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This Week in Managed Care: February 3, 2017


This week, the top managed care stories included Republicans pushing HHS secretary nominee Tom Price, R-Georgia, through without Democrats, PhRMA meeting with President Donald Trump, and patients complaining of price fixing in an insulin lawsuit.

Hello I’m Laura Joszt, with The American Journal of Managed Care. Welcome to This Week in Managed Care From the Managed Markets News Network.

GOP Pushes Through Price

This week, the Senate Finance Committee suspended its rules and cleared Georgia Congressman Tom Price to be the new Secretary of Health and Human Services.

Republicans suspended the rules after Senate Democrats boycotted a committee vote. Democrats said both Price and Treasury nominee Steve Mnuchin had misled them during their initial hearings.

Price has drawn scrutiny over stock trades that appear linked to bills he sponsored, including an effort to block a bundled payment program for joint replacements.

Finance Committee Chairman Orrin Hatch called the Democrats “idiots” and said: “This is the most pathetic treatment I have seen in my 40 years in the United States Senate.”

PhRMA Meets the President

President Donald Trump told leaders from PhRMA, which represents the nation’s drug makers, that he wants to use trade policy and tax breaks to bring down drug prices and bring jobs back to the United States.

Trump met with leaders of PhRMA at the White House after saying a few weeks ago that the drug industry was “getting away with murder.”

As a candidate, Trump called for letting consumers buy imported drugs to save money, but at this week’s meeting, he blasted what he called “global freeloading” by countries that benefit from US innovation.

Said Trump: “I’ll oppose anything that makes it harder for smaller, younger companies to take the risk of bringing their product to a vibrantly competitive market. … That includes price-fixing by the biggest dog in the market, Medicare, which is what’s happening. But we can increase competition and bidding wars, big time.”

Insulin Lawsuit

Trump’s complaints about price fixing came the same week that a group of patients with diabetes filed a class action lawsuit against the top 3 makers of insulin.

The lawsuit, filed in federal court in Massachusetts, accuses Novo Nordisk, Sanofi, and Eli Lilly of manipulating insulin prices and offering discounts to pharmacy benefit managers at the expense of consumers.

Some patients in the lawsuit say they must pay $900 a month to stay alive and have taken measures that harm their health to avoid using too much insulin.

The lawsuit says: “Many patients describe rearranging their lives around their insulin costs—keeping lights off and the heat low to avoid high electric bills, moving back in with their parents, and even leaving school.”

Officials with Novo Nordisk and Sanofi said they will fight the lawsuit, and Eli Lilly said it maintains the highest ethical standards.

Gaps in Cancer Quality Measures

A new study from Discern Health found gaps in current quality measures that accountable care groups use for treating 10 cancer conditions.

The study found:

  • The measures used don’t match the most common cancer conditions,
  • Measures don’t match specific conditions, and
  • Measures don’t address gaps in multidisciplinary care, such as getting access to clinical trials, genetic testing, or palliative care.

Obese Patients' Perceptions

Finally, a new study from the University of Pennsylvania finds that stress from fat-shaming can raise cardiometabolic risk in obese patients who are trying to lose weight.

Fatima Cody Stanford, MD, of Harvard previously told AJMC how improving patients’ self worth is often the first step to overcoming obesity. Watch the interview.

For all of us at the Managed Markets News Network, I’m Laura Joszt.

Thanks for joining us.

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