Wednesday, June 22, 2016

Drug prices may--in the future--head toward value-based

I "attended" another online seminar from the Bipartisan Policy Center, this one on Affordable Medicines.

We have all heard of those cases of a needed medication costing thousands a month. But even more common are the $7 a day anticoagulation or cholesterol pills. Bucks! Are these new meds, especially the ones touted for millions on TV, really a value?

Former Senate Majority Leader Tom Daschle chaired the session. The longest remarks were from the head of the Health Policy Center at Duke--Mark McClellan. In a presentation starring some crammed-full Power Point slides (I am not a fan of PP), he discussed the gradual moves toward determining the value of both Part B (drugs administered in a doc's office, usually anti-cancer) and Part D (prescription) drugs under Medicare. He said this was similar to moves from fee-for-service and the new idea of fee for performance.

Before we get too lost in the weeds here, I was most impressed with the remarks of Lowell E. Schnipper, MD, chair of the American Society of Clinical Oncology (ASCO) Cancer Care Task Group.

Schnipper pointed out that cancer treatment can ruin or bankrupt families. Doctors, he said, need to take this into consideration.

--Patients need to know what they are looking at financially before treatment, he said.

--And they need to know the pros and cons of treatment approaches.

ASCO is developing an app that the doctor and patient can use together to match the patient's priorities to the available treatments. Say the patient prefers a less toxic treatment and is willing to risk some longevity, the app will outline the options, which can then be discussed. Presumably the cost will also be factored in.

Interesting stuff. Of course, I am not facing cancer treatment. That could be a different story from sitting in a webinar.

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