Podcast Episode Recommendation for Deconstructed: Medicare Drug Pricing Negotiations Advance
So, today I am going to share a podcast episode which provides an interesting history of how Medicare ended up being unable to negotiate prescription drug prices which, on its face, seems like it SHOULD make no sense, but somehow price negotiations never happened and the reasons were really absurd. Naturally, since the list of the first 10 drugs to get Medicare price negotiations was published, there has also been considerable discussion of insulin prices which is the poster-child for how broken the prescription drug market is, and even more interestingly was how, included in the first round of Medicare price negotiat...
Source: Scott's Web Log - September 1, 2023 Category: Endocrinology Tags: 2023 Biden Centers for Medicare & Medicaid Services Joe Biden Part D price negotiations Source Type: blogs
Insurance Deductibles Don't Work Well for Patients with Chronic Illnesses. Some strategies for PWD's With HDHP's to Consider.
The U.S. IRS defines a High-Deductible Health Plan (HDHP) as a health plan with an annual deductible that is not less than $1,500 for self-only coverage or $3,000 for family coverage, and for which the annual out-of-pocket expenses (deductibles, co-payments, and other amounts). About half of all Americans with employer-sponsored healthcare insurance plans have deductibles to satisfy before the insurance covers much although some employers provide Health Reimbursement Accounts (HRAs) to help offset the deductible. That said, the IRS has also ruled that an HDHP can cover certain types of " preventive " care without a deducti...
Source: Scott's Web Log - August 24, 2023 Category: Endocrinology Tags: 2023 Ascensia CGM E3 Eversense HDHP Senseonics Source Type: blogs
Why Amazon Pharmacy's Recent Insulin Move is Helpful, But Not Groundbreaking
On August 15, 2023, Amazon Pharmacy (fka PillPack) announced (seehttps://www.aboutamazon.com/news/retail/amazon-pharmacy-insulin-coupons/ for the announcement) that it would begin automatically applying various manufacturer coupons to more than 15 common insulins and diabetes devices (including Dexcom, which offers a coupon for up to $200 per month athttps://www.dexcom.com/en-us/savings-center-cgm-without-insurance/ even without insurance). So far, no coupons from Abbott on Freestyle Libre 3 sensors, but the longer wear-time of 14-days means those cost about one-third less than Dexcom ' s 10-day Some products, such as bloo...
Source: Scott's Web Log - August 22, 2023 Category: Endocrinology Tags: 2023 Amazon Amazon Pharmacy coupons insulin prices Source Type: blogs
Podcast Episode Recommendation: Healthy Dose of Dialogue Episode 31 " A Dose of Prescription Drug Disruption "
Today, I am recommending a podcast episode worth listening to. Specifically, it is an episode from June 15, 2022 of the podcast known as " Healthy Dose of Dialogue " which describes its mission to " gather the brightest minds in healthcare to share their unique perspectives on transformative marketplace trends, industry insights, and their vision for the future " .This particular episode (EP31: " A Dose of Prescription Drug Disruption " ) is an interview with the President of CivicaScript LLC, which in case you weren ' t aware of it, is an affiliated business unit of the nonprofit drug company Civica, Inc. The president of...
Source: Scott's Web Log - August 9, 2023 Category: Endocrinology Tags: 2023 Biosimilar Civica Civica Rx CivicaRx CivicaScript insulin podcast podcast episode recommendations ypsomed Source Type: blogs
Campaign to End Diabetes Stigma
Currently, there is a global effort to pledge to make the world a more supportive, understanding, informed and caring place for people living with diabetes by eradicating " diabetes stigma " . This has been a matter which Renza Scibilia has invested considerable effort to address (catch her post athttps://diabetogenic.blog/2023/07/31/sign-the-pledge-to-end-diabetes-stigma/ for details) and I wish her well in the venture. To sign the pledge, visithttps://enddiabetesstigma.org/. Diabetes stigma is something I ' ve been forced to endure for nearly a half-century (I was diagnosed with T1D in 1976; you do the math). When i...
