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2017 Rx Cost Trend Over 5 Times U.S. Inflation, Segal Projects

Driven by price increases, costs for the prescription drug benefit carve-out will increase 11.6% this year, based on Segal Consulting’s survey report, High Rx Cost Trends Projected to Be Lower for 2018, published today. The report is accessible on the Segal Co. website. While the Segal team expects prescription drug (Rx) benefit plan cost trends to be “less severe” in 2018, Rx cost increases is a top priority for many sponsors of health plans as their rate of increase far exceeds those for inpatient hospital claims or physician expense. Drug costs continue to be the fastest-growing line item in health

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Prescription Drug Coverage at Work: Common, Complex, and Costly

Getting health insurance at work means also having prescription drug coverage; 99% of covered workers’ companies cover drugs, based on the 2017 Employer Health Benefits Survey released by the Kaiser Family Foundation (KFF). I covered the top-line of this important annual report in yesterday’s Health Populi post, which found that the health insurance premium for a family of four covered in the workplace has reached $18,764 — approaching the price of a new 2017 small car according to the Kelley Blue Book. The complexities of prescription drug plans have proliferated, since KFF began monitoring the drug portion of health benefits

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Employees Continue To Pick Up More Health Insurance Costs, Even As Their Growth Slows

The average cost of an employer=sponsored health plan for a family reached $18,764 in 2017. While this premium grew overall by a historically relative low of 3.4%, employees covered under that plan faced an increase of 8.3% over what their plan share cost them in 2016, according to the 2017 Employer Health Benefit Survey published today by the Kaiser Family Foundation. [Here’s a link to the 2016 KFF report, which provided the baseline for this 8.3% calculation]. Average family premiums at the workplace rose 19% since 2012, a slowdown from the two previous five-year periods — 30% between 2007 and 2012, and

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Decline in Pharmacy Reputations Related to Prescription Drug Prices, J.D. Power Finds

Cost is the number one driver among consumers declining satisfaction with pharmacies, J.D. Power found in its 2017 U.S. Pharmacy Study. Historically in J.D. Power’s studies into consumer perceptions of pharmacy, the retail segment has performed very well, However, in 2017, peoples’ concerns about drug prices negatively impact their views of the pharmacy — the front-line at the point-of-purchase for prescription drugs. In the past year, dissatisfaction with brick-and-mortar pharmacies related to the cost of drugs and the in-store experience. For mail-order drugs, consumer dissatisfaction was driven by cost and the prescription ordering process. Among all pharmacy channels, supermarket drugstores

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Celebrating 10 Years of Health Populi, 10 Healthcare Milestones and Learnings

Happy anniversary to me…well, to the Health Populi blog! It’s ten years this week since I launched this site, to share my (then) 20 years of experience advising health care stakeholders in the U.S. and Europe at the convergence of health, economics, technology, and people. To celebrate the decade’s worth of 1,791 posts here on Health Populi (all written by me in my independent voice), I’ll offer ten health/care milestones that represent key themes covered from early September 2007 through to today… 1. Healthcare is one-fifth of the national U.S. economy, and the top worrisome line item in the American

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Employer Health Benefits Stable In the Midst of Uncertain Health Politics

As we look for signs of stability in U.S. health care, there’s one stakeholder that’s holding firm: employers providing healthcare benefits. Two studies out this week demonstrate companies’ commitment to sponsoring health insurance benefits….with continued tweaks to benefit design that nudges workers toward healthier behaviors, lower cost-settings, and greater cost-sharing. As Julie Stone, senior benefits consultant with Willis Towers Watson (WLTW), noted, “The extent of uncertainty in Washington has made people reluctant to make changes to their benefit programs without knowing what’s happening. They’re taking a wait-and-see attitude.” First, the Willis Towers Watson 22nd annual Best Practices in Health Care Employer

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Patients Want Doctors To Know How Much Their Drugs Cost

  Patients want their doctors to know what their personal costs for medicines are; 42% of patients also believe their doctor is aware of how much they spend on prescription drugs. However, 61% of these people have not talked with doctors about drug prices. Nor do most doctors have access to this kind of information at the individual patient level. One important tactic to addressing overall healthcare costs, and managing the prescription drug line item in those costs, is discussed in Doctors and Pharmacists: An Underused Resource to Manage Drug Costs for Older Adults, a report on a survey sponsored

