OBR Daily Commentary

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Top Pharma Lobbyist Pledges To Be ‘Opportunistic’ Pushing Value-Based Reforms

(STAT Plus) Feb 23, 2017 - The drug industry is going all-in on its push to shift the conversation about drug prices to one about value, and its top lobbyist said the industry would be opportunistic in the coming months in finding legislative and administrative avenues to advance policies in pursuit of that goal.

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Winston Wong, PharmD (Posted: February 28, 2017)

quotesThis is a 2-edge sword. I an hopeful that we will continue the movement towards value-based care. I am not all together confident that value based care will help justify drug pricing. One can say that NICE already evaluates drugs in this way, and as a result, many drugs are not covered, or are under limited access due to the heavy discounts the manufacturers have offered. If it takes a significant discount to even be reconsidered by NICE, would that not be interpreted that the value is not present under the original pricing. With that said, we all know our pricing is higher here in the US. I think we might have a false hope here.quotes

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Cancer Can Bankrupt Its Victims. Obamacare Was Designed to Stop That.

(VOX) Feb 23, 2017 - Cancer is hugely expensive to treat. Obamacare provided some protection for patients against those costs. Millions are now in jeopardy under Obamacare repeal-and-replace plans.

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Winston Wong, PharmD (Posted: February 28, 2017)

quotesPre-existing conditions and lifetime patient maximums are major hot points of concern these days, for good reason. And while the insurance mandate is designed to balance out the risk pool, one has to ask is it enough of a balance. I completely understand the issue of the patient financial burden, but the bigger part of the story lies in the fact that healthcare is expensive, especially in Oncology. If the patient does not have to bear any of the burden because of being an essential benefit, then where will the cost be absorbed? Using the 80/20, or even the 10/90 rule, a lot of insured health folks are needed to really balance out the risk pool.quotes

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Express Scripts Says Prescription Drug Spending Slowed In 2016

(Reuters) Feb 6, 2017 - Express Scripts Holding Co, the largest pharmacy benefit manager in the United States, said prescription drug spending for its members slowed to less than 4 percent in 2016, at a time when scrutiny of drug price hikes has intensified.

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Winston Wong, PharmD (Posted: February 08, 2017)

quotesKeep in mind that Express Scrips is a PBM, monitoring ambulatory prescription cost. These are mostly self-administered, with some mixing in of medications under the medical benefit. Significant increases were noted in the Oncology and anti infective arena, which are mostly under the medical benefit, hence is not being readily tracked by the PBM. I would surmise that if the overall medical spend was tracked, the level of increase would be higher.quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Associate Cancer Center Director, Yale Cancer Center P...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Professor and Chair, Department of Radiation Oncology...

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Jeff Patton, M.D.

CEO Tennessee Oncology...

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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Health Policy
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Joseph Bailes, MD

National Health Policy Expert...

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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Professor and Physician-in-Chief of the Ohios State Uni...

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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...