LTC Pharmacy News
July 2021
LTC Pharmacy News Will Not Publish in August
August is typically a slow month so we will use some time to work on the web site and add some new content.

Look forward to checking back in when September rolls around.

Have a wonderful summer!
Paul Baldwin
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Federal Updates
President's Executive Order and Healthcare
President Biden issued a sweeping executive order that directs executive agencies to review anti-competitive practices across several industries, including prescription drugs.

The president has directed the FDA to work with states to facilitate drug importation from foreign countries. The order also demands tighter reviews of hospital mergers and non-compete agreements.

CMS Draft Physician Payment Rule: Vaccine Payments and More
CMS has published the proposed rule on Medicare physician payments. Among the topics covered are CMS request for comments on paying for vaccinations, not just for physicians but also for mass vaccinators.

The proposed rule also discusses CMS interest in increasing participation in the diabetes prevention program.

Infrastructure Bill to Expand Medicare
The Democrats' legislation to fund major infrastructure projects, which totals $3.5 trillion, includes provisions which are not exactly what we think of as "infrastructure", including more dedicated to adding vision, dental and hearing coverage to the Medicare program.

The legislation will be considered under special provisions, referred to as reconciliation, that don't rely on Republican support to pass Congress and head to the president's desk.

MedPAC Publishes 2021 Data Book on Healthcare Spending
The Medicare Payment Advisory Commission published its 2021 edition of Health Care Spending in Medicare. The publication provides data on Medicare spending, demographics of the Medicare population, beneficiaries’ access to care, and quality of care in the program, among other information.

FDA Revises Adulhem Label
The Food and Drug Administration has changed the approved labeling of Biogen's Alzheimer's drug Adulhem. The originally-approved label was for the treatment of Alzheimer's disease, and changed to limit the indication for mild cognitive impairment or a mild form of the disease.

The agency was criticized for its broad labeling and critics noted that the studies on which the drug was approved included only mild forms of Alzheimer's disease.

The List You Want to Avoid
The US Dept. of Justice and the Dept. of Health and Human Services have teamed up to create a report on healthcare fraud and abuse in the United States.

The report is a catalog of fiscal year 2020's bad actors, including the subjects of more than 1100 health care fraud investigations and more than $3 billion in recoveries for abusive practices. 

Everything Else
DrugCompanies Raising Prices at Brisk Pace
GoodRx reports that pharmaceutical manufacturers have raised prices on 65 drugs by an average 3.5 percent during this month. While the number of drugs increasing in price is far lower than January's total of more than 800, the July tally indicates the industry isn't shy about raising prices, even in the midst of a health crisis.

Most price increases came on single-source drugs.

Payers Not Enthusiastic About Aduhelm
Biogen's recently-approved Alzheimer's disease treatment is getting the cold shoulder from some high-profile health systems and payers. 

The Cleveland Clinic and Mount Sinai Health System have decided not to stock the drug, which costs more than $57,000 per year, and was approved in a controversial FDA process.

Nursing Home Staff Vaccination Rates Remain Low
A  report from AARP reveals that only about half of nursing home staff have received COVID-19 vaccination, while nearly 80 percent of nursing home residents have been inoculated.

Nursing homes struggle with mandating staff vaccination in light of the serious staffing shortages in the industry.
Google Announces Healthcare Data Engine
Google seeks to alleviate a longstanding problem physicians experience accessing healthcare data from many sources, including health records, claims, and clinical trials. The Google Healthcare Data Engine aims to assemble data from several sources to give physicians an edge in determining the diagnosis and beginning appropriate treatment.

COVID-19 Surge Concentrated in Few States
Florida, Texas and Missouri account for 40 percent of all new COVID-19 cases. What do all these states have in common? Low vaccination rates.

All these states have vaccination rates of less than 50 percent of the population.
Healthcare Consumers Love Digital (Or Do They?)
While strong majorities of healthcare consumers claim to place a high value on using digital tools to manage their health, how many actually use them?

Not many. For example, 81 percent of survey respondents claim to place a high value on using digital tools to monitor health metrics, while only 11 percent actually use them.

NCPA: PBMs are Modern Robber Barons
National Community Pharmacists Association president calls out pharmacy benefit managers as "robber barons" a moniker from the 19th century, originally directed at the likes of John D. Rockefeller, J.P. Morgan and Andrew Carnegie