Widening gap between brand and generic

The gap between brand and generic drug prices is widening, according to this New York Times piece published this week.
It says that generic prices fell 22 percent in the past year while brand-name drug prices rose 13 percent. The rise in brand prices is due to the host of expensive new specialty drugs coming on the market, for example, many of the recent releases are drugs used to treat advanced cancer when other drugs don't work.
It echoes the debate we discussed in class, between PhRMA defending the need to support drug innovation and advance new treatments, and the pushback about whether the potentially marginal benefits are worth the high costs.

Stephen W. Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota, is quoted saying that drug benefit managers are going to have a tough time deciding how and whether to cover many of these drugs:“We’re going to be faced with the issue that any drug at any price will not be sustainable.”

Medicaid expansion in Texas

It's interesting to contrast liberal and conservative media's discussion of Medicaid expansion.

1. The Atlantic, arguing that Texas should expand Medicaid. 

"Maybe governors like Perry don't believe in higher spending or a bigger social safety net. But surely they believe on getting a good deal on insuring a large number of their residents, rather than a bad deal on insuring just a few of them. Failing that, they have to believe in retrieving as much of their citizens' tax dollars as they can. Really, that's just fiscal conservatism."

2. The Texas Public Policy Foundation published an article a few days ago (and another today) defending Texas' decision to reject Medicaid expansion. 

Their argument is based off of:

-fear of post 2020 costs, fueled by doubt that the government will, as promised, fund 90% of these costs

-worry about what effect changing the system would have on existing Medicaid recipients in their state. 

They don't, however, suggest alternatives for what they see as "our nation’s worst health care program," and  don't discuss their state's poor performance among most measures of health outcome.

Are their other conservative media think tanks engaging in discussions about the benefits and drawbacks of expansion, or proposing alternate solutions within the parameters of the ACA? 

ACA Infographics

Hello,

Check out this infographic that helps explain the ACA to Americans.  Keith and I helped work on it for a Health Information class at the School of Information. http://imgur.com/lPFHQ

Profiles Of The Robert Wood Johnson Foundation's Young Leader Awardees

• http://www.healthaffairs.org/young_leaders.php
• 
  
• "Each winner has made an exceptional contribution to improving the health of the nation. Their accomplishments range from building a network of urban community gardens to addressing disparities in treating chronic kidney diseases." 

It's inspiring to see how young leaders are improving the health of communities nationwide through using leadership, innovation, creativity, and strategic tools. 

HHS releases Health Insurance rules

This Article I found on the Forbes website discusses that the recent release of the HHS regulations for Health Reform. It focuses on the rule that will not allow health insurers to make consumers pay a surcharge or be excluded for pre-existing conditions. The author suggests that this ban will make premiums increase for everyone. The author further speculates that people will opt to pay the penalties as opposed to paying high monthly premiums.

Frivolous ACA Lawsuits?

As some of you may know, despite the SCOTUS upholding the ACA, there are still legal challenges being fought. Chief among them, at least in terms of newsworthiness, is Liberty University's claim that the ACA violates First Amendment rights in requiring employers to provide health insurance for employees where that insurance covers contraception. Their argument is essentially that the requirement violates their religious freedoms--contraception being against the religious beliefs of the Christian evangelical school's doctrine.

A quick primer on First Amendment and religion: there are 2 primary 'rights' under the First Amendment related to religion. The first is the Establishment Clause, which essentially enforces the concept that church and state should be separate--another way of saying this is that the Federal government cannot favor one religious institution over another. The second is the Free Exercise of Religion clause which protects the beliefs of individuals from encroachment by the government (which is why, for example, we have laws protecting the right of refusal of treatment in favor of prayer).

So how exactly would the ACA be violating one or both of these rights? I am curious as to their Establishment Clause argument, as the law makes no mention of any religion, let alone favoring one over another. This leaves the Free Exercise clause.

A classic First Amendment case on point is the practically stone-age Reynolds vs. United States (1878) which held that laws banning polygamy did not violate the free exercise clause. The Court drew a clear distinction between beliefs and practices, saying that laws could not touch beliefs, but could regulate practices which may be extreme (i.e. polygamy, human sacrifice, etc.). The practice here, would be the failure to provide health insurance in furtherance of religious beliefs (guarding against sinful contraception).

Without going into the whole mess, I believe very strongly that Liberty University will lose this lawsuit. Among other reasons, the ACA does not require Liberty University to directly provide contraceptive services. It requires Liberty University to provide health insurance, a requirement which has been upheld by SCOTUS. The fact that health plans are required to provide contraceptive services is irrelevant. Liberty University's lawsuit is a poorly-veiled dig at the Obama Administration and, I believe, verges on the edge of frivolity.

A little humor

Pearls Before Swine is one of my favorite comic strips.  I think today's strip is just to make us smile as we go into crunch week(s)!!