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Is U.S. Drug Pricing Debate Leaving Europe Feeling Good?

The Wall Street Journal, Money Beat, April 22, 2016
by Helen Thomas

Are the transatlantic tables turning in pharmaceuticals?

Switzerland’s Novartis said this week that it was seeing faster uptake of its heart failure drug Entresto in Europe than in the U.S. The potential blockbuster, which Novartis believes could generate $5 billion in annual peak sales, has been struggling: it sold just $17 million in the first quarter with Novartis guiding to $200 million for the year, well below consensus forecasts.

With heightened focus on the burden of high U.S. drug prices, Novartis said it was getting a better reception in Europe’s single-payer system than in the U.S. for its value-for-money pitch for Entresto, which helps to reduce rates of hospitalization. That would be a real turn-around: for years, pharma companies have benefited from high prices for innovative drugs in the U.S., while struggling in Europe.

The shift may be less dramatic than it seems. Novartis later conceded that Entresto is priced at €5.50 a pill in Europe, about half the list price in the U.S. Of course, no one pays the list price. But Novartis also suggested that its pricing of the drug, which got a nod of approval from the Institute for Clinical and Economic Review, meant more limited discounts on offer to payers than seen elsewhere.

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Analysis of Claims Data Finds Workers' Out-of-Pocket Health Costs Growing Faster Than Costs Paid by Insurers

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The Lund Report, April 13, 2016
by Amy Jeter

For workers covered by their employer's health plans, out-of-pocket costs including deductibles and coinsurance have been increasing significantly faster than costs paid by insurers, reflecting a decade-long trend toward slightly less generous coverage, a new Kaiser Family Foundation analysis finds.

Between 2004 and 2014, covered workers' average out-of-pocket costs grew 77 percent, outpacing health plans’ average payment per enrollee, which rose by 58 percent. Overall, workers' out-of-pocket costs rose from an average of $422 in 2004 to $747 in 2014, while average payments by health plans rose from $2,748 to $4,354. As a result, the average generosity of health plans declined slightly, covering 85.3 percent of covered medical expenses in 2014, compared with 86.7 percent in 2004.

Trends varied for different types of patient cost-sharing. Workers’ payments toward deductibles rose 256 percent (from an average of $99 to $353), and their payments towards coinsurance increased 107 percent (from an average of $117 to $242). Average payments for copays decreased by 26 percent, from $206 to $152.

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Single-payer backers say plan would rein in health costs

   Sen. Barbara L'Italien, D-Andover

Sen. Barbara L'Italien, D-Andover

Eagle Tribune, April 2, 2016
by Christian M. Wade Statehouse Reporter

BOSTON -- Nearly a decade after Massachusetts started requiring every citizen to carry health insurance, advocates say they're building support to again transform health care in the state.

Nearly 40 of 200 lawmakers -- including some in legislative leadership -- have signaled support for proposals to create a single-payer health care system.

"While we've done a good job at insuring folks, we've not done a good job at containing costs," said Sen. Barbara L'Italien, D-Andover, one of nine senators backing the idea. "We need to start the conversation on this."

L'Italien, a member of the Legislature's Joint Committee on Healthcare Financing, said switching to some form of a single-payer system will curb the state's skyrocketing health care spending and free up money for other areas of the state budget.

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