GDP Blog

TRACTION or TALK: The Impact of the Administrations Approach to Prescription Drugs

Posted by Seth Denson

Feb 13, 2019 7:24:12 AM

When it comes to health care, targeting the cost of Prescription Drugs has become to the Trump Administration what the ACA was to the Obama Administration – its primary focus. Since his inauguration, President Trump has continuously challenged the pharmaceutical industry, even appointing Alex Azar, a former Big Pharma Exec, to head the Department of Health and Human Services. During his recent State of the Union address, the President continued his rallying cry stating, “It is unacceptable that Americans pay vastly more than people in other countries foPrescription Drugsr the exact same drugs, often made in the exact same place. This is wrong, this is unfair, and together we will stop it. We will stop it fast,” he said. However, when it comes to prescription drugs, the Administration may be reaching the limit on what it can do on its own and ultimately will need Congress to pass new legislation to move the needle much further. Recognizing this, the President went on to say in the SOTU address when referring to prescription drugs, “I am asking the Congress to pass legislation that finally takes on the problem of global freeloading and delivers fairness and price transparency for American patients.” But Congress may be faced with a challenge when addressing this issue, as the most common approaches aren’t without their possible political ramifications. For example:

  • Allowing Americans to import cheaper drugs from Canada may be a challenge as it could be seen as undercutting U.S. jobs;
  • Tying prices in the United States to what companies charge in foreign countries could be seen as price fixing; and
  • Allowing the U.S. Government to negotiate costs in Medicare Part D may prove difficult because of the ultimate power of Pharma lobbying.
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Topics: prescription drugs, Trump, congress, pbm, costs, hhs, big pharma, pharmaceutical, legislation

THE ECONOMIC PRINCIPAL IN HEALTHCARE

Posted by Seth Denson

Feb 4, 2019 7:17:15 AM

Economic Principal HealthcareSo often while talking with employers, we find that when it comes to providing health insurance to their employees, they think of this process as a transactional one rather than one of continued engagement. We will regularly refer to this as the ‘Transactional’ approach vs. the ‘Asset Management’ approach (more about this later). Don’t get me wrong, insurance has been long thought of in a transactional manner. Most insurance advertising is just that – transitionally based (i.e. 15 minutes can save you 15% etc.). When it comes to health insurance; however, employers have seen a very different result over the past decade than they have when comparing other types of insurance. While the traditional Property and Casualty markets have had what we refer to as soft market times and hard market times (soft being where the carriers are much more aggressive in their pricing vs. hard markets where they are not), rarely do we see soft markets when it comes to health insurance. This is largely due to the fact that health insurance really is no longer insurance at all rather it has become healthcare financing with some risk pooling involved.

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Topics: healthcare, Health Insurance, underwriting, economics, differentiation, pbm, costs, premiums

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