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Lawmakers will consider the bill at an Assembly Health Committee hearing on Tuesday.\u003c/p>\n\u003cp>“Californians and Americans are frustrated with the lack of progress around drug prices,” Chiu said, citing the uproar over EpiPen and hepatitis C medications.\u003c/p>\n\u003cp>He said state agencies should pool their efforts “so that we can leverage that consumer power and get the best deal for our money.”\u003c/p>\n\u003cp>While the proposed California Drug Costs Reduction Act does not mandate that various California health programs such as Medi-Cal or Covered California purchase drugs together, it would require administrators of those programs and 17 other state agencies to convene twice a year to strategize about ways to keep costs down.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Through the California Pharmaceutical Collaborative (CPC), state officials would consider a uniform state drug formulary and look at paying for drugs based on the value they bring to the health system.\u003c/p>\n\u003cp>A pharmaceutical collaborative by that name already exists within the California Department of General Services and purchases drugs for state prisons, hospitals and universities. This bill would significantly expand on those efforts.\u003c/p>\n\u003cp>Chiu says it’s unclear what the current program is doing, and if it has been successful in bringing down drug costs. The 2002 legislation that created the collaborative required only a few agencies to participate, and only one report back to the legislature in 2005.\u003c/p>\n\u003cp>A 2005 report from the California State Auditor suggested the Department of General Services could do more to bring down pharmaceutical costs for California.\u003c/p>\n\u003cp>A more recent analysis from the nonpartisan Legislative Analyst’s Office showed spending by the Department of General Services has increased at a relatively high rate — about 20 percent annually between 2012 and 2016, although that trend may have been skewed by the release of high-cost hepatitis C drugs during that time.\u003c/p>\n\u003cp>“I haven’t had transparency about the work that’s happened,” Chiu said. During a February 2017 California legislative hearing about drug prices, the lawmaker expressed frustration about not being able to get information about the workings of the CPC.\u003c/p>\n\u003cp>Chiu’s bill would require annual reports from the pharmaceutical collaborative, which the lawmaker says would ensure more accountability.\u003c/p>\n\u003cp>A spokesman with the Department of General Services, Brian Ferguson, wrote in a statement that it has been meeting “regularly” to create a “roadmap” to cut drug costs.\u003c/p>\n\u003cp>The proposal so far has no registered opposition. Priscilla VanderVeer, a spokeswoman with the drug company trade association Pharmaceutical Research and Manufacturers of America (PhRMA) had no comment on the proposal.\u003c/p>\n\u003cp>Other states such as Massachusetts have bulk purchasing programs for drugs, according to the National Academy for State Health Policy. And Oregon and Washington have joined together to create a bulk purchasing program. It is one of five multi-state pharmaceutical programs in the country, according to the National Conference of State Legislatures.\u003c/p>\n\u003cp>About a third of Californians have health care coverage through Medi-Cal alone. Together with Covered California, and the California Public Employees’ Retirement System (CalPERS), these agencies insure more than 16 million people.\u003c/p>\n\u003cp>Experts say the diverse ways state programs pay for drugs would make it hard to implement an across-the-board prescription drug purchasing system in California.\u003c/p>\n\u003cp>Ben Johnson, fiscal and policy analyst with the Legislative Analyst’s Office said that the Medi-Cal program has different rules for payment and coverage than the state’s prison system. Medi-Cal is also entitled to deep drug discounts that other state agencies don’t receive.\u003c/p>\n\u003cp>“A lot of work would have to be done to be able to actually harmonize and create a uniform system of drug procurement in the state,” Johnson said. His agency does not take positions on legislation.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Advocates for AIDS patients and retired people support the bill. The California Public Interest Research Group (CALPIRG), which sponsored the initial legislation to create the collaborative in 2002, supports the current proposal as well. In a letter to the bill’s author, the group said the measure would provide “additional tools and direction” and increase accountability on the state government’s actions to reduce drug prices.\u003c/p>\n\n","blocks":[],"excerpt":"Lawmakers will consider a plan to require administrators from about 20 state agencies to meet twice a year to strategize ways to keep costs down.","status":"publish","parent":0,"modified":1493136123,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":748},"headData":{"title":"Should California Agencies Work Together to Negotiate Better Drug Prices? | KQED","description":"Lawmakers will consider a plan to require administrators from about 20 state agencies to meet twice a year to strategize ways to keep costs down.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Should California Agencies Work Together to Negotiate Better Drug Prices?","datePublished":"2017-04-25T16:02:03.000Z","dateModified":"2017-04-25T16:02:03.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"322154 https://ww2.kqed.org/stateofhealth/?p=322154","disqusUrl":"https://ww2.kqed.org/stateofhealth/2017/04/25/should-california-agencies-work-together-to-negotiate-better-drug-prices/","disqusTitle":"Should California Agencies Work Together to Negotiate Better Drug Prices?","nprByline":"\u003cstrong>\u003ca href=\"http://californiahealthline.org/news/author/pauline-bartolone/\">Pauline Bartolone\u003c/strong>\u003c/a>\u003c/br>California HealthLine","path":"/stateofhealth/322154/should-california-agencies-work-together-to-negotiate-better-drug-prices","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Citing budget-busting drug costs, a California lawmaker wants state health programs to band together to negotiate better prices with drug companies.\u003c/p>\n\u003cp>Assemblymember David Chiu (D-San Francisco) has introduced a bill that would strengthen intra-agency collaboration on drug cost-saving strategies. Lawmakers will consider the bill at an Assembly Health Committee hearing on Tuesday.\u003c/p>\n\u003cp>“Californians and Americans are frustrated with the lack of progress around drug prices,” Chiu said, citing the uproar over EpiPen and hepatitis C medications.\u003c/p>\n\u003cp>He said state agencies should pool their efforts “so that we can leverage that consumer power and get the best deal for our money.”\u003c/p>\n\u003cp>While the proposed California Drug Costs Reduction Act does not mandate that various California health programs such as Medi-Cal or Covered California purchase drugs together, it would require administrators of those programs and 17 other state agencies to convene twice a year to strategize about ways to keep costs down.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Through the California Pharmaceutical Collaborative (CPC), state officials would consider a uniform state drug formulary and look at paying for drugs based on the value they bring to the health system.\u003c/p>\n\u003cp>A pharmaceutical collaborative by that name already exists within the California Department of General Services and purchases drugs for state prisons, hospitals and universities. This bill would significantly expand on those efforts.\u003c/p>\n\u003cp>Chiu says it’s unclear what the current program is doing, and if it has been successful in bringing down drug costs. The 2002 legislation that created the collaborative required only a few agencies to participate, and only one report back to the legislature in 2005.\u003c/p>\n\u003cp>A 2005 report from the California State Auditor suggested the Department of General Services could do more to bring down pharmaceutical costs for California.\u003c/p>\n\u003cp>A more recent analysis from the nonpartisan Legislative Analyst’s Office showed spending by the Department of General Services has increased at a relatively high rate — about 20 percent annually between 2012 and 2016, although that trend may have been skewed by the release of high-cost hepatitis C drugs during that time.\u003c/p>\n\u003cp>“I haven’t had transparency about the work that’s happened,” Chiu said. During a February 2017 California legislative hearing about drug prices, the lawmaker expressed frustration about not being able to get information about the workings of the CPC.\u003c/p>\n\u003cp>Chiu’s bill would require annual reports from the pharmaceutical collaborative, which the lawmaker says would ensure more accountability.\u003c/p>\n\u003cp>A spokesman with the Department of General Services, Brian Ferguson, wrote in a statement that it has been meeting “regularly” to create a “roadmap” to cut drug costs.\u003c/p>\n\u003cp>The proposal so far has no registered opposition. Priscilla VanderVeer, a spokeswoman with the drug company trade association Pharmaceutical Research and Manufacturers of America (PhRMA) had no comment on the proposal.\u003c/p>\n\u003cp>Other states such as Massachusetts have bulk purchasing programs for drugs, according to the National Academy for State Health Policy. And Oregon and Washington have joined together to create a bulk purchasing program. It is one of five multi-state pharmaceutical programs in the country, according to the National Conference of State Legislatures.\u003c/p>\n\u003cp>About a third of Californians have health care coverage through Medi-Cal alone. Together with Covered California, and the California Public Employees’ Retirement System (CalPERS), these agencies insure more than 16 million people.\u003c/p>\n\u003cp>Experts say the diverse ways state programs pay for drugs would make it hard to implement an across-the-board prescription drug purchasing system in California.\u003c/p>\n\u003cp>Ben Johnson, fiscal and policy analyst with the Legislative Analyst’s Office said that the Medi-Cal program has different rules for payment and coverage than the state’s prison system. Medi-Cal is also entitled to deep drug discounts that other state agencies don’t receive.\u003c/p>\n\u003cp>“A lot of work would have to be done to be able to actually harmonize and create a uniform system of drug procurement in the state,” Johnson said. His agency does not take positions on legislation.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Advocates for AIDS patients and retired people support the bill. The California Public Interest Research Group (CALPIRG), which sponsored the initial legislation to create the collaborative in 2002, supports the current proposal as well. In a letter to the bill’s author, the group said the measure would provide “additional tools and direction” and increase accountability on the state government’s actions to reduce drug prices.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/322154/should-california-agencies-work-together-to-negotiate-better-drug-prices","authors":["byline_stateofhealth_322154"],"categories":["stateofhealth_14"],"tags":["stateofhealth_2722","stateofhealth_2650","stateofhealth_2808","stateofhealth_2519"],"featImg":"stateofhealth_322155","label":"stateofhealth"},"stateofhealth_242894":{"type":"posts","id":"stateofhealth_242894","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"242894","score":null,"sort":[1475168327000]},"guestAuthors":[],"slug":"most-americans-want-the-government-to-rein-in-prescription-drug-costs","title":"Most Americans Want the Government to Rein In Prescription Drug Costs","publishDate":1475168327,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>An overwhelming majority of Americans favor government action to restrain prescription drug prices, according to a poll released Thursday.\u003c/p>\n\u003cp>Eighty-two percent of those polled said they want Medicare to negotiate prices with the companies, which Congress does not allow. Seventy-eight percent favored limiting the amount companies can charge for high-cost drugs, such as those that fight cancer or hepatitis, according to \u003ca href=\"http://kff.org/health-reform/report/kaiser-health-tracking-poll-september-2016\" target=\"_blank\">the poll\u003c/a> from the Kaiser Family Foundation. And more than two-thirds want to let Americans buy drugs imported from Canada. Support is strong no matter the political party. (KHN is an editorially independent program of the foundation.)