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What We’re Reading: 340B Contract Pharmacies; Nursing Home Ownership; Health Items in Proposed Budget
An appeals court rules against the Pharmaceutical Research and Manufacturers of America in a 340B contract pharmacy dispute; for-profit investors’ acquisition of nursing homes has raised concerns about the quality of care provided in these facilities; President Joe Biden’s proposed budget for 2025 includes changes that would do away with the current system of biosimilar interchangeability.
Appeals Court Rules Against PhRMA in 340B Contract Pharmacy Dispute
Arkansas can prevent drug manufacturers from limiting the use of 340B drug discounts at certain pharmacies, according to a decision from the 8th US Circuit Court of Appeals, Axios reported. The Pharmaceutical Research and Manufacturers of America (PhRMA), a group that represents the largest drug makers in the US, had challenged an Arkansas law that penalized manufacturers for refusing to sell drugs to contract pharmacies, which provide discounted drugs to hospitals, clinics, and other safety-net facilities under 340B. The decision, which rested on the federal 340B law not specifying how drugs must be delivered by pharmacies to patients, may pave the way for similar laws in other states.
Investor Acquisition of Nonprofit Nursing Homes Sparks Quality Concerns
As more and more for-profit companies, including private equity investors, purchase nonprofit nursing homes, advocates and families are raising concerns about what this change in ownership could mean for the quality of care at these facilities, according to KFF Health News. Tactics by some investors to squeeze profit out of the nursing homes include contracting with a related company for fee-based services or collecting high rent on the facility’s real estate via a sale to a sister company, but these expenses equal fewer dollars to spend on staffing and care. Defenders of the for-profit corporations say all nursing homes are in a precarious situation due to labor shortages and low Medicaid reimbursement, and without for-profit entities stepping in, the facilities would be forced to close altogether.
Biden’s Requested Budget for 2025 Includes Health Care Priorities
President Joe Biden’s requested budget for 2025 is lower than this year’s but includes a number of priorities aligning with his health care agenda on items such as drug costs and access, biosimilars, cancer research, and more, according to Stat. Coming in at $130.7 billion vs 2024’s $144.3 billion, the proposal includes funding for a yet-to-be-created office coordinating the government’s response to drug shortages, as well as funding for the Office of Climate Change and Health Equity, which was established in 2021. The budget also proposes allowing pharmacists to fill prescriptions for reference biologics with biosimilars without needing prescriber approval, effectively discarding the interchangeability designation system.
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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The Federal Trade Commission's (FTC's) vote to ban most employers from issuing and enforcing noncompete clauses could have varying impacts on the health care workforce; federal regulators vastly under-enforced antitrust laws in the hospital sector during the last 2 decades, resulting in increased health costs; the FDA recently found genetic evidence of the H5N1 bird flu virus in pasteurized commercially purchased milk.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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What We’re Reading: Abortion Privacy Rules; Alzheimer Drug Hurdles; Nursing Home Staffing Overhaul
April 23rd 2024New health privacy rules aim to protect patients and providers in an evolving abortion landscape; some physicians express concerns about efficacy, risks, and entrenched beliefs in treating Alzheimer disease; CMS addresses longstanding staffing deficits in nursing homes.
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