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Pharmacies Morph Into Primary Care Health Destinations

The business and mission of pharmacies are being re-shaped by several major market forces, most impactful being uncertain health reform prospects at the Federal level — especially for Medicaid, which is a major payor for prescription drugs. Medicaid covered 14% of retail prescriptions dispensed in 2016, according to QuintilesIMS; Medicare accounted for 27% of retail prescriptions. “But if affordability, accessibility, quality, innovation, responsiveness and choices are among the standards that will be applied to any future changes, pharmacy has strong legs to stand on,” Steve Anderson, president and CEO of the National Association of Chain Drug Stores, said in the PoweRx Top 50

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Is There Political Will for Healthcare Access in the US?

The Netherlands, France and Germany are the best places to be a patient, based on the Global Access to Healthcare Index, developed by the Economist Intelligence Unit (EIU). Throughout the world, nations wrestle with how to provide healthcare to health citizens, in the context of stretched government budgets and demand for innovative and accessible services. The Global Access to Healthcare Index gauges countries’ healthcare systems in light of peoples’ ability to access services, detailed in Global Access to Healthcare: Building Sustainable Health Systems. The United States comes up 10th in line (tied with Spain) in this analysis. Countries that score the

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Global Drug Sales Forecasts Fall For Next Five Years

Total prescription drug sales have been trimmed, based on calculations of EvaluatePharma which forecasts a $390 bn drop in revenues between 2017 and 2022. “Political and public scrutiny over pricing of both new and old drugs is not going to go away,” EvaluatePharma called out in its report. The intense scrutiny on pharma industry pricing was fostered by Martin Shkreli in his pricing of Daraprim (taking a $13.50 product raising the price to $750), Harvoni and Sovaldi pricing for Hepatitis C therapies, and last year’s EpiPen pricing uproar. A May 2017 analysis of prescription drug costs by AARP judges that, “Nothing

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Pharmacy and Outpatient Costs Will Take A Larger Portion of Health Spending in 2018

Health care costs will trend upward by 6.5% in 2018 according to the forecast, Medical Cost Trends: Behind the Numbers 2018, from PwC’s Health Research Institute. The expected increase of 6.5% is a half-percentage point up from the 2017 rate of 6.0%, which is 8% higher than last year’s rate matching that of 2014. PwC’s Health Research Institute has tracked medical cost trends since 2007, as the line chart illustrates, when trend was nearly double at nearly 12%. The research consider medical prices, health care services and goods utilization, and a PwC employer benefit cost index for the U.S. The key

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Medicines in America: The Half-Trillion Dollar Line Item

Prescription drug spending in the U.S. grew nearly 6% in 2016, reaching $450 billion, according to the QuintilesIMS Institute report, Medicines Use and Spending in the U.S., published today. U.S. drug spending is forecasted to grow by 30% over the next 5 years to 2021, amounting to $610 billion. In 2016, per capita (per person) spending on medicines for U.S. health citizens averaged $895. Specialty drugs made up $384 of that total, equal to 43% of personal drug spending, shown in the first chart. Spending on specialty drugs continues to increase as a proportion of total drug spending: traditional medicines’ share

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Most Physicians Say Patients, Doctors and Hospitals Are All Losers Under Trump

“Overall, Council members express pessimism about the health are landscape in the wake of the Trump administration’s proposed plans, citing no clear winners, only losers: patients, clinicians, and provider organizations.” This is the summary of the Leadership Survey report, Anticipating the Trump Administration’s Impact on Health Care, developed by the New England Journal of Medicine‘s NEJM Group. The first chart illustrates the “biggest healthcare losers” finding, detailed on the bottom three bars of patients, clinicians, and provider organizations. The stakeholders that will fare best under a President Trump healthcare agenda would be drug companies, payers, and employers. The biggest loser

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Diet, Surgery and Pharmacy – The Pillars of Healthcare for 500 Years

Healthcare was based on three pillars in 16th century Florence, Italy: diet, surgery, and pharmacy. Five centuries later, not much has changed in Italy or the U.S. But how healthcare gets funded and delivered in the context of these pillars significantly varies between the two countries, and impacts each nation’s health. To put this in context, visiting the Biblioteca Medicea Laurenziana (the Medici’s Laurentian Library) today in Florence was a trip through medical-surgical history, starting in the second half of the 16th century. The design of this magnificent library’s foyer and reading room was initially conceived by Michelangelo. The reading room

