|Good morning TWTW readers. With another soggy, news-filled week under our belts, TWTW is starting to think we’re ready for fall. Pumpkin spice lattes, anyone?|
This week, in healthcare:
But there’s even more news, so let’s get to it.
|►MEDICARE GETS AN ADVANTAGE?|
Earlier this week, HHS announced that Medicare Advantage plans would gain some negotiating power for drugs covered under Medicare Part B. With this change, set to go into effect in 2019, plans would be able to negotiate for discounts and rebates, and apply step edits to certain medicines. The plans could also manage a class of drugs across Parts D and B. The effort has been announced as a cost-saving initiative, with Secretary Azar saying: “By allowing Medicare Advantage plans to negotiate for physician-administered drugs like private-sector insurers already do, we can drive down prices for some of the most expensive drugs seniors use.”
While this change is planned for 2019, its longer term impact will be more obvious in 2020. It will impact certain categories, particularly diseases like rheumatoid arthritis or oncology where therapies are available at the pharmacy but can also be administered at a hospital or practice. Azar noted the cost-savings from the program will directly impact patients, with over half of the savings going back to patients. He also mentioned that patients could apply for an exception from step edits or switch plans if they were not satisfied with their coverage options. Still, the change may see some pushback from some advocates, who have firmly stated the importance of patient choice and the potential harm of step edits on patient experience and outcomes.
►HEALTHCARE NEEDS TO MIND THE [GENDER] GAP
As you know, TWTW team is a bunch of new junkies. We’ve recently seen quite a bit of coverage focused systemic gender-based disparities in the healthcare system—and the harmful, often life-threatening impact on female patients. Specifically, recent stories have examined the rampant overlooking, underdiagnosing, misdiagnosing and undertreating of female patients. The causes? Well, it’s due in part to how the health system measures pain, and has been reinforced by the clinical trial model, which for decades did not include women. According to studies, the disparities cut across all diseases. For example:
Moreover, the impact gets worse when gender is combined with other factors: socio-economic status, race and weight can further impact the kind of care women receive. A harrowing feature for the New York Times, examines the maternal mortality disparity for black women in America. The Atlantic’s piece on healthcare “gaslighting” offers the example that women with Polycystic Ovary Syndrome, a condition that can cause obesity or weight problems, are routinely advised to eat less and exercise more. Regardless of the condition or statistic, these stories all have something in common: they highlight how women’s unique health needs and risks have been woefully overlooked by the current system.
While recent research and storytelling has certainly evolved our understanding of this issue, scientists have been investigating it for some time now. The chest pain data (above) was released in 2001. But as the #MeToo phenomenon evolves, it’s incorporating all sorts of stories about the ways in which women are routinely disenfranchised by established systems. Add that to our populist, politically polarizing, pre-midterm environment, and you’ve got a trend with serious potential to impact the healthcare industry.
So what do pharma and biotech companies need to consider?
For those TWTW readers wanting to delve deeper into this topic, we recommend the BBC’s series on the “Health Gap.”
That’s all from us. Have a wonderful week.
- The Reputation & Risk Management [email protected] Syneos Health Communications