\u003c/p>\n\u003cp>The views come as the skyrocketing prices of some drugs are under intense scrutiny, with new evidence showing massive price hikes by some companies. Some members of Congress have called for investigations, but there is no consensus on how to effectively rein in the cost, particularly for lifesaving and unique treatments such as the EpiPen for people with deadly allergies and the hepatitis C-curing drug Sovaldi.\u003c/p>\n\u003cp>The poll found that while a majority of Americans still believed prescription drugs developed over the past two decades have improved lives, respect is dwindling. In 2008, 73 percent of Americans said the medicines had this positive effect, but that number dropped to 62 percent in August 2015. The new poll found that now 56 percent of Americans consider the drugs beneficial.\u003c/p>\n\u003cp>“Cost could be one reason why the share of Americans who say prescription drugs have made the lives of people in the U.S. better is declining,” the pollsters wrote.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The poll found that three-quarters of Americans considered drug costs unreasonable. Despite the perceived burden, the poll also discovered that 73 percent of people taking prescription medicines said it had been easy to afford their drugs. People in fair or poor health and those taking four or more drugs were more likely to say they were having trouble affording prescriptions than more healthy people.\u003c/p>\n\u003cp>Among the policy ideas the respondents were asked to consider, the most popular was requiring drug companies to explain how they set drug prices, with 86 percent support. Two-thirds of Americans favored Democratic presidential nominee Hillary Clinton’s suggestion to create an independent group to oversee drug pricing.\u003c/p>\n\u003cp>Other ideas were less popular, including two restricting consumers. A minority of those polled favored eliminating prescription drug advertisements, which has been suggested to quell the aggressive marketing companies do directly to consumers. Only 4 in 10 Americans favored requiring people to pay more if they don’t choose the least expensive version of a drug to treat their illness.\u003c/p>\n\u003cp>Separately, the poll also found that only a quarter of Americans were aware that the number of people without health insurance is at a record low. Just 9 percent went without coverage last year, according to the U.S. Census.\u003c/p>\n\u003cp>The survey found that the country is evenly divided about the success of the insurance marketplaces created by the Affordable Care Act to assist people without employer or government coverage. People in states that are running their own marketplaces were more positive about them than are people in states that rely on the federal website, healthcare.gov.\u003c/p>\n\u003cp>The survey was conducted between Sept. 14 and 20 among 1,204 people, using both land lines and cell phones. The margin of error was +/- 3 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\" target=\"\">Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The views come as the skyrocketing prices of some drugs are under intense scrutiny, with new evidence showing massive price hikes by some companies.","status":"publish","parent":0,"modified":1475185687,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":584},"headData":{"title":"Most Americans Want the Government to Rein In Prescription Drug Costs | KQED","description":"The views come as the skyrocketing prices of some drugs are under intense scrutiny, with new evidence showing massive price hikes by some companies.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Most Americans Want the Government to Rein In Prescription Drug Costs","datePublished":"2016-09-29T16:58:47.000Z","dateModified":"2016-09-29T21:48:07.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"242894 http://ww2.kqed.org/stateofhealth/?p=242894","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/09/29/most-americans-want-the-government-to-rein-in-prescription-drug-costs/","disqusTitle":"Most Americans Want the Government to Rein In Prescription Drug Costs","nprByline":"Jordan Rau\u003cbr />\u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>","path":"/stateofhealth/242894/most-americans-want-the-government-to-rein-in-prescription-drug-costs","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>An overwhelming majority of Americans favor government action to restrain prescription drug prices, according to a poll released Thursday.\u003c/p>\n\u003cp>Eighty-two percent of those polled said they want Medicare to negotiate prices with the companies, which Congress does not allow. Seventy-eight percent favored limiting the amount companies can charge for high-cost drugs, such as those that fight cancer or hepatitis, according to \u003ca href=\"http://kff.org/health-reform/report/kaiser-health-tracking-poll-september-2016\" target=\"_blank\">the poll\u003c/a> from the Kaiser Family Foundation. And more than two-thirds want to let Americans buy drugs imported from Canada. Support is strong no matter the political party. (KHN is an editorially independent program of the foundation.)\u003c/p>\n\u003cp>The views come as the skyrocketing prices of some drugs are under intense scrutiny, with new evidence showing massive price hikes by some companies. Some members of Congress have called for investigations, but there is no consensus on how to effectively rein in the cost, particularly for lifesaving and unique treatments such as the EpiPen for people with deadly allergies and the hepatitis C-curing drug Sovaldi.\u003c/p>\n\u003cp>The poll found that while a majority of Americans still believed prescription drugs developed over the past two decades have improved lives, respect is dwindling. In 2008, 73 percent of Americans said the medicines had this positive effect, but that number dropped to 62 percent in August 2015. The new poll found that now 56 percent of Americans consider the drugs beneficial.\u003c/p>\n\u003cp>“Cost could be one reason why the share of Americans who say prescription drugs have made the lives of people in the U.S. better is declining,” the pollsters wrote.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The poll found that three-quarters of Americans considered drug costs unreasonable. Despite the perceived burden, the poll also discovered that 73 percent of people taking prescription medicines said it had been easy to afford their drugs. People in fair or poor health and those taking four or more drugs were more likely to say they were having trouble affording prescriptions than more healthy people.\u003c/p>\n\u003cp>Among the policy ideas the respondents were asked to consider, the most popular was requiring drug companies to explain how they set drug prices, with 86 percent support. Two-thirds of Americans favored Democratic presidential nominee Hillary Clinton’s suggestion to create an independent group to oversee drug pricing.\u003c/p>\n\u003cp>Other ideas were less popular, including two restricting consumers. A minority of those polled favored eliminating prescription drug advertisements, which has been suggested to quell the aggressive marketing companies do directly to consumers. Only 4 in 10 Americans favored requiring people to pay more if they don’t choose the least expensive version of a drug to treat their illness.\u003c/p>\n\u003cp>Separately, the poll also found that only a quarter of Americans were aware that the number of people without health insurance is at a record low. Just 9 percent went without coverage last year, according to the U.S. Census.\u003c/p>\n\u003cp>The survey found that the country is evenly divided about the success of the insurance marketplaces created by the Affordable Care Act to assist people without employer or government coverage. People in states that are running their own marketplaces were more positive about them than are people in states that rely on the federal website, healthcare.gov.\u003c/p>\n\u003cp>The survey was conducted between Sept. 14 and 20 among 1,204 people, using both land lines and cell phones. The margin of error was +/- 3 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003ca href=\"http://khn.org/\" target=\"_blank\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\" target=\"\">Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/242894/most-americans-want-the-government-to-rein-in-prescription-drug-costs","authors":["byline_stateofhealth_242894"],"categories":["stateofhealth_14","stateofhealth_2746"],"tags":["stateofhealth_2650","stateofhealth_2640","stateofhealth_2966","stateofhealth_2868","stateofhealth_2808","stateofhealth_2519","stateofhealth_2961","stateofhealth_2962"],"featImg":"stateofhealth_242896","label":"stateofhealth"},"stateofhealth_238915":{"type":"posts","id":"stateofhealth_238915","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"238915","score":null,"sort":[1474303348000]},"guestAuthors":[],"slug":"gov-brown-signs-law-allowing-businesses-to-stockpile-epipens-but-blasts-unconscionable-price-hike","title":"Gov. Brown Lets Businesses Stockpile EpiPens, But Blasts ‘Unconscionable’ Price Hike","publishDate":1474303348,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Gov. Jerry Brown berated the manufacturer of a life-saving emergency allergy treatment on Friday for price gouging, even as he signed legislation to make it easier for afterschool programs, daycare centers, colleges and businesses to obtain the treatment.\u003c/p>\n\u003cp>The pharmaceutical company Mylan raised the price of a two-pack of EpiPen epinephrine auto-injectors from $100 in 2008 to more than $600 today, Brown wrote in his signing message. EpiPens, which reportedly face little competition in the market, deliver a dose of epinephrine to counteract anaphylaxis, a potentially life-threatening allergic reaction that includes difficulty breathing.\u003c/p>\n\u003cp>“State government cannot stop unconscionable price increases but it can shed light on such rapacious corporate behavior,” Brown’s message said.\u003c/p>\n\u003cp>“It is difficult to imagine how they can justify the 500 percent increase in the price of EpiPens,” wrote Gov. Jerry Brown.\u003c/p>\n\u003cp>Declaring his “strong objection” to the price increases, Brown noted that they occurred as Mylan was expanding sales by promoting the stockpiling of EpiPens as a matter of public health in schools, scout troops, colleges and businesses in California and across the country. Mylan is listed as the sponsor of the new law, Assembly Bill 1386, by Assemblyman Evan Low, D-San Jose, and as a supporter of Senate Bill 1266, by Sen. Bob Huff, R-San Dimas, which passed in 2014 and requires schools to stock epinephrine auto-injectors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While he was at it, Brown sent a letter Friday to Congressional leaders Mitch McConnell, Paul Ryan, Harry Reid and Nancy Pelosi in support of a bipartisan oversight hearing set for next week concerning Mylan’s pricing of EpiPens. “It is difficult to imagine how they can justify the 500 percent increase in the price of EpiPens, the 600 percent increase in executive pay and the tax move of their corporate offices to the Netherlands, as recently reported in numerous publications,” Brown wrote.\u003c/p>\n\u003cp>The new California law will make it easier for summer camps, restaurants and sports leagues to obtain prescriptions for pre-loaded epinephrine auto-injectors by allowing doctors to write prescriptions in the name of an organization, rather than an individual. Someone in the organization must be trained to use the disposable device; a provision to limit the liability for prescription-writing physicians is part of the law.\u003c/p>\n\u003cp>EpiPens often are carried in lunchboxes, backpacks or briefcases by children and adults who know they have serious allergies to a food, drug, bee sting or other matter. Through its “EpiPen4Schools” program started in 2012, Mylan provides eligible public and private schools two free twin-packs of Epi-Pens a year. Last year, a program manager said it appeared that 766 public and private schools in California had placed orders for the free devices from January through mid-May 2015. The EpiPen4Schools program allegedly required schools to agree they would not buy or obtain another brand of injector.\u003c/p>\n\u003cp>Parents who fear that their child will be caught without an injector or suffer a severe first-time allergic reaction have called for epinephrine auto-injectors to be widely available as a first-aid provision. During legislative debate, Low noted that “schools are not the only place where children can come into contact with allergens capable of causing anaphylaxis.”