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The Pharmacy as Herbalist – An Italian Prescription

CNN called it, “the ancient perfume store you never heard of,” but the Officina Profumo-Farmaceutica di Santa Maria Novella had its literal roots in medicinal herbs. With scents wafting onto a 13th century Florence piazza, the Farmacia now operates as a pharmacy storefront for homeopathic and herbal supplements, along with perfumes and home scents. A visit to the pharmacy today is a journey into medicinal time-travel, back to the year 1221. I spent time in the pharmacy today to learn about the literal roots of the shop in medicinal herbs cultivated in a monastery garden and reformulated by monks into

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The Healthcare Reform Issue Americans Agree On: Lowering Rx Costs

Yesterday, the Tweeter-in-Chief President Donald Trump tweeted, “I am working on a new system where there will be competition in the Drug Industry. Pricing for the American people will come way down!” Those 140 characters sent pharma stocks tumbling, as illustrated by the chart for Mylan shares dated 7 March 2017. This is one issue that Americans across the political spectrum agree on with the POTUS. The latest Zogby poll into this issue, conducted for Prescription Justice, found 3 in 4 Americans agree that pharmaceutical companies are “getting away with murder,” as President Trump said in a TIME magazine interview

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Marketing Medicines: Going Boldly and Accessibly for Rx

Over the past two weeks, we see two marketing campaigns emerge to market medicines: first, from the branded pharmaceutical association PhRMA, the #GoBoldly initiative with a theme of innovation and personalized medicine. Second, there’s a campaign from the Generic Pharmaceutical Association (GPhA), rebranding the organization as the Association for Accessible Medicines with the tagline, “keep medicines in reach.” What’s this all about? To put these marketing initiatives in context, let’s start with the publication of Express Scripts 2016 Drug Trend Report. “Drug trend” is short-hand for growth in prescription drug spending, year on year. The first graph illustrates the price index

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More Consumers Use Retail Health Clinics for Healthcare Management, Harris Finds

1 in 5 U.S. adults used a retail clinic in 2016. Increasingly, health consumers seek care from retail clinics for more complex healthcare services beyond flu shots and pre-school exams, according to the Harris Poll’s survey, One in Five Adults Turn to Retail Health Clinics for Treatment, Prevention, and More, published January 5, 2017. Additional points the poll revealed are worth attention for public health policy purposes: Twice as many people who identify as LGBT turn to retail clinics than others (35% vs. 18%) Older people frequent retail clinics for flu vaccines more than younger people do More younger men

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The Shift to Healthcare Value in a Post-Trump America, via PwC

In President Donald Trump’s preliminary thoughts about health care in America, the landscape would feature a mix of tax credits, health savings accounts, high-risk pool, state Medicaid block grants, and regulatory control shifting from the Federal government to the states, according to PwC’s forecast for the new year, Top health industry issues of 2017. PwC frames the 2017 top healthcare issues under the overall strategic imperative of value, with three categories: Adapting for value Innovating for value Building for value. The ten top issues that will shape U.S. healthcare for the next year, PwC expects, will be: An uncertain fate for the

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A Growing Medicines Bill for Global Health Consumers to 2021

The global market for spending on medicines will high $1.5 trillion by 2021, according to the latest forecast from QuintilesIMS. Drug spending grew about 9% in the past two years, and is expected to moderate to 4 to 7 percent annually over the next five years. That dramatic 9% growth was heavily driven by new (expensive) specialty drugs to treat Hepatitis C (e.g., Harvoni and Sovaldi) and cancer therapies that hit the market in the past couple of years. There will be a “healthy level” of new innovative meds coming out of the drug pipeline in the next several years

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U.S. Healthcare Spending Hit Nearly $10,000 A Person In 2015

Spending on health care in the U.S. hit $3.2 trillion in 2015, increasing 5.8% from 2014. This works out to $9,990 per person in the U.S., and nearly 18% of the nation’s gross domestic product (GDP). Factors that drove such significant spending growth included increases in private health insurance coverage owing to the Affordable Care Act (ACA) coverage (7.2%), and spending on physician services (7.2%) and hospital care (5.6%). Prescription drug spending grew by 9% between 2014 and 2015 (a topic which I’ll cover in tomorrow’s Health Populi discussing IMS Institute’s latest report into global medicines spending). The topic of

