麻豆女优

Skip to main content

The independent source for health policy research, polling, and news.

Subscribe Follow Us
  • Trump 2.0

    Trump 2.0

    • Agency Watch
    • State Watch
    • Medicaid Watch
    • Rural Health Payout
  • Public Health

    Public Health

    • Vaccines
    • CDC & Disease
    • Environmental Health
  • Audio Reports

    Audio Reports

    • What the Health?
    • Health Care Helpline
    • 麻豆女优 Health News Minute
    • An Arm and a Leg
    • Health Hub
    • HealthQ
    • Silence in Sikeston
    • Epidemic
    • See All Audio
  • Special Reports

    Special Reports

    • Bill Of The Month
    • The Body Shops
    • Broken Rehab
    • Deadly Denials
    • Priced Out
    • Dead Zone
    • Diagnosis: Debt
    • Overpayment Outrage
    • Opioid Settlement Tracking
    • See All Special Reports
  • More Topics

    More Topics

    • Elections
    • Health Care Costs
    • Insurance
    • Prescription Drugs
    • Health Industry
    • Immigration
    • Reproductive Health
    • Technology
    • Rural Health
    • Race and Health
    • Aging
    • Mental Health
    • Affordable Care Act
    • Medicare
    • Medicaid
    • Children’s Health

  • Emergency Room Boarding
  • Device Coverage by Medicare
  • Planned Parenthood Funding
  • Covid/Flu Combo Shot
  • RFK Jr. vs. Congress

TRENDING TOPICS:

  • Emergency Room Boarding
  • Device Coverage by Medicare
  • Planned Parenthood Funding
  • Covid/Flu Combo Shot
  • RFK Jr. vs. Congress

Morning Briefing

Summaries of health policy coverage from major news organizations

  • Email

Wednesday, May 27 2015

Full Issue

Insurers, Drug-Benefit Managers Seek To Link Drug Prices To Effectiveness

The sky-rocketing costs for new drugs are propelling the effort. But pharmaceutical companies suggest there are better ways to set new pricing models. Also in the news, two patients are suing Anthem Blue Cross, alleging that the insurer would not pay for an expensive new Hepatitis C drug, and a rebuff by the Supreme Court is raising interest among drug makers.

Express Scripts Holding Co., a large manager of prescription-drug benefits for U.S. employers and insurers, is seeking deals with pharmaceutical companies that would set pricing for some cancer drugs based on how well they work. The effort is part of a growing push for so-called pay-for-performance deals amid complaints about the rising price of medications, some of which cost more than $100,000 per patient a year. Some insurers and prescription-benefit managers are pushing back by arguing that they should pay less when drugs don鈥檛 work well in certain patients. Drug companies are countering with pricing models of their own, such as offering free doses during a trial period. (Loftus, 5/26)

The controversy over the new crop of hepatitis C treatments has taken yet another turn as consumers are starting to file lawsuits against insurers that deny them access to the medicines. Over the past two weeks, two different women alleged that Anthem Blue Cross refused to pay for the Harvoni treatment sold by Gilead Sciences because it was not deemed 鈥渕edically necessary.鈥 The issue emerges after more than a year of debate over the cost of the medicines and complaints by public and private payers that the treatments have become budget busters. The new hepatitis C treatments, which are sold by Gilead Science and AbbVie, cure more than 90% of those infected and, in the U.S., cost from $63,000 to $94,500, depending upon the drug and regimen, before any discounts. (Silverman, 5/26)

Local drug disposal laws are likely to be high on the pharmaceutical industry鈥檚 radar now that the Supreme Court has declined to review an Alameda County, Calif., ordinance that puts drug manufacturers on the hook for funding a prescription drug take-back program. (Karlin, 5/26)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Newsletter icon

Sign Up For Our Newsletter

Stay informed by signing up for the Morning Briefing and other emails:

Recent Morning Briefings

  • Today, April 27
  • Friday, April 24
  • Thursday, April 23
  • Wednesday, April 22
  • Tuesday, April 21
  • Monday, April 20
More Morning Briefings
RSS Feeds
  • Podcasts
  • Special Reports
  • Morning Briefing
  • About Us
  • Republish Our Content
  • Contact Us

Follow Us

  • RSS

Sign up for emails

Join our email list for regular updates based on your personal preferences.

Sign up
  • Editorial Policy
  • Privacy Policy

漏 2026 麻豆女优