OBR Daily Commentary

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Administration To 'Unleash' Medicare Advantage Plans' Bargaining Power On Some Drug Prices

(KHN Morning Briefing) Aug 8, 2018 - As a negotiation tool, Medicare Advantage plans will now be able to require patients getting drugs in a doctor's office or the hospital to try lower-cost medicines before moving up to more expensive ones in a process called step therapy.

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Winston Wong, PharmD (Posted: August 13, 2018)

quotesSpecific to cancer care, it will be interesting to see how the discussion plays out with the allowance of so-called "Step-Therapy" and the requirement to cover anything listed in the NCCN guidelines. Will the two be allowed together? quotes

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Sorry About Your Stage 3 Cancer. Here's A Bill For $21,000 In Charges You Thought Were Covered

(Los Angeles Times) Aug 7, 2018 - When Michele Brough was diagnosed with Stage 3 breast cancer in April, her oncologist wasted no time in reaching out to her insurer, Anthem Blue Cross and Blue Shield, to obtain pre-approval for a drug that would strengthen her immune system to better withstand chemotherapy.

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Winston Wong, PharmD (Posted: August 13, 2018)

quotesUnfortunately, stories and reports like these are all too common. I have to wonder as I read this. Was the misfortune due to the mis-interpretation of Neulasta Onpro vs. Neupogen? The majority of Neulata is under the medical benefit. I can see the Neupogen being forced through specialty and self-administered. Nevertheless, the timing for responses was poor.quotes

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Meet the Rebate, the New Villain of High Drug Prices

(New York Times) July 27, 2018 - An increasingly popular culprit in the debate over high drug prices is the pharmaceutical rebate, the after-the-fact discounts that form the heart of the nation’s arcane — many would say broken — market for prescription drugs.

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Winston Wong, PharmD (Posted: August 13, 2018)

quotesInteresting article. Cites insurers and employers as the revenue hounds. Not entirely true. Yes, these are the true payers, but I would contend that employers don't see a large portion of the rebates. The article states PBM's and Insurers are largely opposed to the elimination of rebate. Why would you be opposed if it did not matter to you. The article implies the PBM's only keep a small percentage and pass on the rest. HUH? This is why we need a more transparent system in place. We can still have the rebates to promote competition, but we also need clear and clean tracking of the dollar flow.quotes

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Meet the Editorial Board

Prostate Cancer
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Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

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

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

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

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

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...