Source: Scott's Web Log - August 7, 2023 Category: Endocrinology Tags: 2023 diabetes stigma renza scibilia Source Type: blogs
When Mark Cuban Cost Plus Drug Company Says Your Prescription is " Out of stock "
My followers may recall that about a year ago (on August 22, 2023), I blogged about (see https://blog.sstrumello.com/2022/08/generic-crestor-pricing-insanity.html for the post) that I had made a conscious decision to simply disintermediate my own insurance pharmacy benefit to buy an inexpensive generic statin drug because my own pharmacy benefit manager was screwing me. Currently, I ' m covered by Aetna which is now owned by CVS Health, which also owns the PBM known as Caremark. Caremark was robbing me on the statin. It was overcharging me. They were trying to charge me $33.85 for a 90-day supply of a cheap...
Source: Scott's Web Log - August 1, 2023 Category: Endocrinology Tags: 2023 cash pharmacy cash-only pharmacy Crestor Mark Cuban Cost Plus Drug Company rosuvastatin calcium Source Type: blogs
Podcast Episode Recommendation: FierceHealthcare's Podnosis
The publisher of FiercePharma, FierceBiotech, and FierceHealthcare (of note:
they also publish other " Fierce " publications focused on Telecom, Cable TV,
Entertainment, etc.) has a healthcare podcast which is calls "Podnosis"https://www.fiercehealthcare.com/fiercehealthcarecom/fierce-healthcare-podcasts/. The FierceHealthcare team first began podcasting in 2020, but the
healthcare focus shifted when it introduced a new podcast named " Podnosis " in
2022 and even gave it a logo (which if you look carefully, features a human
heart in the center). The graphic describes the podcast as " The Pulse of the Healthcare
I...
Source: Scott's Web Log - July 31, 2023 Category: Endocrinology Tags: 2023 PBM podcast podcast episode recommendations Source Type: blogs
Testimony from Actress Justine Bateman, JDRF's Aaron Turner-Phifer FTC Testimony and 2007 Express Scripts Study on Potential Savings of Biogenerics in the U.S.
Back in 2007, I blogged that the PBM Express Scripts (five years before that company acquired rival PBM Medco Health Solutions in 2012 before selling itself to the insurance company Cigna when it lost most of its paying clients in 2018) published a report on its forecast for savings which might come from biosimilar competition (see my original post athttps://blog.sstrumello.com/2007/03/generic-biologics-could-save-71-billion.html for more). An archived copy of the old Express Scripts report is archived athttp://web.archive.org/web/20100922170223/http://express-scripts.com/research/studies/pharmacybenefitresearch/specialtyp...
Source: Scott's Web Log - July 25, 2023 Category: Endocrinology Tags: 2007 2023 Biosimilar biosimilars FTC insulin JDRF Source Type: blogs
Opinion Piece from Pharmacists United for Truth & Transparency ( " PUTT " )
Pharmacists United for Truth& Transparency ( " PUTT " ) is a non-profit advocacy organization founded by independent pharmacists and pharmacy owners devoted to exposing what they describe as anti-competitive tactics deployed by the largest Pharmacy Benefit Managers (PBMs - aka Pharmacy Benefit Companies or PBCs as the trade organization known as the Pharmaceutical Care Management Association or PCMA has tried to rebrand its industry since the acronym PBM has become toxic) recently published an opinion piece with an interesting title: " The Deadliest Addiction in the U.S. Isn ' t What You Think It Is " (read it athttps:...
Source: Scott's Web Log - July 12, 2023 Category: Endocrinology Tags: 2023 drug prices PBM Pharmacists United for Truth & Transparency PUTT Source Type: blogs
Navitus 2022 Drug Trend Report
Its been many years since I posted news of a PBM Drug Trend Report. Once upon a time, PBM drug trend reports contained lots of interesting information. However, over time (in 2021, for example, when reports from the preceding year were published), CVS Caremark published only a bare-bones summary, while Prime Therapeutics, MedImpact, and other large PBMs all completelystopped publishing drug trend reports. The reason is basically because its becoming harder and harder for PBMs to present themselves as saving money when the biggest PBMs aren ' t saving any entities any money on prescription drugs anymore (I...
