before the other kit comes to market, we hope they’ll at least change the name, which one Attorney General called “shameless” for taking “financial advantage of the ‘Me Too’ movement.”
Who wrote this? The managing editor of TWTW is Randi Kahn, who just learned that there exists date-rape-drug detecting nail polish and is wondering what other problems a good manicure could solve. Mani, pedi, preventive care?
Syneos Health Communications' Reputation & Risk Management Practice is a team of healthcare communications consultants, policy-shapers and crisis response specialists. We provide unique solutions to the evolving communications challenges in today’s healthcare industry, using evidence-based approaches to help our clients successfully navigate the most sensitive of situations.
Got thoughts? Contact Randi
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