OBR Daily Commentary

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February 3: InsideHealthPolicy: Oncologists-Backed Paper Takes PBMs To Task Over Pharmacy Concessions

(COA) Feb 3, 2017 - Oncologists and pharmacists are touting an oncologist-financed paper on the pharmacy benefit manager practice of demanding retroactive concessions from pharmacies, which the paper argues are unfair.

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

quotesThe DIR reporting process was intended to increase the level of transparency throughout the prescription transaction process. As with all good intentions, reality never seemed to occur. It is now a convoluted process that is just as murky as the overall rebate process. The ramifications are far down stream, impacting pharmacies, in addition to the overall cost to the patient and payers. Diplomat Specialty Pharmacy was hit hard last year due to what was called a DIR pullback by a PBM. So much for Transparency.quotes

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UnitedHealth, Aetna, Anthem Near 50% Value-Based Care Spending

(Forbes) Feb 2, 2017 - The nation’s largest health insurers say they are paying out almost half of their reimbursements via value-based care models sweeping the U.S. medical system.

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Winston Wong, PharmD (Posted: February 06, 2017)

quotesWhile these penetration numbers are encouraging and impressive, it would be interesting to see the details e.g. what is defined as value based care, and what is the metric that drives the reimbursement. The interest here is that there really is not any accepted standard definition of value-based care. So it could be anything that is not fee-for-service.quotes

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Here's Why Trump Will Struggle To Control 'Murderous' Drug Prices

(Forbes) Jan 30, 2017 - Trump says drug companies are "getting away with murder" on drug prices. But most of the ideas batted around for controlling drug pricing have serious flaws.

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Winston Wong, PharmD (Posted: January 31, 2017)

quotesThe issue here is that if the government were to be able to negotiate discounts, it would take a massive overhaul of the current programs. The piece touched on it, but did not specifically state that major changes in the entire system are needed to be able to put radically new programs in place. However with that said, even if discounts could be negotiated with all of the other classes outside of the six protected classes, saving could be realized. Insurance companies do that today. Finally on the topic of transparency, many States have regulations in place. No one knows how to enforce them.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...

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...

Health Policy
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Joseph Bailes, MD

National Health Policy Expert...

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

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

Editor-In-Chief
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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...