The Weekly Roundup

April 01, 2016 | Pamela Youngberg Dickson

Last week we noted Anthem’s sharp poke at existing pricing structures and have been watching for updates as the ongoing saga unfolds. But New York isn’t the only game in town. Significant calls for leadership on the issue at the national level are in the works, too. We think you’ll love this video of Rep. Doug Collins (R-Georgia) pushing for the reintroduction of the MAC Transparency Act. (As our colleagues at IPCN so aptly put it this week: You might just want to give him a cape.)

I talked with our own Tim Gallagher, former president of Astrup Drug and currently president of Sterling Specialty Pharmacy, who had this to say:

“This is definitely a good bill. More than 85% of our business is in generics and we are expected to sign contracts with PBMs where we not only have no idea what we will get paid, we also have no idea how they determine what our generic reimbursement will be, nor are they even required to reimburse us above our cost. Even in states where these laws have passed, however (e.g. Ohio), the PBM's are blatantly disregarding the law and refusing to comply.”

Of course, there’s always the “Government interference in market negotiations is not the answer” crowd, which sounds a lot like PBM lobbyists in sheep’s clothing, suggesting that they won’t get the great deals from drug manufacturers (that are, of course, passed on – eye roll) if a light is shone on their negotiations.

Here are a few other pieces we thought you might enjoy:

  • In Iowa the legislature approved a bill making it easier to establish telepharmacy in rural and underserved communities.
  • This report from Health and Human Services found that Medicare spending went down significantly between 2009 and 2014. Of course, stats is stats—there’s ways aplenty to slice and dice the data to keep both sides of the political aisle kvetching until doomsday.
  • Pharmacy Times recently ran an overview of the top drug spending categories in 2015 by therapeutic class. Or, you can also check out our Top-10 “lite” version on specific drugs here.

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Pamela Youngberg Dickson

Before she came to Smart-Fill, Pamela developed marketing strategy and content for a range of technology start-ups and large-cap enterprises. Outside the office, she's into gardening, renaissance history, the Big Ten, and exploring the great outdoors.