Wednesday, February 18, 2015

Midweek Update

 CVS Health raised the alarm yesterday about a new class of injectable drugs called PCSK9 inhibitors that are expected to receive Food and Drug Administration approval for marketing in the middle of this year. This class of drugs which is designed to reduce levels of "bad" LDL cholesterol in the bloodstream, may cost insurers more than the Hepatitis C drugs because a lot more people are afflicted with bad cholesterol levels.
Estimates of annual pricing for PCSK9 inhibitors are in the range of $7,000-$12,000. Even if PCSK9 inhibitors are indicated for a very narrow patient population, cost estimates show that this new class of drugs will eclipse initial costs of Sovaldi seen at its launch. In addition, PCSK9 inhibitors are biologics, so there will not be a simple pathway to cheaper generics for at least a decade.
Carriers should start discussing how to manage this new class of drugs with their prescription benefit managers now.

Speaking of warnings, Kaiser Health News reports that a Palm Beach County, Florida, jury held MDVIP, the nation's largest concierge care management firm, liable for malpractice committed by one of its contracted doctors.  The firms offers patients quick access to physician care in return for an annual fee. The $8.5 million verdict is considered to be the first such judgment against a concierge management firm. This decision, which is on appeal, should remind MDVIP and health plans should remind the importance of making crystal clear to consumers the fact that network providers are independent contractors.  

Here's a link to an interesting Health Affairs blog post on the efforts by Lowes with 260,000 employees to engage their employees in the company's efforts to control health care costs.  Lowes is concentrating on building employee trust in its efforts.
As part of its evolution in engaging employees, Lowe’s now pioneers a model that offers employees free access to third-party personal health assistants who are unaffiliated with a specific health care provider, insurance company, or even Lowe’s. As the company’s benefits program continues to evolve, Lowe’s is seeing a noticeable change — employees trust the independent third party and listen to its counsel. The health assistant, available to help employees with anything related to their care, has proven to be an unbiased resource and trusted partner.
99% of the 20,000 employees using such an assistant are satisfied with their health benefits, and Lowe's sees that the program is producing significant savings. .

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