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Consumers Feel More Respect from Personal Care and Grocery Brands Than Pharma or Insurance

People feel like get-no-respect Rodney Dangerfield when they deal with health insurance, government agencies, or pharma companies. Consumers feel much more love from personal care and beauty companies, grocery and fitness, according to a brand equity study by a team from C Space, published in Harvard Businss Review. As consumer-directed health care (high deductibles, first-dollar payments out-of-pocket) continues to grow, bridging consumer trust and values will be a critical factor for building consumer market share in the expanding retail health landscape. Nine of the top 10 companies C Space identified with the greatest “customer quotient” are adjacent in some way to health:

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43% of Americans Worry About How They’ll Pay for Health Care

4 in 10 Americans are worried about how they’ll pay for health care, according to Americans’ Views on Current Trade and Health Policies, a poll conducted jointly between the Harvard T.H. Chan School of Public Health and Politico. There are no significant party differences between Democrats and Republicans regarding peoples’ worrying about their ability to pay medical costs in the next year. But there are differences in geography, with 53% of people in the South significantly more worried about health care costs compared with other regions of the U.S. Who’s to blame for the high costs of health care that

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Let’s Go Healthcare Shopping!

Healthcare is going direct-to-consumer for a lot more than over-the-counter medicines and retail clinic visits to deal with little Johnny’s sore throat on a Sunday afternoon. Entrepreneurs recognize the growing opportunity to support patients, now consumers, in going shopping for health care products and services. Those health consumers are in search of specific offerings, in accessible locations and channels, and — perhaps top-of-mind — at value-based prices as defined by the consumer herself. (Remember: value-based healthcare means valuing what matters to patients, as a recent JAMA article attested). At this week’s tenth annual Health 2.0 Conference, I’m in the zeitgeist

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Healthcare Stakeholders’ Kumbaya Moment at Walmart’s Retail Health Summit

Walmart is already in the healthcare business, serving 140 million customer visits weekly, millions of whom fill prescriptions at the store pharmacy, seek personal care in the health and beauty aisles, track blood pressure using a Higi health kiosk, and shop for healthier foods in the grocery aisles. The world’s largest company on the Global Fortune 500 list hosted a Retail Health Summit in June, the details of which have been published in a special report by Drug Store News. The Summit, produced by Dan Mack’s Mack Elevation Forum and Drug Store News, convened stakeholders from across the retail health landscape: including

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Naloxone in Retail Health – Helping The Opioid Epidemic at Pharmacies and Grocery Stores

The ranks of pharmacies making available the overdose reversal medication naloxone without a prescription or seeing a doctor, is fast-growing. These announcements from retail pharmacy chains and grocery stores is a collective retail health-response to the opioid epidemic, a mainstream public health challenge across America. Naloxone is used in the event of an overdose. It can reverse the impacts of opioids, administered by injection or nasal spray. The statistics on opioid overdoses in the U.S. are chilling. Mortality (death rate) from opioid overdose in the U.S. grew 200% since 2000. Deaths have been higher among people between 25 and 44 years of

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Health Care Costs in Retirement Will Run $260K If You’re Retiring This Year

If you’re retiring in 2016, you’ll need $260,000 to cover your health care costs during your retirement years. In 2015, that number was $245,000, so retiree health care costs increased 6% in one year according to Fidelity’s Retirement Health Care Cost Estimator. The 6% annual cost increase is exactly what the National Business Group on Health found in their recently published 2017 Health Plan Design Survey polling large employers covering health care, discussed here in Health Populi. The 6% health care cost increases are driven primary by people using more health services and the higher costs for many medicines — specifically, specialty

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Most US Doctors Say They Ration Patients’ Healthcare

Rationing has long been seen as a common practice in national, single-payer health systems like the UK’s National Health Service and Canada’s national health insurance program (known as “Medicare”).  However, over half of U.S. physicians say they ration care to patients. In a peer-reviewed column in the Journal of General Internal Medicine published in July 2016, Dr. Robert Sheeler and colleagues at the Mayo Clinic, University of Iowa, and University of Michigan, found that 53% of physicians surveyed personally “refrained” in the past six months from using specific clinical services that would have provided the “best patient care” due to cost.