Source: Scott's Web Log - July 5, 2023 Category: Endocrinology Tags: 2022 2023 Drug Trend Report Navitus Navitus Health Solutions PBM Source Type: blogs
Like Don Quixote Chasing Windmills, I Aim to See Financial Remediation for Patients Still Suffering in a Predatory U.S Healthcare System
Sometimes, I feel (if you pardon the metaphor) a bit like Don Quixote chasing windmills with my efforts to see true financial remediation introduced in the predatory U.S. healthcare " system " (and I am glad to see that the term " predatory " is now being used by a growing number of medical doctors, which I think is great). I envision a type of financial remediation whereby patients will be able to get access to the care they need without having to face financial predators trying to pick their pockets with illegal discount bribes standing in the way of their getting access to things they need like insulin, CGM senors ...
Source: Scott's Web Log - June 25, 2023 Category: Endocrinology Tags: 2023 CGM Formulary Exclusion insulin PBM Source Type: blogs
What happens when Rx price bubbles (such as on insulin) burst?
In the first half of 2023, Americans witnessed evidence of a rather fundamental shift in the manner pharma had traditionally opted to commercialize selected prescription drugs. Specifically, in March 2023,Lilly,Novo Nordisk andSanofi each announced they planned to slash insulin list prices for insulin. To do so, they would disintermediate PBMs from the transaction and " opt out " of the PBM commercialization channel.The decision wasn ' t really all that difficult; for years branded insulin-makers had been complaining that PBMs and other drug distribution system entities had been gobbling up an ever-larger share of their re...
Source: Scott's Web Log - June 19, 2023 Category: Endocrinology Tags: 2023 Source Type: blogs
Sandoz/Gan & Lee Now Has Applications for Glargine, Lispro and Aspart Insulin Biosimilars on File with FDA, Expect them to come to market in early 2024.
Five years ago, back on December 19, 2018, Swiss pharmaceutical giant Novartis Pharma AG quietly issued a press release (seehttps://www.globenewswire.com/news-release/2018/12/19/1669194/0/en/Sandoz-enters-into-commercialization-and-supply-agreement-for-insulin-biosimilars-anticipating-growing-demand-as-diabetes-burden-rises.html for the release itself) on behalf of the company ' s business unit known as Sandoz. Specifically, Novartis said that its Sandoz generics unit planned to introduce biosimilars, or near-copy, versions of Sanofi ' s Lantus (glargine), Novo Nordisk ' s Novolog (aspart), and Eli Lilly ' s Humalog (lispr...
Source: Scott's Web Log - June 16, 2023 Category: Endocrinology Tags: 2023 Biosimilar biosimilars Gan & Lee insulin Sandoz Source Type: blogs
Free Download of The Capitol Forum's Report: " Exclusive Drug Dealing: Anticompetitive Practices in the Pharmaceutical Supply Chain "
In 2020, I wrote a blog post entitled " It ' s the Rx rebates, stupid! " (seehttps://blog.sstrumello.com/2020/09/its-rx-rebates-stupid.html for the post) in which I revealed the reason everyone was overpaying for insulin was because of rebating paid by insulin-makers to secure PBM formulary placement. Novo Nordisk revealed to its investors that it was spending 74% of its gross U.S. sales in the form of legally-exempted rebate kickbacks paid to PBMs. The good news is thanks to a series of actions by a number of different parties, the insulin PBM rebate price bubble finally burst whenLilly, followed byNovo Nordisk and thenSa...
Source: Scott's Web Log - June 11, 2023 Category: Endocrinology Tags: 2023 Exclusive Drug Dealing: Anticompetitive Practices in the Pharmaceutical Supply Chain report The Capitol Forum Source Type: blogs
Dexcom Pays PBMs Kickbacks to Exclude Rival CGMs; Senseonics Found a Way Around That
This week (on June 3, 2023), there was an interestingannouncement from the Maryland-based medical device startupSenseonics, Inc. that UnitedHealthcare will begin providing coverage for theEversense E3 CGM System effective July 1, 2023 for people with Type 1 and insulin-requiring Type 2 diabetes. You may recall that Senseonics received a cash-infusion financial lifeline from Ascensia Diabetes Care back on August 10, 2020 (see the news release for that athttps://www.businesswire.com/news/home/20200810005677/en/Senseonics-Announces-Strategic-Collaboration-with-Ascensia-Diabetes-Care for more) when that company effectively pai...
Source: Scott's Web Log - June 7, 2023 Category: Endocrinology Tags: 2023 Ascensia bribes CGM Eversense Formulary Exclusion kickbacks PBM Senseonics Source Type: blogs
