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Government Intervention in Drug Pricing
Scott Gottlieb, MD, and Ted Okon, MBA, discuss controversies surrounding a proposed legislative amendment that would allow the government to negotiate drug prices with pharmaceutical companies.
Government intervention in drug pricing would impede fair market competition, remarks Mr Okon. Dr Gottlieb and Mr Okon further discuss how the government’s control of drug pricing may affect innovation. Together, they conclude that pricing controls may affect pharmaceutical companies’ decision making regarding drug contracting and pricing. As an example, Dr Gottlieb highlights the effects of the Medicaid “best price” system.
Dr Gottlieb explains the importance of a fair market and competitive pricing scheme and their effects on insurance companies, pharmacy benefit managers, and other stakeholders in healthcare, and suggests that these are potential market-based answers to the question of how to make healthcare more affordable.
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Eliminating Enhanced PTCs Would Have Cascading Economic Impacts, Report Estimates
March 6th 2025Enhanced premium tax credits (PTCs) have made marketplace health insurance more affordable, and eliminating them could have sweeping impacts on consumers and the health care industry, according to a new report.
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Facilitators of and Barriers to Medicaid Investment in Electronic Consultation Services
March 5th 2025In this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.
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