Model health care sites opening across the nation

Rachel Zimmerman of Common Health looks at Donald Berwick, who is the new Director of Centers for Medicare and Medicaid Services, and his plan to expand model healthcare sites across the United States. The goal is to have these sites launched throughout the US by the end of 2011. These sites will focus on the safety of patients and quality care while maintaining an affordable cost. They will be the new model for how physicians are paid with the new plans for healthcare.

Are you concerned about the influx of Medicaid Managed Care invoices from the States?

At the 2010 MDRP Summit, you can:
→ Learn how manufactures dealing with this invoicing increase
→ Determine how each system can handle the Medicaid Managed Care invoices from States
→ Identify the process that each state will use to be able to manage invoice expectations
→ Understand the role of CMS in this new process

Need Answers to Changing Regulations?
→ Gain the best access available to federal government policy and operations contacts for MDRP and other public sector reimbursement programs
→ Learn from 60+ senior experts share how they are complying with new regulations
→ Witness HHS and OIG share lessons learned from current litigations
→ Take part in organized dispute resolution meetings

For more information about the MDRP Summit taking place September 15-17, 2010, visit the webpage. We hope to see you in Chicago!

HealthSpring becomes 7th largest Medicare Advantage plan provider

Ritter Insurance Marketing has news that HealthSpring has purchased Bravo Health to add 100,000 members to their Medicare Advantage coverage. This will make them the seventh largets Medicare Advantage provider with 397,000 members. The company primarily covers markets in Texas and Philadelphia.

Seniors will see a gap closing in the doughnut hole

The Seattle Times notes that seniors will see a slight increase in premiums for their Medicare Drug Plans. Even though the costs will be increasing, seniors will see the improvements in their plans by the beginning of the closing of the doughnut hole.

Some physicians leaving Medicare due to costs

Many doctors are leaving Medicare, while many others have stopped accepting new Medicare patients reports WRAL of Raleigh, North Carolina. In North Carolina, 80 physicians have opted out of Medicare in the last year. Many cite the fact that while the cost of treating patients has gone up, the government has failed to increase the rates at which they reimburse the doctors.

One doctor, Dr. Conrad Flick, a partner in Family Medical Associates and a board member of the American Academy of Family Physicians, stated,"The payment from Medicare for our services is less than it costs us to provide those services. Our job is to take care of patients, which is what we love, but if we can't run our business, we can't take care of any patients."

What effect will Avastin's fate have on healthcare?

The Daily Telegraph in the UK has the latest on the vote from the FDA Advisory Panel to drop Avastin as an endorsed treatment for breast cancer patients. The drug prevented blood flow to the tumors, extending the amount of time before the disease worsened. However, now that the FDA Advisory Panel has dropped their endorsement because the drug may only extend lives by a month, possibly even less, US Insurers could possibly stop covering the drug in their health plans. They cited "cost effectiveness" was the reason their endorsement was dropped.

What are the long term effects this will have on healthcare coverage in the United States? What kind of implications could "Cost Effectiveness" have on future drugs and their coverage on healthcare plans?

Pharma and Health Plan executives debate criteria for formulary placement and reimbursement

IIR’s 2nd Annual Value-Driven Pharma event is the only conference that delivers the tools and the know how pharmaceutical executives need to meet payers increasingly strict criteria for coverage and reimbursement. No other managed market event offers wider accents to industry experts and solutions.

Obtain the tools to deliver solid economic health data applicable to real-world needs and decisions faced by patients, clinicians, and payers necessary to obtain formulary placement.

Respond to the shifting payer mix and optimize your formulary and reimbursement strategy to ensure you reap the benefits of increased prescription volumes.

This is the last week to save, so register now for Value-Driven Pharma to navigate the changing reimbursement paradigm to ensure your product’s value is undisputable.

We know that budgets are tight and it can be difficult to get time away from the office – however, we continue to hear from the industry that it is more important than ever to gain insights from industry thought leaders speaking at Value- Driven Pharma.
To learn more about this year’s agenda and impressive speaker line-up, download the brochure or visit our website. We are confident that once you do, you and your team will discover that Value-Driven Pharma is a can’t-miss event for 2010.

MDRP 2010: Attending Companies to Date

Who is scheduled to attend this year's MDRP Summit? Join us and these companies September 15-17, 2010 in Chicago, Illinois!



