iLoveBenefits: Industry News Blog

Majority of Physicians Accepted Pharma Payments in 2014

I was under the impression that this practice had ceased??

ProPublica recently conducted an analysis on the relationship between physician prescribing practices and money received from pharmaceutical companies in 2014. Here are some key findings from the report:

  • Nearly 90% of cardiologists received payments from a drug or device company in 2014.
  • 7 in 10 internists and family practitioners received payments from a drug or device company in 2014.
  • Nationally, about 3 in 4 doctors across five common specialties received at least one payment in 2014.
  • Nevada has the highest proportion (90.3%) of doctors who received payments in 2014.
  • Internists who received no payments had an average brand-name prescribing rate of about 20%.
  • Internists who received more than $5,000/year prescribed brand-name drugs 30% of the time.

Source: NPR, March 17, 2016

Open Payments website launches

The federal government today launched a highly anticipated website detailing at least $3.5 billion in financial ties in a five-month period between medical device and drug companies and physicians and teaching hospitals.

The Open Payments website is the first public repository of national data describing financial relationships between industry and healthcare providers. Critics of these payments say these payments can inappropriately influence clinical decisions.

The database was required by the Physician Payments Sunshine Act, a provision of the Patient Protection and Affordable Care Act that was spearheaded by Sen. Chuck Grassley (R-Iowa).

In drug purchasing size matters . . . a great deal

 

Type of Pharmacy Benefit Rebate Arrangement by Employer Size

Large Employer

Small Employer

Flat guaranteed amount per specialty Rx

24%

10%

Percentage share of rebates, no guarantee

22%

30%

Percentage share of rebates, minimum guarantee per specialty   Rx

23%

6%

Do not receive rebates

13%

16%

Not sure

18%

38%

Publication Source: Managed Care, April 2013
Data Source: 2013 Specialty Drug Benefit Report, Pharmacy Benefit Management institute

Who is winning / losing in health care

Projected Economic Winners and Losers for 2013
Who stakeholders think will be economically better off, the same or worse off by this time next year

Consumers

Employers

Health Plans

Hospitals

Physicians

Pharmaceutical

Better Off

29.8%

19.1%

26.6%

13.8%

12.8%

24.5%

Same

25.5%

30.9%

34.0%

25.5%

34.0%

44.7%

Worse Off

44.7%

50.0%

39.4%

60.6%

53.2%

30.9%

Source: MCOL e-Poll Results, 11th Annual Future Care Web Summit
http://www.healthwebsummit.com/futurecare.htm

Pharmaceutical Political Contributor . . . so far

Top 10 Political Contributors Among Pharmaceuticals / Health Products, 2011-2012(so far)

  1.  Pfizer Inc – $1,495,189
  2. Amgen Inc – $1,228,321
  3. Health Foods of America – $1,207,500
  4. Abbott Laboratories – $1,041,734
  5. Ischemix – $1,034,600
  6. Exoxemis Inc – $1,030,000
  7. Astrazeneca PLC – $940,217
  8. Merck & Co – $870,692
  9. Johnson & Johnson – $835,118
  10. Eli Lilly & Co – $768,825

    Source: Open Secrets, Center for Responsive Politics
    http://www.opensecrets.org/industries/indus.php?ind=H04

November 8, 2012 | Categories: Cost,drugs,healthcare | Tags: , , , , | Comments (0)

There is no doubt that shifting business models is hard work

As the health care industry works to change its business model, it is confronting many challenges. Chief among the challenges may be how to ‘re-wire the system while the electricity is on.’ With every part of the system undergoing fundamental change, getting the entire supply chain to move in lock step is hard work and essential for the benefit of the patients.

“A new survey of healthcare providers, plans and pharmaceutical companies reveals that these institutions have internally contradictory approaches in managing the changes wrought by healthcare reform, especially as it relates to the shift from fee-for-service to a more value-based system.”

 

“The findings really underscore the key question of whether or not any organization can be both committed to nonvolume-based care economics while at the same time working to sustain a volume-driven reimbursement status quo,” said Ed Giniat, national sector leader, KPMG Healthcare & Pharmaceuticals, in a news release. “The institutional schizophrenia that emerges will be challenging to manage at best.”

Read the whole story here: http://medcitynews.com/2012/08/institutional-schizophrenia-occurring-in-healthcare-industry-as-they-ponder-business-model-shift/

Venture Capital Deals in the Healthcare Sector

In the first quarter of 2012, healthcare companies raised $1.5 billion for 165 venture capital deals, an 18% decline in investment and 9% decline in deals. Within healthcare, the biopharmaceuticals sector saw the most significant decline as 53 deals raised $523 million, a 31% drop in deals and 46% decline in capital raised.

Also during the first quarter, medical device companies raised $748 million for 83 deals, a 2% decline in investment and 14% increase in deals. Investors favored later-stage rounds, with more than half (51%) of the deals going to companies raising later-stage or restart rounds.

The health IT sector remained small but solid thanks to interest in technologies that manage health information and data. Health IT companies raised $102 million for 18 deals in the first quarter, a 75% increase in capital and one more deal than was completed in the same period a year ago.

