Good morning. Here is a fun fact, per JAMA: "The United States alone accounts for 41.7% of global health spending, although it accounts for only 4.4% of the global population."
Test tubes in a lab at the National Cancer Institute at the National Institutes of Health. Photo: Saul Loeb/AFP/Getty Images
The Trump administration proposed bumping up hospital payments for CAR-T cancer therapy last week, but the question of how to pay for these procedures — which are individualized for each patient — is far from settled.
The big picture: Hospitals don't want to keep losing money over this treatment, and that could affect who gets it. More CAR-T therapies are in the development pipeline, but competition isn't a surefire solution, given its personalized nature.
Hospitals can lose upwards of $100,000 when they provide CAR-T therapy to a Medicare beneficiary on an inpatient basis.
What they're saying: "Some hospitals just aren’t going to pay this ... and that's counter to the general objective, I think, of having new innovative treatments, which is that they get to patients," Memorial Sloan-Kettering Cancer Center's Peter Bach said.
What we're watching: There are more CAR-T therapies in the development pipeline. If they make it to market, they'll be available for more uses, but it's unclear what this will do to the price.
The bottom line: Unless and until competition drives down the cost of CAR-T, or either Medicare or manufacturers cave, the system is at a standoff — one that isn't sustainable in the long run.
Gross prescription drug spending appears to be on the rise, Axios' Bob Herman reports.
Yes, but: The data points do not factor in the rebates and discounts that drug manufacturers pass along to industry middlemen. So that higher spending rate doesn't tell the full story, and real spending growth almost certainly is lower.
Details: The BEA will revise these numbers twice by June, but they still won't account for drug rebates.
The bottom line: "The rebate issue really makes a mess of these things," said Paul Hughes-Cromwick, a health economist at research firm Altarum. Until the federal government gets real-time rebate data from drugmakers or pharmacy benefit managers, he said, "we're all running around chasing our tails."
The Trump administration is about to formally give up on a part of the Affordable Care Act that had largely died on its own, Axios' Sam Baker writes.
Driving the news: The Office of Personnel Management intends to stop administering the ACA's multi-state insurance plans. Axios reviewed a draft of the notification letter OPM is planning to send to congressional leaders.
How it works: The ACA initially envisioned creating 2 multi-state plans — private insurance policies that would be available through the ACA's insurance exchanges in every state. The goal was to provide guaranteed competition in states that lacked it.
Between the lines: An administration official framed the death of the multi-state plans as a bad omen for "Medicare for All," arguing that it was "a pilot program for the public option, and it’s been a dismal failure with even the most liberal states balking on it."
Innovative medical technology is trying to solve the problem of getting people to take their medicine, but its cost and its unfamiliarity has blocked widespread use, the Washington Post reports.
The big picture: The collision of drugs and medical devices with Silicon Valley has resulted in apps to help treat numerous health care conditions, and there are studies underway for more digital pills to treat cancer and other diseases.
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