* 3 Rivers Pharmaceuticals * 340B Prime Vendor Program * Abbott Laboratories * Abbott Labs * Actavis * Afaxys Inc * Alabama Medicaid Agency * Alcon Laboratories * Alexion Pharmaceuticals * Allergan * Alvogen Inc * AMAG Pharmecueticals * American Pharmaceutical Association * AmerisourceBergen Speciality Group * Amgen Inc * Amneal Pharmaceuticals * Amylin Pharmaceuticals Inc * Apotex Corporation * APP Pharmaceuticals LLC a Fresenius Kabi Company * Astellas Pharma US * AstraZeneca * Aurobindo Pharma USA * Auxilium Pharmaceuticals * Axiom Resource Management & Tricare * B Braun Medical Inc * Baxter Healthcare Corporation * Bayer Healthcare Pharmaceuticals * Becton Dickinson & Company * Becton Dickinson Medical - Diabetes Care * Biogen Idec * Biotest Pharmaceuticals Corporation * Biovail Pharmaceuticals * Boehringer Ingelheim * Brookings Institution * Cangene BioPharma * Celgene Corporation * Centers for Medicare and Medicaid Services * Centocor Ortho Biotech * Cephalon * Cephalon Inc * CMS * Compliance Implementation Services LLC * Cornerstone Biopharma Inc * County Line Pharmacueticals * Covidien * Cubist Pharmaceuticals Inc * Daiichi Sankyo Inc * Data Niche Associates * DDN Propelling Life Science * Department of Health & Human Services * Department of Veterans Affairs * Dey Pharma LP * Dr Reddys Laboratories Inc * Drug Discount Monitor * EDS North Carolina Medicaid * EISAI Corporation of North America * Elan Pharmaceuticals * Eli Lilly & Company * EMD Serono * Endo Pharmaceuticals Inc * Epstein Becker & Green * Faulkner Mackie & Cochran PC * Ferring Pharmaceuticals Inc * Forest Laboratories Inc * Galderma Laboratories * Genzyme Corporation * Georgia Department of Community Health * Gilead Sciences Inc * GlaxoSmithKline * Glenmark Pharmaceuticals Inc USA * Global Environment Research Pvt Ltd * Gold Standard Inc * Graceway Pharmaceuticals * Grifols Inc * Health Resources & Services Administration * Healthpoint Solutions * Medical Affairs * Hear With Us LLC * HHS * Hogan Lovells US LLP * Hospira Inc * Human Genome Sciences Inc * I Many * ICS * Illinois Department of Healthcare and Family Services * I-many Inc * Impax Laboratories Inc * IMS Health * Intendis * Ipsen * Jazz Pharmaceuticals Inc * JHP Pharmaceuticals LLC * Johnson & Johnson * KPMG LLP * Kremers Urban * LEO Pharma Inc * McKesson Packaging Services * Meda Pharmaceuticals * Medco * Medicis Pharmaceutical Corporation * MedImmune Inc * Medimpact * Merck & Company Inc * MERZ Pharmaceuticals LLC * Midlothian Laboratories * Millenium Pharmaceuticals * Mission Pharmacal Company * MLEE Consulting * Model N * Molina Medicaid Solutions * Morton Grove * Pharmaceuticals Inc * National Association of Chain Drug Stores * Nautilus Neurosciences Inc * Navigant Consulting * Nephron Pharmaceuticals Corporation * Neurogesx Inc * New Jersey Divison of Medical Assistance & Health Services * Novartis Consumer Health * Novartis Pharmaceuticals * Novo Nordisk Pharmaceuticals Inc * Nycomed US Inc * Octapharma * Office of Pharmacy Affairs HRSA * OIG Office of Audit Services * Oklahoma Health Care Authority * Ortho McNeil Neurologics * Paddock Laboratories Inc * Pamlab LLC * Par Pharmaceuticals Inc * Pedinol Pharmaceutical Inc * Perrigo Pharmaceuticals * Pfizer Inc * PhRMA * Plasma Protein Therapeutics Associates * Prasco * PriceWaterhouseCoopers * Proctor & Gamble * Purdue Pharma LP * Qualitest Pharmaceuticals * Ramie Zomisky * Reckitt Benckiser Pharmaceuticals * Rhodes Pharmaceuticals * Rivers Edge Pharmaceuticals * Rockford Health System * Safety Net Hospitals for Pharmaceutical Access * Salix Pharmaceuticals Inc * Sandoz Inc * Sanofi Aventis * Sepracor * Sepracor Inc * Shire Pharmaceuticals * Sigma-Tau Pharmaceuticals Inc * Southeastern Consultants Inc * State of Illinois * Stiefel Laboratories Inc * SXC Health Solutions Inc * Talecris Biotherapeutics * UCB Pharma Inc * United Therapeutics Corporation * Upsher Smith Laboratories Inc * URL Pharma * US Attorney's Office Eastern District of Pennsylvania * Vaal Pamela * Value Options Inc * Ventiv Commercial Services * Vertex Pharmaceuticals Inc * Veterans Affairs Office of Inspector General * Victory Pharma * Vistex Inc * Watson Pharmaceuticals * Wockhardt MGP * World Gen LLC * X Gen Pharmaceuticals * Xanodyne Pharmaceuticals

Overspending on many drugs in Medicaid

I recently found the white paper Overspending on Multi-Source Drugs in Medicaid. It looks at 2009 Medicaid drug data that shows that in the case of multi-source drugs, there are often frequently more sales on the more costly brands.

According to the article at the American Enterprise Insitute: Because there is usually a large price differential between brand and generic drugs, a high generic substitution rate ensures cost-effectiveness in the Medicaid drug program without engaging in policies that affect clinical decisions.

Read the white paper here:
http://bit.ly/a0Iqwm

Doctors not taking full advantage of ePrescribing

A recent report at American Medical News looks how how few doctors are taking advantage of the unique features of ePrescribing. According to the article, only 65% are checking drug interactions of the drugs they prescribe, 54% are transmitting the prescriptions to pharmacies, and 34% are checking insurance formulary lists. Less than 25% of doctors are using all three features. What should the public focus on? Moving from the traditional prescribing system to the electronic system, or moving from traditional medical records to electronic medical records? What are some of the benefits you see when doctors achieve the use of both electronic medical records and ePrescibing?