\u003c/p>\n\u003cp>On Friday, Low applauded the signing of the bill into law but called Mylan’s increases in EpiPen prices and executive salaries “simply unconscionable.” While Mylan sponsored Assembly Bill 1386, Low’s office said Mylan has not made a contribution to the assemblyman.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In response to the outcry in recent weeks over the rising cost of EpiPens, Mylan announced it will create a generic EpiPen to be sold in a pack of two for $300. The company also is asking that the federal government add the EpiPen to its list of preventive medications that are made available to patients with no insurance co-pay. The cost would be born by insurance companies, the government or employers.\u003c/p>\n\n","blocks":[],"excerpt":"“It is difficult to imagine how they can justify the 500 percent increase in the price of EpiPens,” wrote Gov. Jerry Brown.","status":"publish","parent":0,"modified":1474315310,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":673},"headData":{"title":"Gov. Brown Lets Businesses Stockpile EpiPens, But Blasts ‘Unconscionable’ Price Hike | KQED","description":"“It is difficult to imagine how they can justify the 500 percent increase in the price of EpiPens,” wrote Gov. Jerry Brown.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Gov. Brown Lets Businesses Stockpile EpiPens, But Blasts ‘Unconscionable’ Price Hike","datePublished":"2016-09-19T16:42:28.000Z","dateModified":"2016-09-19T20:01:50.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"238915 http://ww2.kqed.org/stateofhealth/?p=238915","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/09/19/gov-brown-signs-law-allowing-businesses-to-stockpile-epipens-but-blasts-unconscionable-price-hike/","disqusTitle":"Gov. Brown Lets Businesses Stockpile EpiPens, But Blasts ‘Unconscionable’ Price Hike","nprByline":"Jane Meredith Adams\u003cbr />\u003ca href=\"http://edsource.org\">Ed Source\u003c/a>","path":"/stateofhealth/238915/gov-brown-signs-law-allowing-businesses-to-stockpile-epipens-but-blasts-unconscionable-price-hike","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Jerry Brown berated the manufacturer of a life-saving emergency allergy treatment on Friday for price gouging, even as he signed legislation to make it easier for afterschool programs, daycare centers, colleges and businesses to obtain the treatment.\u003c/p>\n\u003cp>The pharmaceutical company Mylan raised the price of a two-pack of EpiPen epinephrine auto-injectors from $100 in 2008 to more than $600 today, Brown wrote in his signing message. EpiPens, which reportedly face little competition in the market, deliver a dose of epinephrine to counteract anaphylaxis, a potentially life-threatening allergic reaction that includes difficulty breathing.\u003c/p>\n\u003cp>“State government cannot stop unconscionable price increases but it can shed light on such rapacious corporate behavior,” Brown’s message said.\u003c/p>\n\u003cp>“It is difficult to imagine how they can justify the 500 percent increase in the price of EpiPens,” wrote Gov. Jerry Brown.\u003c/p>\n\u003cp>Declaring his “strong objection” to the price increases, Brown noted that they occurred as Mylan was expanding sales by promoting the stockpiling of EpiPens as a matter of public health in schools, scout troops, colleges and businesses in California and across the country. Mylan is listed as the sponsor of the new law, Assembly Bill 1386, by Assemblyman Evan Low, D-San Jose, and as a supporter of Senate Bill 1266, by Sen. Bob Huff, R-San Dimas, which passed in 2014 and requires schools to stock epinephrine auto-injectors.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While he was at it, Brown sent a letter Friday to Congressional leaders Mitch McConnell, Paul Ryan, Harry Reid and Nancy Pelosi in support of a bipartisan oversight hearing set for next week concerning Mylan’s pricing of EpiPens. “It is difficult to imagine how they can justify the 500 percent increase in the price of EpiPens, the 600 percent increase in executive pay and the tax move of their corporate offices to the Netherlands, as recently reported in numerous publications,” Brown wrote.\u003c/p>\n\u003cp>The new California law will make it easier for summer camps, restaurants and sports leagues to obtain prescriptions for pre-loaded epinephrine auto-injectors by allowing doctors to write prescriptions in the name of an organization, rather than an individual. Someone in the organization must be trained to use the disposable device; a provision to limit the liability for prescription-writing physicians is part of the law.\u003c/p>\n\u003cp>EpiPens often are carried in lunchboxes, backpacks or briefcases by children and adults who know they have serious allergies to a food, drug, bee sting or other matter. Through its “EpiPen4Schools” program started in 2012, Mylan provides eligible public and private schools two free twin-packs of Epi-Pens a year. Last year, a program manager said it appeared that 766 public and private schools in California had placed orders for the free devices from January through mid-May 2015. The EpiPen4Schools program allegedly required schools to agree they would not buy or obtain another brand of injector.\u003c/p>\n\u003cp>Parents who fear that their child will be caught without an injector or suffer a severe first-time allergic reaction have called for epinephrine auto-injectors to be widely available as a first-aid provision. During legislative debate, Low noted that “schools are not the only place where children can come into contact with allergens capable of causing anaphylaxis.”\u003c/p>\n\u003cp>On Friday, Low applauded the signing of the bill into law but called Mylan’s increases in EpiPen prices and executive salaries “simply unconscionable.” While Mylan sponsored Assembly Bill 1386, Low’s office said Mylan has not made a contribution to the assemblyman.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In response to the outcry in recent weeks over the rising cost of EpiPens, Mylan announced it will create a generic EpiPen to be sold in a pack of two for $300. The company also is asking that the federal government add the EpiPen to its list of preventive medications that are made available to patients with no insurance co-pay. The cost would be born by insurance companies, the government or employers.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/238915/gov-brown-signs-law-allowing-businesses-to-stockpile-epipens-but-blasts-unconscionable-price-hike","authors":["byline_stateofhealth_238915"],"categories":["stateofhealth_14"],"tags":["stateofhealth_2650","stateofhealth_2868","stateofhealth_2808","stateofhealth_2921","stateofhealth_2519"],"featImg":"stateofhealth_238938","label":"stateofhealth"},"stateofhealth_235188":{"type":"posts","id":"stateofhealth_235188","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"235188","score":null,"sort":[1473446409000]},"guestAuthors":[],"slug":"california-insurers-may-be-exploiting-outrage-over-drug-prices-to-inflate-health-plan-premiums-consumer-advocates-say","title":"California Insurers May Be Exploiting Outrage Over Drug Prices to Inflate Health Plan Premiums, Consumer Advocates Say","publishDate":1473446409,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Rising drug costs are often blamed for driving up health insurance premiums, but a major consumer group says the numbers don’t add up — at least in California.\u003c/p>\n\u003cp>The advocacy group Consumers Union says two of California's largest insurers may be exploiting the outrage over high drug prices to artificially inflate their premiums for individual coverage under the Affordable Care Act.\u003c/p>\n\u003cp>State regulators are independently examining the issue and pressing both Anthem Inc. and Blue Shield of California to justify their rate hikes of nearly 20 percent before open enrollment this fall. Together, the insurers cover more than half of enrollees in the state’s insurance exchange, Covered California.\u003c/p>\n\u003cp>Despite the uproar over expensive hepatitis C pills and, more recently, the $600 price tag for EpiPens, the growth in spending on prescription drugs has been slowing. After a 12 percent jump in 2014, drug costs are expected to climb by roughly 7 percent next year, according to federal officials.\u003c/p>\n\u003cp>“The cost of prescription drugs is an issue,” said Dena Mendelsohn, a staff attorney at Consumers Union in San Francisco. “But pharmaceutical expenses may be the factor most open to exploitation by health plans searching for a Trojan horse with which to usher in excessively priced insurance rates.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In detailed comments recently filed with the California Department of Managed Health Care, Consumers Union asked why the cost projections submitted by Anthem and Blue Shield are so much higher than some of their competitors and other industry-wide figures. (The Consumers Union comments are included in rate filing documents \u003ca href=\"http://wpso.dmhc.ca.gov/RateReview/Detail.aspx?lrh=XbZWkzRmrkA%24\" target=\"_blank\">here\u003c/a> and \u003ca href=\"http://wpso.dmhc.ca.gov/RateReview/Detail.aspx?lrh=0QtDat9Z%2fL8%24\" target=\"_blank\">here\u003c/a>.)\u003c/p>\n\u003cp>Separately, the managed care agency has requested more information from both companies ahead of an Oct. 3 deadline to finish its review into whether their premium increases are reasonable. Blue Shield has proposed an average 19.4 percent increase for about 550,000 individual policyholders, both in the Covered California exchange and outside the marketplace. Anthem, the nation’s second-largest health insurer, wants a 17.2 percent increase for nearly 580,000 customers in and outside the exchange.\u003c/p>\n\u003cp>The state agency can pressure the insurers to reduce the increases by calling them into question, but it doesn’t have the authority to block them.\u003c/p>\n\u003cp>“We are seeking additional information and clarity from Anthem and Blue Shield on their filings,” said spokeswoman Rachel Arrezola. “We cannot discuss findings until we’ve completed our review.”\u003c/p>\n\u003cp>To make the case for substantial rate hikes, both Anthem and Blue Shield cited higher drug spending as a major factor. Anthem forecast a 17.7 percent jump in prescription drug costs for 2017; Blue Shield was close behind at 15.2 percent.\u003c/p>\n\u003cp>Blue Shield said soaring drug costs are one reason it lost money on individual policies in the first half of this year. The company said pharmacy costs on a per-member basis rose more than 30 percent last year in the individual market.\u003c/p>\n\u003cp>“We are not using any sleight of hand to justify rate increases,” said Steve Shivinsky, a spokesman for Blue Shield, a nonprofit health plan based in San Francisco. “Our numbers reflect what we’re experiencing in the market, not some national average or trend. We’re seeing a dramatic inflation in cost for run-of-the-mill drugs like EpiPen.”\u003c/p>\n\u003cp>Anthem declined to answer specific questions about its rates while the state review is pending. In a statement, the company said “factors such as increased use of medical services and added costs of drugs and medical therapies put upward pressure on rates and underscore the additional work that needs to be done to moderate the growth in health care costs.”\u003c/p>\n\u003cp>Two other big insurers in the California exchange saw things differently, according to their regulatory filings. HMO giant Kaiser Permanente predicts a 6 percent increase in drug costs next year and Health Net Inc. estimated 11 percent. Consumers Union asked regulators to seek a detailed justification for Health Net’s average rate increase of 9.4 percent as well, \u003ca href=\"http://wpso.dmhc.ca.gov/RateReview/Detail.aspx?lrh=bSEB7eCDslo%24\" target=\"_blank\">documents\u003c/a> show.\u003c/p>\n\u003cp>\u003cstrong> \u003c/strong>Other state exchanges are facing even steeper rate hikes, approaching 60 percent from some major insurers reporting heavy losses under the health law. Consumers Union said the questionable data it found in California may apply to insurers elsewhere and it urges all regulators to conduct a thorough review.\u003c/p>\n\u003cp>“We think it’s likely happening across the country with insurers using this as an opportunity to raise rates more than they should,” Mendelsohn said.\u003c/p>\n\u003cp>Many health insurers insist their losses in the individual market are substantial and higher rates are necessary to make the Obamacare marketplaces sustainable for the long term. In crafting 2017 rates, insurers said they had the benefit of detailed data on exchange customers for the first time, and it showed they had underpriced the coverage compared to the services used by members.