Pharmaceutical Industry CEOs Face Senate Hearing on Drug Prices

Everlong gives you the ability to use a Pharmacy Benefit Manager (PBM) that provides 100% transparency into pricing and passes rebates on to the employers. Just another way we are fixing the broken system.

If you are looking for a better way to purchase group health insurance, let’s talk.

 

Pharmaceutical Industry CEOs Face Senate Hearing on Drug Prices

The Wall Street Journal

Americans continue to grapple with the rising cost of health care, including out-of-pocket costs for prescription drugs. In Washington, drug pricing may be one of the few issues that President Donald Trump and the Democrats could find common ground. While the pharmaceutical industry has for years been a major lobbying player, its critics are also spending millions of dollars to influence lawmakers.

On Tuesday, when senators ask about high list prices for drugs, expect the companies to respond by saying the prices aren’t meaningful because they don’t include discounts and rebates that companies give to pharmacy-benefit managers in order to gain plan coverage, said Ira Loss, senior health-care analyst at research firm Washington Analysis.

“The drug industry is going to come in and blame the pharmacy-benefit managers for the problems and say, ‘It’s not our fault,’ ” Mr. Loss said. Industrywide, net prices have been falling as list prices rise, according to data from SSR Health. Few patients pay “list” prices, which don’t take into account rebates, discounts and insurance payments, but some pay the full price at times, such as when they haven’t met their deductible.

Read More: https://www.wsj.com/articles/pharmaceutical-industry-ceos-face-senate-hearing-on-drug-prices

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Is This Health Benefit The “Future” of Employee Care?

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There’s a new healthcare model that’s not only changing the way people get and receive care — it’s also an employee benefit that’s about to blow up.

Direct primary care (DPC) — a fee-based model that gives individuals unlimited access to a primary care doctor for anywhere between $60 to $150 a month, without insurance being billed — is the “future of healthcare,” Dan Thompson, a healthcare consultant and president of Thompson Risk, said Thursday during a panel at Employee Benefit Adviser’s Workplace Benefits Renaissance conference. The model covers much of what a patient needs, including tests, consulting, drugs and treatment, typically at a much lower cost than through insurance.

The model is fairly new, but it’s gaining momentum: There are roughly 1,000 DPC practices across 48 states and Washington, the panelists said this week. The majority of patients who use the model are families and individuals who pay for the service out of pocket, but a growing number of employers are turning to the practice as an employee benefit offering.

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How Utilizing Data Can Impact Health Costs, Improve Employee Health

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Forget tweaking healthcare plans. Analyzing data might be the key for how employers can really start to save money on healthcare. Companies need to look beyond just the financial numbers, experts say. Instead, look at the bigger picture, from health risk and claims data to how new treatments and therapies can impact employee productivity and presenteeism, as a way to improve customer service and save on health costs.

The data that drug companies and device makers gather from trials on treatment efficacy provides the basic clinical evidence,but there also is a host of data from other sources that helps indicate what is happening to an employer’s population, he said, speaking at the Integrated Benefits Institute/Patient-Centered Outcomes Research Institute regional forum Tuesday.

From health risk assessments to claims data, employers can get a robust amount of information when crafting health programs.“Focusing on improved health is how to bring costs down, rather than manipulating the health plan,” said Brian Davey, director of health and safety at the World Bank.

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Winners And Losers Under Bold Trump Plan To Slash Drug Rebate Deals

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In pointed language sure to anger middlemen who benefit from the deals, administration officials proposed banning rebates paid by drug companies to ensure coverage for their products under Medicare and Medicaid plans.

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8 Biggest Healthcare Trends For Employers To Watch

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Megamergers such as the CVS-Aetna and Cigna-Express Scripts deals both passed, and the Amazon, Berkshire Hathaway and JPMorgan Chase venture shook up the market. At the same time, heated debates in Washington and increased scrutiny of healthcare organizations have brought to light the need for greater healthcare transparency.

This issue has become a tremendous challenge to employees seeking and receiving the medical care and prescription drugs they need — a challenge that, when coupled with low healthcare literacy, has led to excess expenses and both unnecessary and avoided care.

In 2019, the healthcare system is facing — if not a turning point — a call-to-action for progress. As the industry works to meet this demand, there are a few key trends on the healthcare horizon.

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