This Week in Managed Care: June 30, 2017

This week, the top managed care news included the Senate announcing it would delay voting on the healthcare bill until after July 4; the FDA outlined a plan to expedite drug approvals; and Joe and Jill Biden launched the Biden Cancer Initiative.

Senate leaders delay a vote on their health bill, the FDA wants faster approvals for certain generic drugs, and Joe and Jill Biden launch a new venture to fight cancer.

Welcome to This Week in Managed Care, I’m Kelly Davio.

Senate Delays Vote on Health Bill

Senate leaders delayed a vote on their replacement for the Affordable Care Act until after the July 4 recess after five senators said they were not ready to let the bill move forward.

The announcement came the day after the Congressional Budget Office said the Senate bill would cause 22 million more Americans to become uninsured over 10 years, even though it would save 321 billion dollars.

Senate leaders are caught between members who oppose Medicaid cuts, and those like Kentucky Senator Rand Paul, who say the bill should undo more of the ACA.

Paul told PBS Newshour: “The fundamental flaw of Obamacare was that they put regulations on the insurance, about 12 regulations, which increased the cost of the insurance. And so, President Obama wanted to help poor, working-class people, but he actually hurts them by making the insurance too expensive to want to buy.”

Expediting Drug Approvals

As part of his campaign to lower drug prices, FDA Commissioner Dr. Scott Gottlieb this week called for accelerated approvals for generic drugs that have no competitors.

As part of the plan, FDA published a list of drugs that have no approved generics, which would be eligible for faster approvals.

FDA said the policy is based on data that show prices come down when more generic choices are available. Said Gottlieb:

“Getting safe and effective generic products to market in an effective way, being risk-based in our own work and making sure our rules aren’t being used to create obstacles to new competition can all help make sure that patients have access to more lower-cost options.”

FDA also published a list of drugs without generics that have no patent or exclusivity barriers, giving manufacturers a road map for new products.

Learn more.

Biden Cancer Initiative

Former Vice President Joe Biden and his wife, Jill Biden, went to New York this week to launch the Biden Cancer Initiative, which will continue the fight in cancer prevention, detection, treatment, and care.

Joe Biden said his goal is not to “reinvent the wheel” of other cancer groups, but to create a sense of urgency among the stakeholders in the field. The Bidens lost their son, former Delaware Attorney General Beau Biden, to brain cancer in 2015.

He said of the Cancer Moonshot, which made breakthroughs during his last year in office, “Everything we put in place for the Moonshot is still in place, but there’s no mission control right now. … To continue to do what Jill and I are capable of doing is to maintain the sense of urgency as well as continue to change the culture, by breaking down silos and sharing data and information.”

Outcomes-Based Agreement in Diabetes

The medical device maker Medtronic and health insurer Aetna announced an outcomes-based payment deal for Medtronic’s insulin pumps. The deal applies to patients with type 1 and type 2 diabetes who are transitioning from multiple daily insulin injections to an insulin pump.

A study published just this month in The American Journal of Managed Care, involving claims data from another insurer, showed that this transition may not be cost-effective until the second or third year, which raises questions of value for commercial payers.

However, the Medtronic and Aetna agreement will measure patient satisfaction, something earlier claims studies did not capture.

The risk-sharing agreement will include Medtronic’s MiniMed 670G, the first device that meets FDA criteria for the term “artificial pancreas,” which was approved last fall and is reaching its first customers this summer.

This spring, Aetna Medical Director Dr. John Snow signaled that value-based agreements for diabetes technology would be coming when he took part in AJMC’s Diabetes Stakeholder Summit, part of our Peer Exchange series.

Hear more from the Peer Exchange.

New in Evidence-Based Diabetes ManagementTM

Finally, the current issue of Evidence-Based Diabetes ManagementTM examines the rise of diabetes and obesity in children. Our coverage includes:

  • What claims data tell us about the rise of type 2 diabetes in youth
  • The importance of mental health care for children with diabetes
  • An interview with an expert on helping youth with type 1 diabetes make the transition to self-care

Check out the full issue.

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

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