\u003c/p>\n\u003cp>Drug costs are just one factor pushing up premiums. Another is the discontinuation of a federal reinsurance program later this year that helps insurers with large claims. Also, many companies have complained about higher than expected costs for people who sign up outside the regular open enrollment period, citing special circumstances such as a job loss.\u003c/p>\n\u003cp>Federal data and several industry reports suggest that drug costs are leveling off nationwide after a spike from several high-priced hepatitis C medications bursting on the market. Prescription drug spending grew 3.9 percent for the past 12 months through July, according to the Altarum Institute. That’s down from 8.5 percent for the previous year.\u003c/p>\n\u003cp>“We are seeing a moderation of the cost trend,” said Barbara Gniewek, a partner and health benefits expert at consulting firm PricewaterhouseCoopers. “The hepatitis C drugs were a tsunami and really caught people off guard. But I don’t see those types of blockbusters in the pipeline right now.”\u003c/p>\n\u003cp>Gniewek said the drug cost projections from Anthem and Blue Shield are outliers. “I haven’t seen numbers that high,” she said.\u003c/p>\n\u003cp>Other health policy experts, however, said there’s ample evidence that drug costs are forcing premiums higher, particularly in the more volatile individual market, and insurers might have good reason to fear the worst from drug makers.\u003c/p>\n\u003cp>“Even though there has been some moderation in drug costs, I don’t think insurers have any confidence it will last,” said Paul Ginsburg, a health economist and professor at the University of Southern California. “They are waiting for the next major drug launch. They were burned by hepatitis C and might be more conservative now.”\u003c/p>\n\u003cp>California’s health exchange negotiated the rate increases with Blue Shield and Anthem, and the agency vetted them before they were announced in July. The two big insurers drove the statewide rate increase on the exchange to 13.2 percent for next year, a sharp uptick from 4 percent average increases the previous two years.\u003c/p>\n\u003cp>Mendelsohn questioned why large insurers such as Anthem and Blue Shield can’t use their market power to better control pharmacy costs and whether the companies are fully accounting for the rebates they receive from drug manufacturers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Shivinsky acknowledged that there’s more Blue Shield could do to address drug prices. “We’re looking at changes in our formulary and how we purchase drugs in the future,” he said.\u003c/p>\n\n","blocks":[],"excerpt":"State regulators are independently examining the issue and pressing both Anthem Inc. and Blue Shield of California to justify their rate hikes. ","status":"publish","parent":0,"modified":1473446409,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1254},"headData":{"title":"California Insurers May Be Exploiting Outrage Over Drug Prices to Inflate Health Plan Premiums, Consumer Advocates Say | KQED","description":"State regulators are independently examining the issue and pressing both Anthem Inc. and Blue Shield of California to justify their rate hikes. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California Insurers May Be Exploiting Outrage Over Drug Prices to Inflate Health Plan Premiums, Consumer Advocates Say","datePublished":"2016-09-09T18:40:09.000Z","dateModified":"2016-09-09T18:40:09.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"235188 http://ww2.kqed.org/stateofhealth/?p=235188","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/09/09/california-insurers-may-be-exploiting-outrage-over-drug-prices-to-inflate-health-plan-premiums-consumer-advocates-say/","disqusTitle":"California Insurers May Be Exploiting Outrage Over Drug Prices to Inflate Health Plan Premiums, Consumer Advocates Say","nprByline":"\u003cstrong>Chad Terhune\u003cbr />\u003ca href=\"http://californiahealthline.org\"/> California Healthline\u003c/a>\u003c/strong>","path":"/stateofhealth/235188/california-insurers-may-be-exploiting-outrage-over-drug-prices-to-inflate-health-plan-premiums-consumer-advocates-say","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Rising drug costs are often blamed for driving up health insurance premiums, but a major consumer group says the numbers don’t add up — at least in California.\u003c/p>\n\u003cp>The advocacy group Consumers Union says two of California's largest insurers may be exploiting the outrage over high drug prices to artificially inflate their premiums for individual coverage under the Affordable Care Act.\u003c/p>\n\u003cp>State regulators are independently examining the issue and pressing both Anthem Inc. and Blue Shield of California to justify their rate hikes of nearly 20 percent before open enrollment this fall. Together, the insurers cover more than half of enrollees in the state’s insurance exchange, Covered California.\u003c/p>\n\u003cp>Despite the uproar over expensive hepatitis C pills and, more recently, the $600 price tag for EpiPens, the growth in spending on prescription drugs has been slowing. After a 12 percent jump in 2014, drug costs are expected to climb by roughly 7 percent next year, according to federal officials.\u003c/p>\n\u003cp>“The cost of prescription drugs is an issue,” said Dena Mendelsohn, a staff attorney at Consumers Union in San Francisco. “But pharmaceutical expenses may be the factor most open to exploitation by health plans searching for a Trojan horse with which to usher in excessively priced insurance rates.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In detailed comments recently filed with the California Department of Managed Health Care, Consumers Union asked why the cost projections submitted by Anthem and Blue Shield are so much higher than some of their competitors and other industry-wide figures. (The Consumers Union comments are included in rate filing documents \u003ca href=\"http://wpso.dmhc.ca.gov/RateReview/Detail.aspx?lrh=XbZWkzRmrkA%24\" target=\"_blank\">here\u003c/a> and \u003ca href=\"http://wpso.dmhc.ca.gov/RateReview/Detail.aspx?lrh=0QtDat9Z%2fL8%24\" target=\"_blank\">here\u003c/a>.)\u003c/p>\n\u003cp>Separately, the managed care agency has requested more information from both companies ahead of an Oct. 3 deadline to finish its review into whether their premium increases are reasonable. Blue Shield has proposed an average 19.4 percent increase for about 550,000 individual policyholders, both in the Covered California exchange and outside the marketplace. Anthem, the nation’s second-largest health insurer, wants a 17.2 percent increase for nearly 580,000 customers in and outside the exchange.\u003c/p>\n\u003cp>The state agency can pressure the insurers to reduce the increases by calling them into question, but it doesn’t have the authority to block them.\u003c/p>\n\u003cp>“We are seeking additional information and clarity from Anthem and Blue Shield on their filings,” said spokeswoman Rachel Arrezola. “We cannot discuss findings until we’ve completed our review.”\u003c/p>\n\u003cp>To make the case for substantial rate hikes, both Anthem and Blue Shield cited higher drug spending as a major factor. Anthem forecast a 17.7 percent jump in prescription drug costs for 2017; Blue Shield was close behind at 15.2 percent.\u003c/p>\n\u003cp>Blue Shield said soaring drug costs are one reason it lost money on individual policies in the first half of this year. The company said pharmacy costs on a per-member basis rose more than 30 percent last year in the individual market.\u003c/p>\n\u003cp>“We are not using any sleight of hand to justify rate increases,” said Steve Shivinsky, a spokesman for Blue Shield, a nonprofit health plan based in San Francisco. “Our numbers reflect what we’re experiencing in the market, not some national average or trend. We’re seeing a dramatic inflation in cost for run-of-the-mill drugs like EpiPen.”\u003c/p>\n\u003cp>Anthem declined to answer specific questions about its rates while the state review is pending. In a statement, the company said “factors such as increased use of medical services and added costs of drugs and medical therapies put upward pressure on rates and underscore the additional work that needs to be done to moderate the growth in health care costs.”\u003c/p>\n\u003cp>Two other big insurers in the California exchange saw things differently, according to their regulatory filings. HMO giant Kaiser Permanente predicts a 6 percent increase in drug costs next year and Health Net Inc. estimated 11 percent. Consumers Union asked regulators to seek a detailed justification for Health Net’s average rate increase of 9.4 percent as well, \u003ca href=\"http://wpso.dmhc.ca.gov/RateReview/Detail.aspx?lrh=bSEB7eCDslo%24\" target=\"_blank\">documents\u003c/a> show.\u003c/p>\n\u003cp>\u003cstrong> \u003c/strong>Other state exchanges are facing even steeper rate hikes, approaching 60 percent from some major insurers reporting heavy losses under the health law. Consumers Union said the questionable data it found in California may apply to insurers elsewhere and it urges all regulators to conduct a thorough review.\u003c/p>\n\u003cp>“We think it’s likely happening across the country with insurers using this as an opportunity to raise rates more than they should,” Mendelsohn said.\u003c/p>\n\u003cp>Many health insurers insist their losses in the individual market are substantial and higher rates are necessary to make the Obamacare marketplaces sustainable for the long term. In crafting 2017 rates, insurers said they had the benefit of detailed data on exchange customers for the first time, and it showed they had underpriced the coverage compared to the services used by members.\u003c/p>\n\u003cp>Drug costs are just one factor pushing up premiums. Another is the discontinuation of a federal reinsurance program later this year that helps insurers with large claims. Also, many companies have complained about higher than expected costs for people who sign up outside the regular open enrollment period, citing special circumstances such as a job loss.\u003c/p>\n\u003cp>Federal data and several industry reports suggest that drug costs are leveling off nationwide after a spike from several high-priced hepatitis C medications bursting on the market. Prescription drug spending grew 3.9 percent for the past 12 months through July, according to the Altarum Institute. That’s down from 8.5 percent for the previous year.\u003c/p>\n\u003cp>“We are seeing a moderation of the cost trend,” said Barbara Gniewek, a partner and health benefits expert at consulting firm PricewaterhouseCoopers. “The hepatitis C drugs were a tsunami and really caught people off guard. But I don’t see those types of blockbusters in the pipeline right now.”\u003c/p>\n\u003cp>Gniewek said the drug cost projections from Anthem and Blue Shield are outliers. “I haven’t seen numbers that high,” she said.\u003c/p>\n\u003cp>Other health policy experts, however, said there’s ample evidence that drug costs are forcing premiums higher, particularly in the more volatile individual market, and insurers might have good reason to fear the worst from drug makers.\u003c/p>\n\u003cp>“Even though there has been some moderation in drug costs, I don’t think insurers have any confidence it will last,” said Paul Ginsburg, a health economist and professor at the University of Southern California. “They are waiting for the next major drug launch. They were burned by hepatitis C and might be more conservative now.”\u003c/p>\n\u003cp>California’s health exchange negotiated the rate increases with Blue Shield and Anthem, and the agency vetted them before they were announced in July. The two big insurers drove the statewide rate increase on the exchange to 13.2 percent for next year, a sharp uptick from 4 percent average increases the previous two years.\u003c/p>\n\u003cp>Mendelsohn questioned why large insurers such as Anthem and Blue Shield can’t use their market power to better control pharmacy costs and whether the companies are fully accounting for the rebates they receive from drug manufacturers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Shivinsky acknowledged that there’s more Blue Shield could do to address drug prices. “We’re looking at changes in our formulary and how we purchase drugs in the future,” he said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/235188/california-insurers-may-be-exploiting-outrage-over-drug-prices-to-inflate-health-plan-premiums-consumer-advocates-say","authors":["byline_stateofhealth_235188"],"categories":["stateofhealth_2442","stateofhealth_15"],"tags":["stateofhealth_2698","stateofhealth_228","stateofhealth_368","stateofhealth_2650","stateofhealth_2640","stateofhealth_2808","stateofhealth_2519"],"featImg":"stateofhealth_235210","label":"stateofhealth"},"stateofhealth_201177":{"type":"posts","id":"stateofhealth_201177","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"201177","score":null,"sort":[1466464686000]},"guestAuthors":[],"slug":"ucsf-study-links-pharma-meals-to-brand-name-prescribing-by-doctors","title":"UCSF Study Links Pharma Meals to Brand-Name Prescribing by Doctors","publishDate":1466464686,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Evidence is mounting that doctors who receive as little as one meal from a drug company tend to prescribe more expensive, brand-name medications for common ailments than those who don’t.