The White House’s about-face on drug rebates is a loss for public health

first_img John Arnold: Trump administration’s good effort on drug rebates is bad policy By Peter J. Pitts July 11, 2019 Reprints Peter J. Pitts Can facts win out over fiction?All of this is contingent on the executive branch and Congress being honest brokers and not hucksters. As the great health care philosopher Frank Douglas once said to me, “It’s not what you control, it’s what you contribute.”Taking the heat off of pharmacy benefit managers does nothing to enhance access to essential medicines. The White House’s decision may be a win for the status quo, but it is a lost opportunity for real systemic change.Peter J. Pitts, a former FDA associate commissioner, is president of the Center for Medicine in the Public Interest. Related: BRENDAN SMIALOWSKI/AFP/Getty Images Related: Those rates aren’t set by pharmaceutical companies. They’re the domain of the pharmacy benefit managers and insurance companies. During the last five years, pharmaceutical spending has increased by 38% while the average individual health insurance premium has increased by 107%. During the same period, rebates, discounts and fees paid by the biopharmaceutical industry to insurers and pharmacy benefit managers have risen from $74 billion to the aforementioned $166 billion. Facts, as John Adams said, “are pesky things.”Government policies should encourage rebate dollars to flow back to patients who need to take prescription drugs. Will greater transparency of contracting practices on the state level drive better pharmacy benefit manager behavior? That’s one theory. Such transparency efforts in New York and Connecticut, for example, will be the bellwether. But greed often trumps shame and, without penalties, will the C-suite at Big Payer choose to do the right thing by patients and reduce their hefty profits?At the heart of the debate is whether we are going to improve our health care system through the use of smart and evolving free-market principles, such as more focused regulation that addresses the exclusionary contracting that locks out savings from biosimilars, or go down the sound-bite-laden path of “free health care.” Pharmaceutical company rebates to pharmacy benefit managers that are tied to formulary restrictions create an incentive for entrenched market leaders to “bid” incremental rebates to prevent or limit access to competitive medicines. This model, coupled with escalating cost-sharing requirements, harms patients by driving up prices, which results in reducing access to innovative drugs.Allowing pharmacy benefit managers to continue with business as usual means a continued disincentive to promote a more aggressive uptake of both biosimilars and less-expensive generic drugs. Worse, reinforcing the status quo moves us even further away from a health care ecosystem based on competitive, predictable, free-market principles and not outrageous solutions like “Medicare for All.” Zany ideas don’t solve complicated public health problems. There are no simple solutions to complex obstacles — and politicians hate that.Not following through on the proposed rule to ban rebates is harmful to patient health and the public purse. One of the biggest threats to the body politic is nonadherence to the medicines physicians have prescribed: It causes 125,000 deaths each year and is responsible for 10% of hospitalizations. Why don’t people take their medicines? Often because their copays and co-insurance rates are too high. Now the pharmaceutical industry is off the hook. So are the big payers. And important systemic change is off the table and the status quo rules. What happens to health care reform when all we’re left with are silly soundbite solutions like “drugs from Canada” or “price controls from Slovakia”? That’s no win for patients. [email protected] Related: After Trump pulled the plug on rebates, his options to reduce drug prices narrow. And he may need Congress Trump abandons drug pricing proposal that would have ended certain drug rebates  First OpinionThe White House’s about-face on drug rebates is a loss for public health About the Author Reprints Even in the complicated ecosystem of drug pricing, one fact stands out: $166 billion in discounts from pharmaceutical companies go directly into the coffers of pharmacy benefit managers. That’s 37% of our nation’s entire expense on drugs.Not a single dollar of that largesse is used to reduce patients’ out-of-pocket costs when they need medicines. So when the White House boldly developed a rule to change the dynamic by banning many rebates drug companies pay to pharmacy benefit managers under Medicare, policy experts applauded. That proposed rule died last night, the victim of intense lobbying and general ignorance. Who loses? Patients. Who wins? The status quo.When a group of pharmaceutical CEOs testified before the Senate Finance Committee in February, Pfizer CEO Albert Bourla said he supported “reforms that would create a system in which transparent, upfront discounts benefit patients at the pharmacy counter, rather than a system driven by rebates that are swallowed up by companies in the supply chain.” When asked if they would lower prices if the pharmacy benefit managers played fair, every hand on the panel went up.advertisement For shame, Mr. President. Was all of that really just political theater?advertisement Tags Donald TrumppharmaceuticalsWhite Houselast_img read more