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The Future of Retail Health in 2027

As consumers gain more financial skin in the game of paying for health care, we look for more retail-like experiences that reflect the Burger King approach to consuming: having it our way. For health are, that means access, convenience, transparency and fair costs, respect for our time, and a clear value proposition for services rendered. That doesn’t happen so much in the legacy health care system — in hospitals and doctors’ offices. It has already begun to happen in retail health settings and, especially, in the changing nature of pharmacies. Retail Health 2027, a special supplement to Drug Store News

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The Drug Epidemic-Testing and Data Arm the Battle

More than 40 Americans die every day from prescribed opiate overdoses, Dr. Tom Frieden of the CDC has recognized. The harms of pain-killing drugs have been substantial: Dr. Frieden observed, “the prevalence of opioid dependence may be as high as 26% among patients in primary care receiving opioids for chronic non-cancer-related pain.” There were more deaths due to drug overdoses in 2014 than in any previous year, 61% of which involved opioid pain relieving medications such as oxycodone and hydrocodine, and heroin which has grown in use over the past few years. The CDC has recommended that healthcare providers do

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The State of Health Benefits in 2016: Reallocating the Components

Virtually all employers who offer health coverage to workers extend health benefits to all full-time employees. 94% offer health care coverage to opposite-sex spouses, and 83% to same-sex spouses. One-half off health benefits to both opposite-sex and same-sex domestic partners (unmarried). Dental insurance, prescription drug coverage, vision insurance, mail order prescription programs, and mental health coverage are also offered by a vast majority (85% and over) of employers. Welcome to the detailed profile of workplace benefits for the year, published in 2016 Employee Benefits, Looking Back at 20 Years of Employee Benefits Offerings in the U.S., from the Society for Human

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Prescriptions for Food: the New Medicine

Hippocrates is often quoted as saying, “Let food be thy medicine and medicine be thy food.” While some researchers argue that Hippocrates knew the difference between ‘real’ medicine and clinical therapy, there’s no doubt he appreciated the social determinant of health and wellness that food was 1,000 years ago and continues to be today. Taking a page, or prescription note, from the good doctor’s Rx pad, food retailers, healthcare providers, local food banks, and State healthcare programs are working the food-as-medicine connection to bolster public health. One approach to food-as-medicine is promoting the purchase of fresh fruits and vegetables — the

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Financial Toxicity: The High Cost of Cancer Drugs in the U.S.

Two news items published in the past week point to the yin/yang of cancer survivorship and the high prices of cancer drugs. The good news: a record number of people in the US are surviving cancer, according to the American Cancer Society. That number is 15.5 million Americans, according to a study in the cancer journal CA. Note the demographics of cancer survivors: One-half are 70 years of age and older 56% were diagnosed in the past ten years, and one-third in the past 5 years Women were more likely to have had breast cancer (3.5 mm), uterine cancer (757,000),

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What Health Care Can Learn from the Blood Clot Community

  “Our goal is to create an aware and engaged, irritating set of patients who create a dialogue with health care providers once they’ve had a [blood] clot,” explained Randy Fenninger, CEO of the National Blood Clot Alliance (NBCA). NBCA’s tagline and hashtag is “Stop the Clot.” Welcome to the multi-stakeholder community involved with deep vein thrombosis (DVT) and, clinically speaking, Venous Thromboembolism (VTE). We’re talking blood clots, and the public health burden of this condition is big: it’s a leading cause of death and disability. One in 4 people in the world die of conditions caused by thrombosis. I had

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Control Drug Costs and Regulate Pharma, Most Older Americans Say

The top reason people in America over 50 don’t fill a prescription is the cost of the drug, according to the AARP 2015 Survey on Prescription Drugs. Eight in 10 people 50+ think the cost of prescription drugs is too high, and 4 in 10 are concerned about their ability to afford their medications. Thus, nearly all people over 50 think it’s important for politicians (especially presidential candidates) to control Rx drug costs. Older consumers are connecting dots between the cost of their medications and direct-to-consumer prescription drug advertising: 88% of the 50+ population who have seen or heard drug

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