#6things That Happened in Health Policy This Week

6 Things That Happened in Health Policy This Week is produced by a mix of research assistants from the Healthcare Quality & Outcomes (HQO) Initiative at the Harvard T.H. Chan School of Public Health. In each edition we feature a variety of news articles, reports, and studies focused on U.S. health policy and health services research. This week’s edition is from Kim Reimold (@kimreimold), Stephanie Caty (@stephaniecaty), and Rajkumar Pammal (@rspammal). 

STAT: There’s a possible cure for ‘bubble boy’ disease. It will cost $665,000

  • In a small clinical trial, GlaxoSmithKline found that 100 percent of the children diagnosed with the severe immune deficiency survived past their third birthday with a single dose of their new drug, Strimvelis. These children typically do not live past two years.
    • Italian Medicines Agency just valued the drug at $665k when they agreed to reimburse that price.
    • Compared to the typical treatments that can cost $4 million just over a decade, Strimvelis may be bargain, especially if it lasts a lifetime.
  • This is not the first or the last time pricing of drugs will come into question.
    • In 2012, the gene therapy Glybera was priced at $1 million but failed to transition it to a commercial market.
    • In 2014, Gilead Sciences priced its hepatitis C drug Solvadi at $84k for 12 weeks of treatment, arguing that the drug treatment was cheaper than a transplant.
    • Spark Therapeutics, based in Philadelphia, is expected to get FDA approval for a treatment for a rare eye disorder in the next year, although the long-term efficacy of the drug is not known.
  • How drugs are priced for chronic and rare conditions will continue be essential in policy conversations.

The Hill: Dems to GOP: Come back and fund Zika

  • With 15 people infected with Zika via mosquito bites in Florida and the CDC releasing an historic travel warning for a U.S. city, 40 Senate Democrats are asking GOP leaders to end their summer recess to approve emergency funding to prevent the spread of Zika.
  • The Obama administration had originally set aside $374 million to fight Zika domestically but 76 percent of the remaining funding ($173 million) is going towards vaccine development.
  • The senate was working on a $1.1 billion bipartisan funding package, but GOP leaders would only consider the package if it:
    • Was offset by other healthcare funding.
    • Would prevent any funds from going to Planned Parenthood – family planning services that might be important for Zika-infected women.

MHealth Intelligence: Tying Telehealth to Better Rural Health Outcomes

  • The Federal Communications Commission’s Connect2Health Task Force has released a new tool, Mapping Broadband Health in America, that is designed to enable users to better understand the intersection between broadband access and health status
  • The tool examines broadband access, health-related metrics such as access to physicians and rates of diabetes and obesity, as well as demographic information such as population density and rural vs urban settings
  • Notable takeaways and statistics from the tool:
    • There are many counties with both poor physician access and poor broadband connectivity that could greatly benefit from increased broadband activity to improve telemedicine access
    • Rates of obesity and diabetes are 25% and 35% higher, respectively, in counties where 60% of the population lacks access to broadband and more than 60% lacks access to basic internet at home
  • Telemedicine proponents such as the American Telemedicine Association have noted that expanded broadband access is critical to better utilization of telemedicine technologies such as secure e-visits
  • Information from this tool can help inform policies around how to utilize and expand telemedicine and broadband access to improve health and reduce disparities

POLITICO: Drug Lobby Plans Counterattack on Prices

  • The Pharmaceutical Research and Manufacturers of America (PhRMA) is preparing to spend hundreds of millions of dollars on an ad campaign in response to recent criticisms from politicians
  • This action comes after much critique of the pharmaceutical industry from both Democrats and Republicans, including concerns over high-cost specialty drugs, outrage over the price hikes implemented by former CEO of Turing Pharmaceuticals, Martin Shkreli, and anger over some pharmaceutical companies’ attempts to evade US taxes by coupling with companies overseas
  • In addition to PhRMA’s typical defense of the costs of drugs – the price of research and development – the campaign will take a positive spin and highlight the life-saving capabilities of drugs
  • PhRMA is expanding its membership to include Teva, Alexion Pharmaceuticals, and Jazz Pharmaceuticals, and is looking to add Gilead and Genetech to its ranks. It is raising dues on all members which will significantly increase the lobbying group’s financial resources
  • PhRMA is hoping to facilitate a larger discussion around health care costs, but some policymakers, including Chris Jennings of the Clinton campaign, are skeptical and maintain concerns that PhRMA’s additional financial resources will simply make it more powerful

Kaiser Health News: Medicare’s Readmission Penalties Hit New High

  • Records released on Tuesday show that Medicare will withhold over half a billion dollars in payments over the next year through the Hospital Readmissions Reduction Program (HRRP)
    • This is the highest total ever since the federal government began placing readmission penalties on hospitals in October 2012
  • Though the number of hospitals being penalized this year (2,597) is similar to the number of hospitals penalized last year, penalties have increased per hospital by a fifth on average
  • Medicare has stated that penalties have increased to $528 million (approximately $108 million more than last year) due to changes in how readmissions are measured
    • For the first time this year, coronary artery bypass graft (CABG) surgery was included in the conditions examined for readmission rates
  • Though national readmission rates have declined since the creation of HRRP under the Affordable Care Act, the program has been criticized for unfairly penalizing hospitals that treat large numbers of low-income people
  • Penalized hospitals will receive a reduction in each Medicare case reimbursement from October 2016 through September 2017

Centers for Medicare & Medicaid Services: CMS announces next phase in largest-ever initiative to improve primary care in America

  • On Monday, the Centers for Medicare and Medicaid Services (CMS) announced the opening of applications for Comprehensive Primary Care Plus (CPC+), a five-year primary care medical home model that attempts to improve primary care in America
  • CPC+ is a public-private partnership and multi-payer model that aligns Medicare, Medicaid, and private insurance, thereby departing from an overarching fee-for-service model towards one that supports patient-centered quality care
  • CMS estimates that nearly 5,000 primary care practices serving 3.5 million beneficiaries could participate in CPC+ when it launches in January 2017
  • CPC+ builds upon the Comprehensive Primary Care initiative (2012), and assists primary care practices by delivering preventive care, giving patients 24-hour access to care and health information, engaging patients and families for personalized care, and more
  • This announcement comes as part of a broader strategy to improve America’s health care system through quality improvement approaches, targeting the goal of having 50% of traditional Medicare payments transformed to alternative payment models by 2018

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