Wednesday, January 11, 2012

Tuesday Tidbits

On Monday, the Centers for Medicare and Medicaid Services released the 2010 report on national healthcare expenditures ("NHE report"). "The report notes that U.S. health care spending grew only 3.9 percent in 2010, reaching $2.6 trillion or $8,402 per person, just 0.1 percentage point faster than in 2009."  Business Insurance notes that "Government researchers say the relatively slow growth in spending during the past two years was recession-driven as consumers remained cautious about their spending."

This tidbit from the report caught the FEHBlog's eye:
Retail prescription drug spending (10 percent of total health care spending) grew only 1.2 percent to $259.1 billion in 2010, a substantial slowdown from 5.1-percent growth in 2009 and the slowest rate of growth for prescription drug spending recorded in the NHE.
This calculation was made using data that predates the huge conversion of brand name blockbuster drugs, like Lipitor that began late in 2011. Will we see a decrease in this spending category in future years?

Of course, this cogitation reminds me of the still ongoing dispute between Express Scripts and Walgreens. As the FEHBlog recalls, Walgreens wanted Express Scripts to pay for pharmacist advice to customers. Interestingly, CVS Caremark announced yesterday a study
highlights the central role pharmacists play in improving the health of their patients and how our programs leverage that expertise as we reinvent pharmacy care," Foulkes said. "The program featured counseling by pharmacists at retail stores and a dedicated pharmacist call center for those identified as having diabetes. The pharmacist interventions resulted in increased patient adherence and encouraged higher initiation rates of medications needed to best treat diabetes. The results show we are helping people on their path to better health."
The FEHBlog does expect that the pharmacy chains will win this battle over time.

The NHE reports "Physician and clinical services spending, which accounted for 20 percent of total health care spending, grew 2.5 percent to reach $515.5 billion in 2010, slowing from 3.3-percent growth in 2009." The AMA News has been very concerned about this recession related slowdown. A recent AMA News story concerns a study which finds that more people from age 19 to 26 report having a doctor which offers a glimmer of hope for the medical community.

The FEHBlog is betting that the mapping of the human genome eventually will pull the cost curve down permanently. The Wall Street Journal reports that medical technology is on the verge of charging $1,000 -- the cost of an MRI test -- to map an individual's DNA -- down from $350,000 about five years ago. And the price will go lower over time.
But understanding how genes work together to cause a condition or to develop a treatment will require extensive laboratory research far beyond merely analyzing the genome, said Karen Kaul, a molecular pathologist at NorthShore University HealthSystem in Evanston, Ill., and spokeswoman for the American Society for Clinical Pathology.
"We are just beginning to scratch the surface about what [genomic] changes are clinically relevant," she said. "I think we have to be realistic and a little cautious" about current genomic information.
True but as a wise philosopher once said "If you build it, they will come."

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