\u003c/p>\n\u003cp>A study from researchers at UC San Francisco that was \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2528290\" target=\"_blank\">published online Monday in JAMA Internal Medicine\u003c/a> found significant evidence that doctors who received meals tied to specific drugs prescribed a higher proportion of those products than their peers. Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug. And the more meals they received, the greater share of those drugs they tended to prescribe relative to other medications in the same category.\u003c/p>\n\u003caside class=\"pullquote alignright\">Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug\u003c/aside>\n\u003cp>The researchers did not determine if there was a cause-and-effect relationship between payments and prescribing, a far more difficult proposition, but their study adds to a growing pile of research documenting a link between the two.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.propublica.org/article/doctors-who-take-company-cash-tend-to-prescribe-more-brand-name-drugs\" target=\"_blank\">ProPublica story\u003c/a> published in March found that doctors who took payments from the pharmaceutical and medical device industries prescribed a higher proportion of brand-name medications than those who didn’t. It also found that the more money a doctor received, the higher the percentage of brand-name drugs he or she prescribed, on average.\u003c/p>\n\u003cp>Similarly, a \u003ca href=\"https://www.propublica.org/article/another-study-finds-link-between-pharma-money-and-brand-name-prescribing\" target=\"_blank\">Harvard Medical School study\u003c/a> published in May found that Massachusetts physicians prescribed a larger proportion of brand-name statins — the category of drugs that treat high cholesterol — the more industry money they received. There was no significant increase in brand-name prescribing for those who received less than $2,000.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>What makes the current study different is that it looked at specific drugs.\u003c/p>\n\u003cp>In an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/06/17/orlando-shooting-raises-questions-about-internalized-homophobia-and-violence/\" target=\"_blank\">editor’s note\u003c/a>, Dr. Robert Steinbrook wrote that the recent analyses “raise a broader question. Is it necessary to prove a causal relationship between industry payments to physicians and the prescribing of brand-name medications?”\u003c/p>\n\u003cp>Other than for research and development, and related consulting, Steinbrook wrote, “it is already evident that there are few reasons for physicians to have financial associations with industry. Outright gifts, such as meals, may be legal, but why should physicians either expect or accept them?”\u003c/p>\n\u003cp>Holly Campbell, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, the industry trade group, said the latest study creates more confusion than clarity. In part, that’s because the researchers acknowledge that they could not determine whether the drugs were prescribed before or after doctors received meals paid for by companies.\u003c/p>\n\u003cp>“This study cherry-picks physician prescribing data for a subset of medicines to advance a false narrative,” Campbell wrote in an email. “Manufacturers routinely engage with physicians to share drug safety and efficacy information, new indications for approved medicines and potential side effects of medicines. As the study says, the exchange of this critical information could impact physicians’ prescribing decisions in an effort to improve patient care.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'We were probably surprised that it took so little of a signal and such a low value meal…It has changed our thinking.'\u003ccite> R. Adams Dudley, UCSF \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Since 2013, the government has required all pharmaceutical and medical device makers to publicly report their payments to doctors. The government has released data on transactions from August 2013 to December 2014; data from 2015 is set to be made public next week. Those payments can be searched in ProPublica’s \u003ca href=\"https://projects.propublica.org/docdollars/\" target=\"_blank\">Dollars for Docs\u003c/a> tool.\u003c/p>\n\u003cp>In the study released today, a team led by Colette DeJong at UC San Francisco examined four classes of medications, including those that treat high cholesterol, heart rhythm disorders, high blood pressure and depression. The researchers identified one heavily marketed brand-name drug in each class – Crestor, Bystolic, Benicar and Pristiq – for which there are cheaper, equally effective options.\u003c/p>\n\u003cp>DeJong and her colleagues then looked at physicians who received meals specifically tied to those drugs (companies have to list the products associated with each of their payments) and their 2013 prescriptions in Medicare’s drug program. The researchers excluded physicians who received other types of payments—such as for promotional speaking and consulting–in an effort to isolate any relationship to the meals alone.\u003c/p>\n\u003cp>Though only a relatively small percent of physicians who prescribed the drugs examined in the study received payments from their makers, those doctors prescribed the drugs more often than other doctors.\u003c/p>\n\u003cp>Physicians who received meals related to Crestor on four or more days prescribed the drug at almost twice the rate of doctors who received no meals. The difference was even more marked for the other drugs. Physicians who received meals prescribed Bystolic at more than 5 times the rate of their uncompensated peers, Benicar at a rate 4.5 times higher, and Pristiq at a rate 3.4 times higher.\u003c/p>\n\u003cp>Higher rates of prescribing were also observed when doctors received just a single meal, even after taking into account a physician’s specialty and region of practice.\u003c/p>\n\u003cp>Dr. R. Adams Dudley, a professor of medicine and health policy at UCSF and one of the study’s authors, said he and his colleagues expected to see “some evidence that doctors were responsive to incentives, what with their being humans and all.”\u003c/p>\n\u003cp>Still, he said, “I think we were probably surprised that it took so little of a signal and such a low value meal…It has changed our thinking.”\u003c/p>\n\u003cp>DeJong said the researchers don’t think the meals themselves cause doctors to prescribe more of a drug, but rather the time they spend interacting with drug reps when they drop off those meals.\u003c/p>\n\u003cp>“There’s really no way that a $10 bagel sandwich can influence a doctor in a gift way,” she said. “We think it represents more reciprocity, the time spent with the drug rep and the fact that the doctor is listening to this 10-minute pitch.”\u003c/p>\n\u003cp>Dudley suggested that patients talk to their doctors and ask “Is there a generic that’s just as good?”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Hopefully they can get the doctor off of the prescribing behaviors that we’re observing.”\u003c/p>\n\n","blocks":[],"excerpt":"Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug. ","status":"publish","parent":0,"modified":1466465475,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":1073},"headData":{"title":"UCSF Study Links Pharma Meals to Brand-Name Prescribing by Doctors | KQED","description":"Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"UCSF Study Links Pharma Meals to Brand-Name Prescribing by Doctors","datePublished":"2016-06-20T23:18:06.000Z","dateModified":"2016-06-20T23:31:15.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"201177 http://ww2.kqed.org/stateofhealth/?p=201177","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/06/20/ucsf-study-links-pharma-meals-to-brand-name-prescribing-by-doctors/","disqusTitle":"UCSF Study Links Pharma Meals to Brand-Name Prescribing by Doctors","nprByline":"Charles Ornstein\u003cbr />\u003ca href=\"https://www.propublica.org/article/more-evidence-phrama-meals-are-linked-to-costlier-prescribing\">ProPublica\u003c/a>","path":"/stateofhealth/201177/ucsf-study-links-pharma-meals-to-brand-name-prescribing-by-doctors","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Evidence is mounting that doctors who receive as little as one meal from a drug company tend to prescribe more expensive, brand-name medications for common ailments than those who don’t.\u003c/p>\n\u003cp>A study from researchers at UC San Francisco that was \u003ca href=\"http://archinte.jamanetwork.com/article.aspx?articleid=2528290\" target=\"_blank\">published online Monday in JAMA Internal Medicine\u003c/a> found significant evidence that doctors who received meals tied to specific drugs prescribed a higher proportion of those products than their peers. Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug. And the more meals they received, the greater share of those drugs they tended to prescribe relative to other medications in the same category.\u003c/p>\n\u003caside class=\"pullquote alignright\">Doctors who received even one meal, costing an average $20 or less, were up to twice as likely to prescribe a promoted drug\u003c/aside>\n\u003cp>The researchers did not determine if there was a cause-and-effect relationship between payments and prescribing, a far more difficult proposition, but their study adds to a growing pile of research documenting a link between the two.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.propublica.org/article/doctors-who-take-company-cash-tend-to-prescribe-more-brand-name-drugs\" target=\"_blank\">ProPublica story\u003c/a> published in March found that doctors who took payments from the pharmaceutical and medical device industries prescribed a higher proportion of brand-name medications than those who didn’t. It also found that the more money a doctor received, the higher the percentage of brand-name drugs he or she prescribed, on average.\u003c/p>\n\u003cp>Similarly, a \u003ca href=\"https://www.propublica.org/article/another-study-finds-link-between-pharma-money-and-brand-name-prescribing\" target=\"_blank\">Harvard Medical School study\u003c/a> published in May found that Massachusetts physicians prescribed a larger proportion of brand-name statins — the category of drugs that treat high cholesterol — the more industry money they received. There was no significant increase in brand-name prescribing for those who received less than $2,000.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>What makes the current study different is that it looked at specific drugs.\u003c/p>\n\u003cp>In an \u003ca href=\"http://ww2.kqed.org/stateofhealth/2016/06/17/orlando-shooting-raises-questions-about-internalized-homophobia-and-violence/\" target=\"_blank\">editor’s note\u003c/a>, Dr. Robert Steinbrook wrote that the recent analyses “raise a broader question. Is it necessary to prove a causal relationship between industry payments to physicians and the prescribing of brand-name medications?”\u003c/p>\n\u003cp>Other than for research and development, and related consulting, Steinbrook wrote, “it is already evident that there are few reasons for physicians to have financial associations with industry. Outright gifts, such as meals, may be legal, but why should physicians either expect or accept them?”\u003c/p>\n\u003cp>Holly Campbell, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, the industry trade group, said the latest study creates more confusion than clarity. In part, that’s because the researchers acknowledge that they could not determine whether the drugs were prescribed before or after doctors received meals paid for by companies.\u003c/p>\n\u003cp>“This study cherry-picks physician prescribing data for a subset of medicines to advance a false narrative,” Campbell wrote in an email. “Manufacturers routinely engage with physicians to share drug safety and efficacy information, new indications for approved medicines and potential side effects of medicines. As the study says, the exchange of this critical information could impact physicians’ prescribing decisions in an effort to improve patient care.