Good morning ... From the annals of ostensibly feel-good stories that are actually not great, if you think about them for more than 10 seconds: A high school robotics team stepped up to build an electric wheelchair — for a toddler with a rare genetic disease, whose parents' insurance won’t cover an electric wheelchair.
Illustration: Aïda Amer/Axios
Conventional wisdom says health insurers nudge patients toward generic drugs whenever they can, saving everyone money in the process. As my colleague Bob Herman reports, however, that’s not always true.
Case study: Mylan recently launched a generic version of the popular Advair inhaler at a 70% discount.
How it works: Express Scripts says brand-name Adavir, which is made by GlaxoSmithKline, is the cheapest option after accounting for rebates.
Why it matters: Express Scripts is doing what PBMs are supposed to do — negotiating big discounts, rewarding the lowest-cost drug, and passing along the savings.
Yes, but: Generics still make up 90% of filled prescriptions.
The House Energy and Commerce Committee yesterday approved several bills designed to enhance prescription drug competition, Axios' Caitlin Owens reports.
Go deeper: The drug pricing debate is stuck in the past
Most large U.S. cities have a shortage of affordable housing, and that has a ripple effect on low-income families' health, Curbed reports, citing a new study that adds to the growing focus on social determinants of health.
Details, from Curbed:
What's next: A handful of state Medicaid programs and health systems have both recognized this link, and are steering some of their health care dollars toward affordable housing.
This was 7 years ago. Photo: Chris Maddaloni/CQ Roll Call
The Affordable Care Act was and is a big deal. But it probably should not be the sun around which all health policy must orbit. And the fact that Washington has thrust it into that role, for almost a decade, has diverted attention and political energy from the very important issue of what health care costs.
"We're doing nothing. Nothing. We're heading toward the waterfall," former Congressional Budget Office director Doug Elmendorf told Politico's Joanne Kenen, who has a good piece about the opportunity cost of the ACA wars.
Polls show that the public is worried about cost more than anything else in the health care system, but it's not getting commensurate political attention.
The bottom line: Health care costs are just going to keep on climbing.
You probably saw the news yesterday that Cigna/Express Scripts will be reducing how much many patients must pay each month for insulin. But not everyone's sold on this move, which just so happened to occur right before a big Senate hearing with PBMs.
🔥, from Senate Finance Committee chairman Chuck Grassley:
Grassley has a point — if it's this easy to reduce patients' costs, why have those costs gotten so high, and stayed there for so long? And, as STAT notes, these changes won't be universal: Employers will have to agree to participate in Cigna and Express Scripts' new system.