Wednesday, May 18, 2016

Drug forum looks for state options to control costs

Yesterday’s forum on rising drug costs at the Capitol included the expected messages from the expected sources but the real news was in the second panel that offered solutions. The CT State Medical Society and the State Comptroller’s Office sponsored the forum. Dr. Jacobs, President of CSMS, laid out the problem. One medication that supports the immune system against cancer costs $150,000/year and another combination treatment for cancer costs $300,000/year. The cost of tetracycline, an old, very cheap antibiotic, rose over 75-fold in two years. Drug costs are driving half of patients to skip their meds; failure to take medications causes $125,000 deaths/year and up to 10% of hospitalizations. Representatives of Pharma, Pfizer, UConn School of Pharmacy and CVS laid out their perspectives in the first panel, which got a bit testy at points. But the second panel was helpful. Dan Ollendorf of ICER outlined their independent comparative effectiveness assessments and how they define value-based benchmark prices for new drugs. In addition to traditional quality-adjusted life years (QALYs), ICER’s analysis also includes new drugs’ avoided treatments (e.g. fewer transplants), breakthrough potential, population health impact and the tension between long term health benefit and short term budget impact. Many payers are using ICER’s analyses as a starting point for drug pricing. We also heard from Peter Michaud, MD about Maine’s successful academic detailing program providing independent information to prescribers about the effectiveness and the costs of medication options to treat a dozen common health problems. We wanted to hear more about keeping costs under control but then the lights went out (just saying).