Kip Piper's Health Care Blog
Medicare, Medicaid, Health Reform

Compounded drugs are a new hot issue in the pharmaceuticals industry and in Congress. There are little data about compounding pharmacies, but a new Congressional Research Service brief gives a comprehensive overview. Compounded Drugs Personalize Drug Treatments: Compounded drugs are created when a physician or pharmacist mixes or changes pharmaceuticals to...
The prices of generic drugs vs. brand-name drugs has gathered a lot of attention lately. But buying in bulk and purchasing practices can have as much of an effect on prices as drug patents do.  That’s what the Government Accountability Office (GAO) found when it compared Rx prices paid in prescription...
What's the impact on patient care, particularly prescription drug utilization, as Medicaid beneficiaries move from fee-for-service to Medicaid health plans?  This year, state Medicaid programs will spend over $22.1 billion on pharmacy benefits. This will grow to about $50 billion by 2020, according the CMS actuaries. Nearly half of Medicaid prescriptions...
Medicare Part D, the Medicare drug benefit, served roughly 31 million seniors last year. Medicare Part D is more similar to Medicare Advantage than to traditional Medicare in that enrollees can choose among several private health plans for drug coverage. The lists of which drugs Part D plans cover -...
Independent pharmacies play a central role in the U.S. prescription drug market, distributing almost one in five drugs sold in the country. But small pharmacies often do not have the resources to handle the administrative burden of filing claims with health plans or purchasing stock from prescription drug wholesalers....
A painful fact about the U.S. health system is that roughly one third of health costs and spending are wasted. A study in the Journal of the American Medical Association (JAMA) found that wasted health spending could reach from about $500 billion to almost $1 trillion each year. And...
Generic drugs have operated under a different set of rules than brand-name drugs since 1984, when Congress passed the Drug Price Competition and Patent Term Restoration Act of 1984, or Hatch-Waxman Act. Brand-name drug manufacturers must submit extensive evidence from clinical trials to get approval from the Food and...
The 2012 Supreme Court got a lot of attention for its decision to uphold most of the Affordable Care Act (ACA) health reform law in NFIB v. Sebelius. But this year’s court docket will be no dud. There will be a number of interesting and important cases for pharma...
When Congress enacted the Medicare Modernization Act of 2003 (MMA), it set a spending target of about $400 billion over 10 years for the Medicare Part D drug benefit, after accounting for revenues from premiums and other sources. Seven years into the program’s life, Medicare Part D spending is...
As patents on brand-name drugs expire, and generic drug use increases, the United States, Europe, and Japan will account for a smaller share of worldwide spending on prescription drugs, a report from IMS Institute for Healthcare Informatics says. Yet rising incomes in countries such as Russia, China and India...

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