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What We're Reading: Biosimilar Reimbursement and Scrutinizing Drug Pricing

AJMC Staff
What we're reading, October 15, 2015: federal prosecutors subpoena Valeant Pharmaceuticals over how the company prices drugs, Atul Gawande, MD, makes the case for better coordinated care, and proposed biosimilar reimbursement sparks outrage.
Valeant Subpoenaed for Information on Drug Pricing

Federal prosecutors are seeking information about how Valeant Pharmaceuticals prices drugs, distributes them, and helps patients afford medicine. The company received subpoenas from US attorney offices in New York City’s southern district and Boston, according to the Wall Street Journal. The announcement comes 2 months after Democratic presidential hopeful Senator Bernie Sanders (I-VT) and Representative Elijah E. Cummings (D-MD) ramped up an investigation into drug price increases by requesting information from Valeant about escalating prices for 2 drugs it purchased from another drug company.

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Better Coordinated Care Needed to Improve Patient Outcomes

At the Medical Group Management Association 2015 Annual Conference, Atul Gawande, MD, a health policy professor at the Harvard T.H. Chan School of Public Health in Boston, discussed the importance of well-coordinated care teams. Breakdowns between outpatient physicians and surgeons and the intensive care unit can result in serious consequences for the patient, Medscape reported in a recap of Dr Gawande’s speech.

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Proposed Biosimilar Reimbursement Creates Unhappy Drugmakers

A proposal from CMS to create 1 reimbursement code for all biosimilars a physician might prescribe has upset drugmakers, who addressed fears such a move would undermine the biosimilar market, according to Pharmalot. Meanwhile, the brand-name biologic will have a separate code. One code could cause safety issues by making it difficult to know which treatment caused a side effect, and drugmakers say the move would rob them of incentives to pursue further development.

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