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'We were probably surprised that it took so little of a signal and such a low value meal…It has changed our thinking.'\u003ccite> R. Adams Dudley, UCSF \u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>Since 2013, the government has required all pharmaceutical and medical device makers to publicly report their payments to doctors. The government has released data on transactions from August 2013 to December 2014; data from 2015 is set to be made public next week. Those payments can be searched in ProPublica’s \u003ca href=\"https://projects.propublica.org/docdollars/\" target=\"_blank\">Dollars for Docs\u003c/a> tool.\u003c/p>\n\u003cp>In the study released today, a team led by Colette DeJong at UC San Francisco examined four classes of medications, including those that treat high cholesterol, heart rhythm disorders, high blood pressure and depression. The researchers identified one heavily marketed brand-name drug in each class – Crestor, Bystolic, Benicar and Pristiq – for which there are cheaper, equally effective options.\u003c/p>\n\u003cp>DeJong and her colleagues then looked at physicians who received meals specifically tied to those drugs (companies have to list the products associated with each of their payments) and their 2013 prescriptions in Medicare’s drug program. The researchers excluded physicians who received other types of payments—such as for promotional speaking and consulting–in an effort to isolate any relationship to the meals alone.\u003c/p>\n\u003cp>Though only a relatively small percent of physicians who prescribed the drugs examined in the study received payments from their makers, those doctors prescribed the drugs more often than other doctors.\u003c/p>\n\u003cp>Physicians who received meals related to Crestor on four or more days prescribed the drug at almost twice the rate of doctors who received no meals. The difference was even more marked for the other drugs. Physicians who received meals prescribed Bystolic at more than 5 times the rate of their uncompensated peers, Benicar at a rate 4.5 times higher, and Pristiq at a rate 3.4 times higher.\u003c/p>\n\u003cp>Higher rates of prescribing were also observed when doctors received just a single meal, even after taking into account a physician’s specialty and region of practice.\u003c/p>\n\u003cp>Dr. R. Adams Dudley, a professor of medicine and health policy at UCSF and one of the study’s authors, said he and his colleagues expected to see “some evidence that doctors were responsive to incentives, what with their being humans and all.”\u003c/p>\n\u003cp>Still, he said, “I think we were probably surprised that it took so little of a signal and such a low value meal…It has changed our thinking.”\u003c/p>\n\u003cp>DeJong said the researchers don’t think the meals themselves cause doctors to prescribe more of a drug, but rather the time they spend interacting with drug reps when they drop off those meals.\u003c/p>\n\u003cp>“There’s really no way that a $10 bagel sandwich can influence a doctor in a gift way,” she said. “We think it represents more reciprocity, the time spent with the drug rep and the fact that the doctor is listening to this 10-minute pitch.”\u003c/p>\n\u003cp>Dudley suggested that patients talk to their doctors and ask “Is there a generic that’s just as good?”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Hopefully they can get the doctor off of the prescribing behaviors that we’re observing.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/201177/ucsf-study-links-pharma-meals-to-brand-name-prescribing-by-doctors","authors":["byline_stateofhealth_201177"],"categories":["stateofhealth_13"],"tags":["stateofhealth_2650","stateofhealth_2519"],"featImg":"stateofhealth_201232","label":"stateofhealth"},"stateofhealth_170760":{"type":"posts","id":"stateofhealth_170760","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"170760","score":null,"sort":[1460271697000]},"guestAuthors":[],"slug":"california-searches-for-prescription-to-treat-rising-drug-costs","title":"California Searches for Prescription to Treat Rising Drug Costs","publishDate":1460271697,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In a small room at a neighborhood clinic in Sacramento, a handful of hepatitis C patients wait to see their physician, hoping they’ll be found sick enough to be approved for a cure.\u003c/p>\n\u003caside class=\"pullquote alignright\">“There are very few tools in our toolbox” to control pharmaceutical spending\u003ccite>Diana Dooley, secretary of California’s Health and Human Services\u003c/cite>\u003c/aside>\n\u003cp>The low-income patients hope to be prescribed new breakthrough drugs, such as Sovaldi or Harvoni, which offer cures with almost no side effects. But treating the virus comes with a high price tag: at least $84,000 for a course of treatment. Getting Medi-Cal to pay for such drugs can involve a long, arduous process of tests and paperwork to prove infection has progressed to liver damage.\u003c/p>\n\u003cp>“If you’re practically dead … they’ll approve you,” said Laura Castillo, 54, who has been navigating the Medi-Cal system for four months to get Sovaldi. The former legal clerk said she contracted the virus from a blood transfusion in the early 1980s. Patients can live for years symptom free with hepatitis C, but left untreated, it can eventually lead to liver disease and death. Castillo has waited for treatment with substantial liver damage, which burdens her with overwhelming fatigue, depression and what she describes as a “brain fog.”\u003c/p>\n\u003cp>“It’s very, very frustrating, knowing that you have an illness and there is a cure, and you can’t do anything about it,” Castillo said.\u003c/p>\n\u003cp>Castillo’s physician, Dr. Catherine Moizeau, says she treats hundreds of Medi-Cal patients who wait months to get approval for the hepatitis C drugs. Moizeau says health plans, under state guidelines, are rationing the drugs because of the high cost. But Medi-Cal officials say patients receive the treatments based on medical necessity, not on cost.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Hepatitis C drugs are not the only part of California’s troubling drug spending picture. Despite recent cost-cutting measures, such as putting tighter controls on which patients get coverage for which drugs and when, California’s spending on pharmaceuticals has gone up, and so has the number of pricey drugs it is covering. It’s not clear state agencies have the means to balance drug cost pressures in a way that serves the best interests of patients, taxpayers and public health.\u003c/p>\n\u003cp>“There are very few tools in our toolbox” to control pharmaceutical spending, said Diana Dooley, secretary of California’s Health and Human Services. She says high prescription drug costs are a problem across California’s public and private health insurance, and should be addressed on a national level.\u003c/p>\n\u003cp>Drug price concerns will also be a matter of public policy debate this year. California voters are expected to decide in November on a measure to put a ceiling on what the state pays for drugs, and lawmakers have proposed drug price transparency requirements on pharmaceutical manufacturers and health insurers.\u003c/p>\n\u003cp>“We all have to do everything we can to try to control these drug costs,” Dooley said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"kO3lkbe6TLc7SIMiuJ3FinItNEnjyfYz\"]A CALmatters analysis found that state prisons, a California public pension system, and one subset of the Medi-Cal program spent $600 million more on pharmaceuticals in 2014 than in 2012. That does not include the Medi-Cal population in a health plan, nor does it account for discounts the state may have received from drugmakers.\u003c/p>\n\u003cp>Over the past decade, Medi-Cal has seen a 57 percent increase in the drugs it covers that cost $600 or more per prescription. And when it comes to hepatitis C drugs alone, Medi-Cal estimates it will spend almost $482 million over this fiscal year and last. As of September 2015, only 4,200 Medi-Cal patients had received the drugs in that time period, out of 237,000 who are estimated to have the disease.\u003c/p>\n\u003cp>These cost trends exist despite new protocols various state agencies have introduced to tamp down on pharmaceutical spending, which include stricter controls on which patients get which prescription drugs and how.\u003c/p>\n\u003cp>“The people that pay for health care, be it the government or employers, are asking for more prior authorization because we’re having to scrutinize every penny we spend now,” said Steve Miller, chief medical officer at Express Scripts, which manages pharmacy benefits for health plans nationally, including 7.5 million Californians.\u003c/p>\n\u003cp>Miller said involvement from the payer is meant to get “the right patient, the right drug, at the right dose.” But the process, can be “clunky” and cause delays and frustrations for patients like Castillo.\u003c/p>\n\u003cp>Drugmakers say the value of the new hepatitis C drugs, the first of which hit the market at the end of 2013, is worth the cost, and in the long term, may eventually even bring savings to the health system.\u003c/p>\n\u003cp>The new hepatitis C drugs involve only a few months of treatment, and produce a cure in about 90 percent of patients. The older generation of treatments are cheaper, but are also about half as effective, and have side-effects that resemble the flu.\u003c/p>\n\u003cp>“These patients are now healthier. They’re more productive. They’re functioning,” said Priscilla VanderVeer, deputy vice president of communications at the Pharmaceutical Research and Manufacturers of America (PhRMA).\u003c/p>\n\u003cp>“You’re going to have less people who need long-term medication therapy for their hep C, they’re not going to need liver transplants, they’re not going to need significant hospitalizations,” VanderVeer said.\u003c/p>\n\u003cp>Health consumer advocates and economists argue that paying a lot for some drugs that only treat a limited population may not serve larger public health interests, or be the best use of taxpayer dollars.\u003c/p>\n\u003cp>For example, if the cost of the new hepatitis C drugs were cheaper, the hundreds of millions of dollars spent on treating just a few thousand patients could have been spent to help eradicate the disease, says Anthony Wright, executive director of Health Access, an advocacy group.\u003c/p>\n\u003cp>“You could imagine a strategy to provide this cure in a much more broad population strategy,” Wright said.\u003c/p>\n\u003cp>\u003cimg class=\"alignright wp-image-170763 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/DrugsOver600-400x828.png\" alt=\"DrugsOver600\" width=\"400\" height=\"828\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/DrugsOver600-400x828.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/DrugsOver600.png 550w\" sizes=\"(max-width: 400px) 100vw, 400px\">Specialty drugs, which the federal government defines as costing $600 or more a month, are raising concern among health insurers and state agencies. In CalPERS, for instance, specialty drugs are taking up a larger share of total drug expenditures, despite the fact that they account for a small percentage of prescriptions.\u003c/p>\n\u003cp>Drugmakers are investing more in these types of drugs, said Joel Hay, a pharmaceutical economist at the University of Southern California, because “the profits are very high.”\u003c/p>\n\u003cp>But paying a high price for drugs that treat a small number of patients raises an equity question, Hay said. It may not be fair to the larger patient population for a health system to pay a high price for cancer drugs that extend a patient’s life by three weeks.\u003c/p>\n\u003cp>“You can get a lot more lives saved if you take that budget and put it into colon cancer screening or any number of other more efficient, more effective interventions,” Hay said.\u003c/p>\n\u003cp>The cost pressure from specialty drugs may not go away soon. Pharmaceutical benefits manager Express Scripts estimates that this class of drugs will continue to grow in Medicaid programs by 13.6 percent over the next three years.\u003c/p>\n\u003cp>“Are we going to have a sustainable (pharmaceutical) industry where we are making sure the drug companies make enough money where they can bring great new products to the marketplace, yet we control cost well enough that people –- all people, even the most vulnerable -- have access to the drugs they need?” asked Miller.\u003c/p>\n\u003cp>State Medi-Cal administrators say it’s too soon to assess the sustainability of current prescription drug spending trends. Meantime, their guidelines about which patients can get covered by new hepatitis C drugs has recently loosened up. As of July 2015, patients with a less advanced stage of liver disease can get covered for the drugs, as well as IV drug users and women who want to get pregnant.