How is it mid-December already? Hanukkah just ended, Christmas is in two weeks—and there are only 22 days left in 2018…Feeling sufficiently overwhelmed? We feel you. Luckily, we’ve got a holiday-themed TWTW that will help you Shake It Off (Chanukah-pella style?)
►SENATORS SAY "LETS START THE NEW YEAR RIGHT" ON DRUG PRICING
Senators Chuck Grassley (R-IA) and Ron Wyden (D-OR) this week introduced a bill that aims to “crack down” on companies that are overcharging for Medicaid rebates. Under the bill, when a drug maker misclassifies a drug in an attempt to pay lower rebates, HHS would be able to reclassify those drugs and recover the associated rebates. In a statement, Sen. Wyden said, “This bipartisan bill will crack down on Big Pharma’s games and help prevent them from taking advantage of Medicaid, a program meant to protect the most vulnerable."
►CVS SAYS MERRY CHRISTMAS WITH A 100% REBATE PASS THROUGH
In the face of mounting criticism from the White House on PBMs for a lack of transparency, CVS called on detractors to “Watch Me,” announcing the "guaranteed net cost plan” which will deliver 100% of all rebates to its clients (including government health programs, commercial insurers and employers). Will those rebates make it to patients? That’s up to the plan sponsors who will make the ultimate decision about passing discounts to consumers at the point of sale.
CVS may have thought this would incite critics to shout, “Joy to the World,” but not everyone saw the announcement as a Miracle. Some saw the move as a post Aetna-merger peace offering to keep regulators at bay. Others suggested it was merely at attempt to pre-empt anticipated action from the White House. But no matter how you Spin It Up, an offer of 100%—and the associated promise of transparency—sounds pretty good in the context of drug rebates. With the fierce federal focus on PBMs in recent months, pharma companies may have had a slight reprieve on the reputation front—but scrutiny is always shifting. Drug makers should continue to think about innovative ways to communicate the value of their therapies—both those coming to market, as well as existing treatments with available real world evidence (especially those that may have seen price increases coinciding with formulary negotiations).
►WHAT WE'RE WATCHING: THE MEDICAID WORK REQUIREMENT
CMS has approved work requirement waivers in five states, a measure that requires able-bodied Medicaid beneficiaries to work at least 80 to 100 hours a month. The hours could be put in at a job, volunteering, going to school or attending job training. Beneficiaries unable to meet the requirement could lose Medicaid benefits – for the remainder of the year in some instances. These work requirements are already getting quite a bit of media attention on the local, statelevel. Keep an eye on the story as it unfolds in 2019, particularly in the dozen other states that are pursuing similar waiver programs.
Just for fun, here’s a final story about a man who’s Only Wish is to be 49 again—to improve his chances on dating apps. The 69-year-old may need to try a letter to the North Pole ‘cuz the Dutch Courts said while he is free to feel as young as he likes, he can’t legally lose 20 years of official records…
Who Are We, Anyway?
Syneos Health Communications' Reputation & Risk Management Practiceis a team of healthcare communications consultants, policy-shapers and crisis response specialists. Drawing on our professional experiences from Congress, CMS, HHS, hospitals, health technology and biopharmaceuticals—we provide unique solutions to the evolving communications challenges in today’s healthcare industry. We support trade associations, biopharmaceutical and consumer goods companies’ in evidence-based approaches to successfully navigate the most sensitive of situations facing their industries. In our spare time, we drink too much coffee, geek out on healthcare news, and obsess over Sunday morning political TV.