This Week in Managed Care: January 4, 2018

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This week, the top managed care news included a government shutdown affects healthcare; Democrats take control of the House; and The American Journal of Managed Care® names its most influential person in healthcare.


A government shutdown affects healthcare, Democrats take control of the House, and The American Journal of Managed Care® (AJMC®) names its most influential person in healthcare.

Welcome to This Week in Managed Care, I’m Laura Joszt.

Government Shutdown Begins

The new year began with a government shutdown that affected public health. President Donald Trump’s standoff with Congress over funding for a border wall meant that 41% of the FDA staff was furloughed the day after Christmas, while essential activities to handle drug shortages, foodborne illness, and infectious disease continued.

Said the American Public Health Association’s (AHPA's) executive director Georges Benjamin, MD,: “The administration and Congress’s inability to approve funds to keep the federal government open is unacceptable and poses a threat to public health. This shutdown is a political failure, and AHPA urges the government to put ideology aside and reach a funding solution as soon as possible.”

House Democrats Return to Power

Wednesday marked the start of the 116th Congress, as Democrats took charge of the House of Representatives for the first time since 2011.

Congressman Frank Pallone of New Jersey becomes chairman of the House Energy and Commerce Committee, which handles major healthcare legislation, and has said that he hopes to reverse steps by the Trump administration and work on controlling prices for prescription drugs. He recently told Roll Call: “Our priority has to be stabilizing the Affordable Care Act, preventing the sabotage that the Trump administration has initiated.”

Readers Choose the Most Influential Person in Healthcare

Drug approvals, the future of biosimilars, and the effort to make pharmaceuticals more competitive and affordable were all big healthcare news in the past year. So, it’s no surprise that AJMC® readers selected FDA Commissioner Scott Gottlieb, MD, as the most influential person in healthcare in an online survey.

Among the many initiatives that Gottlieb announced during 2018:

  • He played a major role in American Patients First, President Trump’s plan to rein in the cost of prescription drugs
  • He announced the Biosimilars Action Plan to bring more competition to the market
  • He is taking action against manufacturers of smokeless tobacco who market to kids

CMS Administrator Seema Verma and Amazon CEO Jeff Bezos were tied for second as the most influential in the online poll.

Federal Judge Blocks 340B Drug Discounts

A federal judge has blocked the Trump administration’s cuts to the 340B drug discount program, ruling that the administration acted illegally when it reduced Medicare payments because it acted against Congress’ intent. The rule, which cut payments 30%, was designed to reduce what seniors pay out of pocket for prescription drugs.

Hospital groups that use the program argued that the new rule threatened services they provide to the poor. Groups said in a statement: “For more than 25 years, the 340B program has helped hospitals stretch scarce federal resources to reach more patients and provide more comprehensive services—this was Congress’ clear intent for the program. The court’s ruling will help ensure 340B can continue supporting access to affordable health care for our most vulnerable communities.”

But groups like the Community Oncology Alliance have argued that some hospitals use the 340B program at affiliates that do not served low-income populations and put community oncologists at a financial disadvantage.

Evidence-Based Diabetes Management™ Examines Rise of Cardiovascular Outcomes Trials

Finally, the new issue of Evidence-Based Diabetes Management examines the paradigm shift that has occurred in diabetes care over the past decade with the rise of cardiovascular outcomes trials.

In the past year, the American Diabetes Association, the American College of Cardiology, and the American Heart Association have updated guidelines on hypoglycemia, cholesterol, and treatment of type 2 diabetes for patients with cardiovascular disease. More importantly, the groups are working more closely than ever to align guidelines for newer drug therapy classes. But could the generation of trials do more?

EBDM Editor-in-Chief Robert Gabbay, MD, PhD, FACP says yes, writing: “With so many therapies demonstrating a cardiovascular benefit, the time has come to design studies with cardiovascular benefit as a new starting point so that the next wave of drug development can move the bar even further for patients, with perhaps less of a leap in cost. Offering patients more choices earlier on, before diabetes does irreversible damage, will create value for every stakeholder in the system.”

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