Health Policy Updates: September 16 2017

There were a couple of great articles in JAMA Internal Medicine this week on cancer drug development and pricing.

The first, discussed in this NYTimes article, did a thorough job of tallying the total R&D cost to bring a new cancer drug to market. The study authors ended up with a significantly lower number than has been reported in the past.

“Following approval, the 10 drugs together brought in $67 billion, the researchers also concluded — a more than sevenfold return on investment. Nine out of 10 companies made money, but revenues varied enormously. One drug had not yet earned back its development costs.”

The second found that cancer drugs tend not to decline much in price even after patent expiration.

There were two significant developments in US health policy this week. First, Senator Bernie Sanders release a proposal for a single-payer health care system. While proposing universal, generous benefits, it fails to describe how to go about paying for them.

“The Sanders plan goes into great detail about the type of coverage Americans would receive. But it provides no information on how it would finance such a generous health care system. This is a crucial part of any health care plan, and in the Sanders proposal, it is notably absent.”

Second, the GOP started making a serious push for the one Obamacare repeal bill left standing. It will be a busy two weeks as they work towards the September 30 deadline for passage. It is difficult to see why this bill would end differently than other recent failures – given the similar consequences of taking health insurance away from millions of Americans – but in today’s world, who knows?

“Cassidy-Graham cuts health coverage in two ways: first, by undoing the ACA’s major coverage expansions through a block grant, and second, by radically restructuring and cutting the entire Medicaid program. The bill would eliminate the ACA’s Medicaid expansion and marketplace subsidies starting in 2020, offering in their place only a smaller, temporary block grant that states could use for health coverage or any other health care purposes, with no guarantee of coverage or financial assistance for individuals.”

This data interactive by Bloomberg is a great reminder of the two central problems in US health care: we spend more than other countries, and have worse health care outcomes than other countries.

Great charts from Vox this week, describing the overall improvements in health care insurance rates in recent years.

This post in the Health Affairs blog casts serious doubt on the notion that cutting Medicaid funding would actually improve outcomes in the program, by forcing it to become more efficient. Turns out, it already is.

“In a recent issue brief, we…found no strong evidence to indicate that large Medicaid savings were likely through delivery system and financing reform. However, some approaches, such as complex care management programs and home and community-based services, hold promise for modest cost savings. In most cases, states are already in the process of implementing these strategies.”

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