Source: Dow Jones VentureSource
http://www.dowjones.com/pressroom/releases/2012/04202012-USVC-0030.asp

As Lipitor goes off patent…

There is nothing like a deal with a pharmacy benefit manager to generate intrigue. The recent arrangements that Pfizer struck with several PBMs and health plans to block prescriptions for generic versions of its best-selling Lipitor cholesterol pill are prompting all sorts of reactions, from outrage to confusion.

Read more here: http://www.pharmalot.com/2011/11/pfizer-move-to-block-generic-lipitor-attracts-ftc/

Read more stories on this topic here:

Plan Would Delay Sales of Generic for Lipitor
The New York Times – November 11, 2011
The biggest introduction of a generic drug in pharmaceutical history is being met with tough business strategies by Pfizer and pharmacy benefit companies, according to recent letters to pharmacists.

Pfizer Strikes Pharmacy Deals to Hold Lipitor Sales
Bloomberg – November 16, 2011
Pfizer Inc. is seeking to add Express Scripts Inc. to the list of U.S. pharmacy benefits managers that won’t dispense generic Lipitor after the world’s best-selling drug loses patent protection this month.

November 21, 2011 | Categories: drugs,healthcare | Tags: , , , , , | Comments (0)

Drug shortages – what is the real cause?

As Washington argues about whatever, drug shortages are costing lives, driving costs

Increasing drug shortages are impacting patient care and increasing costs to the nation’s health system, according to a new study released today by the American Society of Health-System Pharmacists (ASHP). The study, Impact of Drug Shortages on U.S. Health Systems, was conducted in partnership with the University of Michigan Health System, and published online by the American Journal of Health-System Pharmacy, ahead of the October 1 print date.

 

The authors, led by Burgunda V. Sweet, Pharm.D., FASHP, director of drug information and medication use policy at the University of Michigan Health System, surveyed 353 directors of pharmacy in hospitals across the country of varying sizes, to quantify the personnel resources required to manage the drug shortages, define the extent to which recent drug shortages impacted health systems nationwide, and to assess the adequacy of information resources available to manage shortages. The research found:

* The labor costs associated with managing shortages translates to an estimated annual impact of $216 million nationally.
* Reallocation of existing staff, including from patient care duties, to allow time for individuals to focus on managing shortages was commonly reported (32 percent),
* More than 90% of respondents agreed that drug shortages were associated with an increased burden and increased costs today compared to two years ago.
* Three specific drug shortages affected over 80 percent of health systems (dextrose syringes, epinephrine injection and succinylcholine injection).
* Seventy percent of respondents felt the information resources available to manage drug shortages are less than good.

“Drug shortages are a national health crisis,” said ASHP executive vice president and CEO, Henri R. Manasse, Jr., Ph.D., Sc.D. “Particularly troubling are reports that pharmacists are being pulled away from clinical duties to manage shortages. This means that patients don’t have access to the medication expertise that pharmacists provide making patients even more vulnerable to harm. The impact on our health care system is enormous. It’s urgent that stakeholders work together to find solutions to this serious public health threat.”

Critical shortage of pharmacists likely to continue.(Healthcare Mississippi): An article from: Mississippi Business Journal (2006)

ASHP is releasing its study in joint announcement with the American Hospital Association (AHA), which is also releasing survey data that complements ASHP’s findings. AHA’s survey of 820 hospitals revealed that nearly 100 percent of hospitals reported having experienced at least one drug shortage in the last six months and nearly half reported experiencing 21 or more shortages in the last six months. The ASHP survey reported similar findings and noted that 47 percent of large hospitals experienced 30 or more shortages.

ASHP helped form a coalition of health care groups who are working to find a way to resolve the ongoing crisis and co-convened a Drug Shortages Summit in November 2010. Together with its partners, the American Hospital Association, the Institute for Safe Medication Practices, the American Society of Clinical Oncology, and the American Society of Anesthesiologists, ASHP is advocating for a number of legislative and regulatory actions to help address the crisis, including:

* Establish an “early warning system” to help avert or mitigate drugs shortages.
* Remove obstacles so that the Food and Drug Administration is able to streamline approval of drugs in shortage.
* Improve communication among stakeholders, including extent and timeliness of information.
* Explore incentives to encourage drug manufacturers to stay in, re-enter or initially enter the market.

The study on drug shortages and how they are harming patients can be found online.

Drug shortages challenge long-term patient care: Number of products affected up sharply. (‘Domino Effect’).: An article from: Clinical Psychiatry News (2005)

Survey: majority of hospitals face serious drug shortages.(PRACTICE TRENDS): An article from: Family Practice News (2011)

Pharmaceutical Expenses per Staffed Bed for All Hospitals, 2005-2009

  • 2005—$39,657
  • 2006—$41,465
  • 2007—$43,767
  • 2008—$46,650
  • 2009—$48,195

Source: sanofi aventis. Managed Care Digest Series. Hospital/Systems Digest 2011-2012. http://www.managedcaredigest.com/.

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