Kenya to invest $2.1bn in power network

first_img Low carbon, solar future could increase jobs in the future – SAPVIA BRICS Previous articleWind and Solar Project Funding Opportunities in AfricaNext articleNigeria: NESI provides updated generation figures Ashley TheronAshley Theron-Ord is based in Cape Town, South Africa at Clarion Events-Africa. She is the Senior Content Producer across media brands including ESI Africa, Smart Energy International, Power Engineering International and Mining Review Africa. UNDP China, CCIEE launch report to facilitate low-carbon development AFD and Eskom commit to a competitive electricity sector Comments are closed.center_img Kenya’s Rural Electrification Authority (REA) said this week that it will invest $2.1 billion in the country’s electricity supply network over the next five years.Kenya to expand accessAccording to REA Chairman, Simon Gicharu, the money has been earmarked to develop sufficient infrastructure that will connect all the public facilities such as churches, health centres, trading centres, mosques and public primary schools, Xinhua News reported.Xinhua News added that the connection initiative will extend to include tea buying centres, coffee, factories and processing plants, police posts, water project and boreholes, secondary schools, institutions of higher learning, and vocational training centres.“The plan focuses more on the use of renewable energy for provision of electricity to areas that are far away from the national grid. This is expected to enhance industrialization and emergence of cottage industries,” Gicharu said during the 2016/17 -2020/2021 strategic plan in Nairobi.Gicharu added that since 2006, the energy authority, through its electricity connection programmes, has bumped up access from 30% in 2006 to 70% in 2016.REA to drive renewables“The 2016/17-2020/2021 strategic plan targets to electrify the remaining public facilities and households within their vicinity by June 2018 and then focus on households,” he added.Media reported that currently 3,787 public facilities in off-grid areas, of which 629 are trading centres, are not electrified.The authority is working to reduce this figure and connect these facilities to renewable sources of power through the development of around 450 renewable energy mini-grids.“The balance of the trading centres and other public facilities will be electrified through interconnection of the existing diesel mini grids and the national grid,”Xinhua News reported.Within the total grid network, the 24,536 unconnected public facilities will be electrified through extension of the grid. Finance and Policy RELATED ARTICLESMORE FROM AUTHOR Generationlast_img read more

Nigeria becomes first nation to qualify for AFCON 2019 last 16

first_imgMadagascar becomes first team to qualify for AFCON 2019 Nigeria’s defender Kenneth Omeruo (C) celebrates his goal with teammates during the 2019 Africa Cup of Nations (CAN) football match between Nigeria and Guinea at the Alexandria Stadium on June 26 , 2019. (Photo by Giuseppe CACACE / AFP) (Photo credit should read GIUSEPPE CACACE/AFP/Getty Images) Nigeria’s defender Kenneth Omeruo celebrates his goal during the 2019 Africa Cup of Nations (CAN) football match between Nigeria and Guinea at the Alexandria Stadium on June 26 , 2019. (Photo by Giuseppe CACACE / AFP) (Photo credit should read GIUSEPPE CACACE/AFP/Getty Images)Nigeria became the first nation to qualify for the knockout stages of the 2019 Africa Cup of Nations following a 1-0 win against Guinea on Wednesday at the Alexandria Stadium in Alexandria.The Super Eagles scored the only goal of the game through Kenneth Omeruo in the 73rd minute.Omeruo, who was unmarked at the near post, rose high to head the ball past Guinean goalkeeper Ibrahim Kone following Moses Simon’s corner kick.The three times AFCON champions top the group with six points from two games. On Saturday, Nigeria beat tournament debutants Burundi 1-0.Guinea, meanwhile, has one point and is third in the group.The top two nations in each of the six groups advance, along with the four best third-placed countries in the new 24-team format.The other teams in the group, Burundi and Madagascar, play each other on Thursday.Related AFCON 2019: Nigeria suspends training strike over unpaid bonusescenter_img Nigeria coach Rohr names provisional 25-man squad for AFCON 2019last_img read more