\u003c/p>\n\u003cp>Castillo got her medication in March, after an attorney helped her challenge denied coverage for Sovaldi through a health insurance regulator. Castillo says she’s glad she’s in treatment now, but she doesn’t know why her Medi-Cal health plan made it so hard for her to get the medicine.\u003c/p>\n\u003cp>“They need to get it together,” she said. “It’s our health and our life that they’re messing with.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>CALmatters data reporter Matt Levin contributed to this article. \u003c/em>\u003ca href=\"https://calmatters.org/\" target=\"_blank\">\u003cem>CALmatters\u003c/em>\u003c/a>\u003cem> is a nonprofit journalism venture dedicated to explaining state policies and politics. Pauline Bartolone wrote this article while participating in the \u003c/em>\u003ca href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\">\u003cem>California Data\u003c/em>\u003c/a> \u003ca href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\" target=\"_blank\">\u003cem>Fellowship,\u003c/em>\u003c/a>\u003cem> a program of the \u003c/em>\u003ca href=\"http://www.centerforhealthjournalism.org/\" target=\"_blank\">\u003cem>Center for Health Journalism\u003c/em>\u003c/a>\u003cem> at USC’s Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"California voters are expected to decide in November on a measure to put a ceiling on what the state pays for drugs.","status":"publish","parent":0,"modified":1460264496,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":33,"wordCount":1503},"headData":{"title":"California Searches for Prescription to Treat Rising Drug Costs | KQED","description":"California voters are expected to decide in November on a measure to put a ceiling on what the state pays for drugs.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California Searches for Prescription to Treat Rising Drug Costs","datePublished":"2016-04-10T07:01:37.000Z","dateModified":"2016-04-10T05:01:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"170760 http://ww2.kqed.org/stateofhealth/?p=170760","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/10/california-searches-for-prescription-to-treat-rising-drug-costs/","disqusTitle":"California Searches for Prescription to Treat Rising Drug Costs","nprByline":"Pauline Bartolone\u003cbr />\u003ca href=\"https://calmatters.org/\">CALmatters\u003c/a>","path":"/stateofhealth/170760/california-searches-for-prescription-to-treat-rising-drug-costs","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a small room at a neighborhood clinic in Sacramento, a handful of hepatitis C patients wait to see their physician, hoping they’ll be found sick enough to be approved for a cure.\u003c/p>\n\u003caside class=\"pullquote alignright\">“There are very few tools in our toolbox” to control pharmaceutical spending\u003ccite>Diana Dooley, secretary of California’s Health and Human Services\u003c/cite>\u003c/aside>\n\u003cp>The low-income patients hope to be prescribed new breakthrough drugs, such as Sovaldi or Harvoni, which offer cures with almost no side effects. But treating the virus comes with a high price tag: at least $84,000 for a course of treatment. Getting Medi-Cal to pay for such drugs can involve a long, arduous process of tests and paperwork to prove infection has progressed to liver damage.\u003c/p>\n\u003cp>“If you’re practically dead … they’ll approve you,” said Laura Castillo, 54, who has been navigating the Medi-Cal system for four months to get Sovaldi. The former legal clerk said she contracted the virus from a blood transfusion in the early 1980s. Patients can live for years symptom free with hepatitis C, but left untreated, it can eventually lead to liver disease and death. Castillo has waited for treatment with substantial liver damage, which burdens her with overwhelming fatigue, depression and what she describes as a “brain fog.”\u003c/p>\n\u003cp>“It’s very, very frustrating, knowing that you have an illness and there is a cure, and you can’t do anything about it,” Castillo said.\u003c/p>\n\u003cp>Castillo’s physician, Dr. Catherine Moizeau, says she treats hundreds of Medi-Cal patients who wait months to get approval for the hepatitis C drugs. Moizeau says health plans, under state guidelines, are rationing the drugs because of the high cost. But Medi-Cal officials say patients receive the treatments based on medical necessity, not on cost.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Hepatitis C drugs are not the only part of California’s troubling drug spending picture. Despite recent cost-cutting measures, such as putting tighter controls on which patients get coverage for which drugs and when, California’s spending on pharmaceuticals has gone up, and so has the number of pricey drugs it is covering. It’s not clear state agencies have the means to balance drug cost pressures in a way that serves the best interests of patients, taxpayers and public health.\u003c/p>\n\u003cp>“There are very few tools in our toolbox” to control pharmaceutical spending, said Diana Dooley, secretary of California’s Health and Human Services. She says high prescription drug costs are a problem across California’s public and private health insurance, and should be addressed on a national level.\u003c/p>\n\u003cp>Drug price concerns will also be a matter of public policy debate this year. California voters are expected to decide in November on a measure to put a ceiling on what the state pays for drugs, and lawmakers have proposed drug price transparency requirements on pharmaceutical manufacturers and health insurers.\u003c/p>\n\u003cp>“We all have to do everything we can to try to control these drug costs,” Dooley said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>A CALmatters analysis found that state prisons, a California public pension system, and one subset of the Medi-Cal program spent $600 million more on pharmaceuticals in 2014 than in 2012. That does not include the Medi-Cal population in a health plan, nor does it account for discounts the state may have received from drugmakers.\u003c/p>\n\u003cp>Over the past decade, Medi-Cal has seen a 57 percent increase in the drugs it covers that cost $600 or more per prescription. And when it comes to hepatitis C drugs alone, Medi-Cal estimates it will spend almost $482 million over this fiscal year and last. As of September 2015, only 4,200 Medi-Cal patients had received the drugs in that time period, out of 237,000 who are estimated to have the disease.\u003c/p>\n\u003cp>These cost trends exist despite new protocols various state agencies have introduced to tamp down on pharmaceutical spending, which include stricter controls on which patients get which prescription drugs and how.\u003c/p>\n\u003cp>“The people that pay for health care, be it the government or employers, are asking for more prior authorization because we’re having to scrutinize every penny we spend now,” said Steve Miller, chief medical officer at Express Scripts, which manages pharmacy benefits for health plans nationally, including 7.5 million Californians.\u003c/p>\n\u003cp>Miller said involvement from the payer is meant to get “the right patient, the right drug, at the right dose.” But the process, can be “clunky” and cause delays and frustrations for patients like Castillo.\u003c/p>\n\u003cp>Drugmakers say the value of the new hepatitis C drugs, the first of which hit the market at the end of 2013, is worth the cost, and in the long term, may eventually even bring savings to the health system.\u003c/p>\n\u003cp>The new hepatitis C drugs involve only a few months of treatment, and produce a cure in about 90 percent of patients. The older generation of treatments are cheaper, but are also about half as effective, and have side-effects that resemble the flu.\u003c/p>\n\u003cp>“These patients are now healthier. They’re more productive. They’re functioning,” said Priscilla VanderVeer, deputy vice president of communications at the Pharmaceutical Research and Manufacturers of America (PhRMA).\u003c/p>\n\u003cp>“You’re going to have less people who need long-term medication therapy for their hep C, they’re not going to need liver transplants, they’re not going to need significant hospitalizations,” VanderVeer said.\u003c/p>\n\u003cp>Health consumer advocates and economists argue that paying a lot for some drugs that only treat a limited population may not serve larger public health interests, or be the best use of taxpayer dollars.\u003c/p>\n\u003cp>For example, if the cost of the new hepatitis C drugs were cheaper, the hundreds of millions of dollars spent on treating just a few thousand patients could have been spent to help eradicate the disease, says Anthony Wright, executive director of Health Access, an advocacy group.\u003c/p>\n\u003cp>“You could imagine a strategy to provide this cure in a much more broad population strategy,” Wright said.\u003c/p>\n\u003cp>\u003cimg class=\"alignright wp-image-170763 size-thumbnail\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/04/DrugsOver600-400x828.png\" alt=\"DrugsOver600\" width=\"400\" height=\"828\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/04/DrugsOver600-400x828.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/04/DrugsOver600.png 550w\" sizes=\"(max-width: 400px) 100vw, 400px\">Specialty drugs, which the federal government defines as costing $600 or more a month, are raising concern among health insurers and state agencies. In CalPERS, for instance, specialty drugs are taking up a larger share of total drug expenditures, despite the fact that they account for a small percentage of prescriptions.\u003c/p>\n\u003cp>Drugmakers are investing more in these types of drugs, said Joel Hay, a pharmaceutical economist at the University of Southern California, because “the profits are very high.”\u003c/p>\n\u003cp>But paying a high price for drugs that treat a small number of patients raises an equity question, Hay said. It may not be fair to the larger patient population for a health system to pay a high price for cancer drugs that extend a patient’s life by three weeks.\u003c/p>\n\u003cp>“You can get a lot more lives saved if you take that budget and put it into colon cancer screening or any number of other more efficient, more effective interventions,” Hay said.\u003c/p>\n\u003cp>The cost pressure from specialty drugs may not go away soon. Pharmaceutical benefits manager Express Scripts estimates that this class of drugs will continue to grow in Medicaid programs by 13.6 percent over the next three years.\u003c/p>\n\u003cp>“Are we going to have a sustainable (pharmaceutical) industry where we are making sure the drug companies make enough money where they can bring great new products to the marketplace, yet we control cost well enough that people –- all people, even the most vulnerable -- have access to the drugs they need?” asked Miller.\u003c/p>\n\u003cp>State Medi-Cal administrators say it’s too soon to assess the sustainability of current prescription drug spending trends. Meantime, their guidelines about which patients can get covered by new hepatitis C drugs has recently loosened up. As of July 2015, patients with a less advanced stage of liver disease can get covered for the drugs, as well as IV drug users and women who want to get pregnant.\u003c/p>\n\u003cp>Castillo got her medication in March, after an attorney helped her challenge denied coverage for Sovaldi through a health insurance regulator. Castillo says she’s glad she’s in treatment now, but she doesn’t know why her Medi-Cal health plan made it so hard for her to get the medicine.\u003c/p>\n\u003cp>“They need to get it together,” she said. “It’s our health and our life that they’re messing with.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>CALmatters data reporter Matt Levin contributed to this article. \u003c/em>\u003ca href=\"https://calmatters.org/\" target=\"_blank\">\u003cem>CALmatters\u003c/em>\u003c/a>\u003cem> is a nonprofit journalism venture dedicated to explaining state policies and politics. Pauline Bartolone wrote this article while participating in the \u003c/em>\u003ca href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\">\u003cem>California Data\u003c/em>\u003c/a> \u003ca href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\" target=\"_blank\">\u003cem>Fellowship,\u003c/em>\u003c/a>\u003cem> a program of the \u003c/em>\u003ca href=\"http://www.centerforhealthjournalism.org/\" target=\"_blank\">\u003cem>Center for Health Journalism\u003c/em>\u003c/a>\u003cem> at USC’s Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/170760/california-searches-for-prescription-to-treat-rising-drug-costs","authors":["byline_stateofhealth_170760"],"categories":["stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_2650","stateofhealth_2519","stateofhealth_2525"],"featImg":"stateofhealth_170766","label":"stateofhealth"},"stateofhealth_145149":{"type":"posts","id":"stateofhealth_145149","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"145149","score":null,"sort":[1454606628000]},"guestAuthors":[],"slug":"how-high-cost-specialty-drugs-impact-california","title":"How High-Cost Specialty Drugs Impact California","publishDate":1454606628,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp id=\"3531\" class=\"graf--p graf-after--figure\">What’s behind the jaw-dropping cost of new “specialty drugs” like Orkambi, which has a sticker price of $259,000 per year for cystic fibrosis patients?