By the Numbers: Specialty Drug Costs Snowball

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Drug prices are higher than ever and getting worse, a new study confirms. Retail prices for some of the most commonly used specialty prescription drugs increased by 9.6% in 2015, the fastest annual change in the past decade.

That's one of the main findings of the AARP's annual drug price report, which was released Thursday morning.

The annual pricetag for treatment with those specialty drugs was a whopping $52,486 dollars -- more than three times higher than it was in 2006, the report found. That annual cost is slightly less than the median household income, but twice the median income for Medicare beneficiaries.

The researchers compared that to the annual inflation increase of 0.1% last year.

"American families can't afford to keep paying for prescription drugs that cost more money than their salaries," said AARP Chief Public Policy Officer Debra Whitman. "These price increases are particularly hard on older adults, who take an average of 4.5 prescription drugs per month and often live on fixed incomes."

The prices for specialty drugs were far higher than for traditional drugs or generics. The annual cost for traditional drugs was $5,800; generics, $523. But in percentage terms, the specialty prices grew less than brand name products, which jumped by more than 15%. Generic drugs, meanwhile, fell by 19.4% from 2014 to 2015.

Three specialty drugs in particular had large percent changes from 2014 to 2015. Forteo, an osteoporosis treatment, increased by 31.8%. Adcirca, a hypertension drug, and Gleevec, a cancer drug, increased by 24.7% and 20.9%, respectively.

The authors justified the focus on specialty drugs by pointing to their dramatic increases.

"While specialty drug products are used by a relatively small, but growing, share of the overall population, they account for the fastest growing portion of U.S. drug expenditures in recent years," they wrote. "There are strong indications that specialty drugs will become the largest share, and the majority, of drug expenditures in the next few years."


Disability Rights Groups Applaud NY Court of Appeals Assisted Suicide Ruling

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Disability rights groups applaud today’s New York Court of Appeals unanimous ruling announcing that “we reject plaintiffs’ argument that an individual has a fundamental constitutional right to aid-in-dying . . . . We also reject plaintiffs’ assertion that the State’s prohibition on assisted suicide is not rationally related to legitimate state interests.”

Not Dead Yet led the filing of a Disability Rights friend-of-the-court brief in the state’s highest court in support of the New York State Attorney General. Joining in the Not Dead Yet brief were ten other national and New York state disability rights organizations: ADAPT, the Autistic Self Advocacy Network, the Center for Disability Rights, the Disability Rights Center, the Disability Rights Education & Defense Fund (DREDF), the National Council on Independent Living, the New York Association on Independent Living, Regional Center for Independent Living and United Spinal Association, collectively referred to as the “Disability Rights Amici.”

“We are tremendously heartened by today’s decision,” said Adam Prizio, attorney for the Disability Rights Amici. “This was the right decision for the Court of Appeals and for the disability community, because the Petitioners were asking the Court to write into law an exception which the Legislature did not create and did not intend. The Court rightly declined to do this. I expect proponents of assisted suicide to redouble their efforts with the Legislature as a result, and to try to push assisted suicide through in a hurry next year. We will be there to push back when they do, because this issue is life and death for the disability community.”

Among other issues, the brief expressed concerns about advocacy for assisted suicide in the context of extreme pressures to cut health care costs. “Elders and people with disabilities too often face economic or other pressures to get out of the way,” said Diane Coleman, president/CEO of Not Dead Yet. “If assisted suicide becomes an accepted practice, coverage may be denied for more expensive healthcare, as we’ve already seen in Oregon and California. In this climate, what is being promoted as a ‘right to die’ could very quickly become an expectation, even a duty to die.”


Money Woes May Shape Metabolic Risk in Young Blacks

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Socioeconomic status was tied to the prevalence of metabolic syndrome among low-income, African-American youth during the last U.S. recession, researchers found.

Black youth from rural Georgia whose socioeconomic status was at poverty level prior to the recession and thus continued to decline had the highest rates of metabolic syndrome at 28.5%, according to Gregory E. Miller, PhD, of Northwestern University in Evanston, Ill., and colleagues.

The lowest prevalence of metabolic syndrome (10.4%) was seen among youth who remained in a stable, low-income household, while those who fell below the poverty line during the recession reported a higher prevalence of 21.8%, they wrote in the Journal of the American Heart Association.


Report: Drug Company Faked Cancer Patients to Sell Opioid Medication

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A pharmaceutical company specializing in “therapeutic solutions” engaged in an elaborate charade involving made-up cancer patients to sell a new opioid medication, congressional investigators say. 

A new report released by Sen. Claire McCaskill’s office Wednesday alleges that the company, Insys Therapeutics, falsified medical records, had employees pose as doctors’ office representatives, and blatantly misled insurance companies to push prescriptions of Subsys, its sprayable fentanyl medication. The company, which allegedly began the scheme in 2014, went so far as to mask its outgoing phone number so insurers couldn’t trace calls back to Insys Therapeutics, according to the report. 

In one episode detailed in the report, an Insys employee allegedly pretended to work for a doctor’s office to get Subsys approved for a New Jersey woman who did not actually have cancer. The woman reportedly later died after overdosing on the drug. The company has already faced criminal charges for its practices, with several former executives charged in December with what prosecutors described as a “nationwide conspiracy.” Those cases are still pending.


Dan Haar: Patients Stuck In Hospital Beds Due To Medicaid Home-Care Cut

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The call from Connecticut Children’s Medical Center on Monday was supposed to be routine.

A case manager at the hospital in Hartford had a 14-year-old patient ready to go home. She needed to make sure the preferred home health agency, Pediatric Services of America, had nurses ready to visit the youth’s home.

Medicaid covers the cost of the home visits. But it’s been 10 years since agencies such as PSA have seen an increase in those basic rates — $37 an hour for a licensed practical nurse, $45 for a registered nurse.

A small add-on fee, less than $2 an hour, also covered by Medicaid, was tacked on a few years ago for some of the most severe cases. But, starting Aug. 11, with no state budget adopted, Gov. Dannel P. Malloy ended those add-on payments in an executive order — to save the state $1.9 million a year.

With that change, PSA could no longer make the numbers work. The Atlanta-based, for-profit company works with about 300 patients at a time, including some of the toughest home-care cases in Connecticut. The company decided it wouldn’t take on new patients as of this week.

That shocked the case manager at Connecticut Children’s.

“She was irate,” said Jeanne Silverwatch, the PSA vice president overseeing Connecticut and Massachusetts. “They wanted to discharge this child. … She’s angry, she’s upset and she said she was going to take it up the administrative ladder.”

She can take it all the way up to Malloy. She might find that this latest cut was too much to bear in a crisis that’s been brewing for more than 15 years as Medicaid payments to private health care providers have squeezed tighter and requirements have ballooned.