\u003c/p>\n\u003cp id=\"4e0b\" class=\"graf--p graf-after--p\">Orkambi, which was approved by the U.S. Food and Drug Administration last July, is expected to take almost $36 million from the state’s general fund this fiscal year and next. Seventy-four Californians with health coverage under the Department of Health Care Services are estimated to receive the drug this year, and next year, 220 people will benefit, some of whom may be the same patients as this year. That does not include any discounts the state may receive from drug manufacturers.\u003c/p>\n\u003cp id=\"5b0e\" class=\"graf--p graf-after--p\">Orkambi is listed as a “specialty tier” drug in some private health plans. That category is reserved for high-cost drugs, or, in the \u003ca class=\"markup--anchor markup--p-anchor\" href=\"https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/SpecialtyTierMethodology.pdf\" rel=\"nofollow\">federal government’s\u003c/a>view, for drugs that cost more than $600 a month and are used by a small proportion of patients.\u003c/p>\n\u003cp id=\"3924\" class=\"graf--p graf-after--p\">Specialty drugs are already proving to be a financial burden on one California agency, the California Public Employees’ Retirement System, which purchases health benefits for active and retired state workers. The state public pension system says that specialty drugs made up less than 1 percent of all prescriptions for its members but 30 percent of the total drugs costs in 2014.\u003c/p>\n\u003cp class=\"graf--p graf-after--p\">The health benefits from specialty drugs justify the cost, according to the pharmaceutical industry.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp id=\"ee28\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“Patients are gaining access to medicines that are better treating their diseases or frankly even curing them,” said Priscilla VanderVeer, deputy vice president of communications at the Pharmaceutical Research and Manufacturers of America (PhRMA). “Patients are now healthier. They’re more productive. They’re functioning.”\u003c/p>\n\u003cp id=\"e169\" class=\"graf--p graf-after--p\">VanderVeer said companies price drugs not just on the cost of production, but on the value the industry believes the drug brings to the health care system, such as:\u003c/p>\n\u003cul class=\"postList\">\n\u003cli id=\"7b31\" class=\"graf--li graf-after--p\">Efficacy of the treatment\u003c/li>\n\u003cli id=\"b80b\" class=\"graf--li graf-after--li\">How it increases the quality or length of life\u003c/li>\n\u003cli id=\"5c88\" class=\"graf--li graf-after--li\">The “unmet need” in the drug market\u003c/li>\n\u003c/ul>\n\u003cp id=\"cc5b\" class=\"graf--p graf-after--li\">The price of the drug also accounts for the cost of developing other drugs and the high risk that a particular drug won’t make it to market, VanderVeer said. Only 12 percent of drugs that go through clinical trials get approved, according to PhRMA.\u003c/p>\n\u003cp id=\"ef58\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“Because of that high rate of failures there would be no innovative incentive for companies to continue to try to invest” if they could not recoup costs and make a profit, VanderVeer said.\u003c/p>\n\u003cp id=\"93ab\" class=\"graf--p graf-after--p\">Finally, she added, the sticker price doesn’t reflect the final price paid for the drug, which can be heavily discounted through negotiations or because of mandated rebates for Medicaid programs.\u003c/p>\n\u003cp id=\"b00f\" class=\"graf--p graf-after--p\">[contextly_sidebar id=\"zzW5l7DTsYNjFFcWE84QTNvLSahLvtDx\"]Drugmakers are following the money, said Joel Hay, professor of pharmaceutical economics and policy at USC. Companies invest in specialty drugs that target a small population because their high price tags can be spread over a large insurance pool, he said.\u003c/p>\n\u003cp id=\"02e0\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">Even though specialty drugs are \"ridiculously expensive per treatment episode,\" Hay said, the cost for each member in a health plan is \"just a few cents.” Raising 10 cents on a diabetes drug, for example, would have a bigger budget impact, he said, because more people have diabetes than cystic fibrosis.\u003c/p>\n\u003cp id=\"14f9\" class=\"graf--p graf-after--p\">Hay says manufacturers are now less inclined to invest in drugs that treat millions of people, because there is more pushback on price.\u003c/p>\n\u003cp id=\"de1b\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“Drug companies are for-profit companies obligated to make money for their stockholders,” Hay said. “They’re not virtuous charitable organizations.”\u003c/p>\n\u003cp id=\"708f\" class=\"graf--p graf-after--p\">Drugmakers are also investing more in treating uncommon illnesses because there is less competition and therefore more opportunity for profit, said Dr. Helene Lipton, professor of health policy at the School of Pharmacy and Institute for Health Policy Studies at UC San Francisco.\u003c/p>\n\u003cp id=\"f652\" class=\"graf--p graf-after--p\">The high price of the drugs affects patients, she noted, because health plans put controls on the drugs so that they’re used as a last resort.\u003c/p>\n\u003cp id=\"ed3c\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“That may mean going through two or more rounds of care with other medications before being able to use the specialty drug,” Lipton said.\u003c/p>\n\u003cp id=\"063c\" class=\"graf--p graf-after--p\">It’s not just specialty drugs that are straining health plans’ budgets, said Steve Miller, chief medical officer at Express Scripts, a pharmaceutical benefits manager that negotiates drug prices for 7.5 million Californians.\u003c/p>\n\u003cp id=\"0f47\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“The price of drugs is just continuing to go up,” said Miller, explaining that the trend is due to both new high-cost drugs coming on the market, and mark-ups of old drugs.\u003c/p>\n\u003cp class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">There’s been an explosion of drugs costing $100,000 a year over the last decade, for things like cystic fibrosis and cancer, Miller said. And there was a 127 percent price increase of branded drugs that had been on the market between 2008 and 2014, he says.\u003c/p>\n\u003cp id=\"0c65\" class=\"graf--p graf-after--p\">Limiting the cost of pharmaceuticals is the basis of a California ballot initiative scheduled to go before voters this November that would limit the amount the state pays for a drug to no more than the lowest price paid for the same drug by the U.S. Department of Veterans Affairs.\u003c/p>\n\u003cp id=\"9370\" class=\"graf--p graf-after--p\">We’ll be exploring how a specialty drug’s cost affects patient access. If you are a chronic disease patient who is having difficulty getting specialty drugs, we’d like to hear from you. \u003ca class=\"markup--anchor markup--p-anchor\" href=\"https://twitter.com/pbartolone\" rel=\"nofollow\">Tweet\u003c/a> or \u003ca class=\"markup--anchor markup--p-anchor\" href=\"mailto:Pauline@Calmatters.org\">email\u003c/a> us.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp id=\"f877\" class=\"graf--p graf-after--p graf--last\">\u003cem class=\"markup--em markup--p-em\">CALmatters is a nonprofit journalism venture dedicated to explaining state policies and politics. Pauline Bartolone wrote this article while participating in the \u003c/em>\u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\" rel=\"nofollow\">\u003cem class=\"markup--em markup--p-em\">California Data\u003c/em>\u003c/a>\u003cem class=\"markup--em markup--p-em\"> \u003c/em>\u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\" rel=\"nofollow\">\u003cem class=\"markup--em markup--p-em\">Fellowship,\u003c/em>\u003c/a>\u003cem class=\"markup--em markup--p-em\"> a program of the \u003c/em>\u003cem class=\"markup--em markup--p-em\">\u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://www.centerforhealthjournalism.org/\" rel=\"nofollow\">Center for Health Journalism\u003c/a> \u003c/em>\u003cem class=\"markup--em markup--p-em\">at USC’s Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"For starters, CalPERS says specialty drugs made up less than 1 percent of prescriptions for its members but 30 percent of total drugs costs in 2014.","status":"publish","parent":0,"modified":1454693614,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":2,"wordCount":967},"headData":{"title":"How High-Cost Specialty Drugs Impact California | KQED","description":"For starters, CalPERS says specialty drugs made up less than 1 percent of prescriptions for its members but 30 percent of total drugs costs in 2014.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"How High-Cost Specialty Drugs Impact California","datePublished":"2016-02-04T17:23:48.000Z","dateModified":"2016-02-05T17:33:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"145149 http://ww2.kqed.org/stateofhealth/?p=145149","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/02/04/how-high-cost-specialty-drugs-impact-california/","disqusTitle":"How High-Cost Specialty Drugs Impact California","nprByline":"Pauline Bartolone, CALmatters","path":"/stateofhealth/145149/how-high-cost-specialty-drugs-impact-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp id=\"3531\" class=\"graf--p graf-after--figure\">What’s behind the jaw-dropping cost of new “specialty drugs” like Orkambi, which has a sticker price of $259,000 per year for cystic fibrosis patients?\u003c/p>\n\u003cp id=\"4e0b\" class=\"graf--p graf-after--p\">Orkambi, which was approved by the U.S. Food and Drug Administration last July, is expected to take almost $36 million from the state’s general fund this fiscal year and next. Seventy-four Californians with health coverage under the Department of Health Care Services are estimated to receive the drug this year, and next year, 220 people will benefit, some of whom may be the same patients as this year. That does not include any discounts the state may receive from drug manufacturers.\u003c/p>\n\u003cp id=\"5b0e\" class=\"graf--p graf-after--p\">Orkambi is listed as a “specialty tier” drug in some private health plans. That category is reserved for high-cost drugs, or, in the \u003ca class=\"markup--anchor markup--p-anchor\" href=\"https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/SpecialtyTierMethodology.pdf\" rel=\"nofollow\">federal government’s\u003c/a>view, for drugs that cost more than $600 a month and are used by a small proportion of patients.\u003c/p>\n\u003cp id=\"3924\" class=\"graf--p graf-after--p\">Specialty drugs are already proving to be a financial burden on one California agency, the California Public Employees’ Retirement System, which purchases health benefits for active and retired state workers. The state public pension system says that specialty drugs made up less than 1 percent of all prescriptions for its members but 30 percent of the total drugs costs in 2014.\u003c/p>\n\u003cp class=\"graf--p graf-after--p\">The health benefits from specialty drugs justify the cost, according to the pharmaceutical industry.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp id=\"ee28\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“Patients are gaining access to medicines that are better treating their diseases or frankly even curing them,” said Priscilla VanderVeer, deputy vice president of communications at the Pharmaceutical Research and Manufacturers of America (PhRMA). “Patients are now healthier. They’re more productive. They’re functioning.”\u003c/p>\n\u003cp id=\"e169\" class=\"graf--p graf-after--p\">VanderVeer said companies price drugs not just on the cost of production, but on the value the industry believes the drug brings to the health care system, such as:\u003c/p>\n\u003cul class=\"postList\">\n\u003cli id=\"7b31\" class=\"graf--li graf-after--p\">Efficacy of the treatment\u003c/li>\n\u003cli id=\"b80b\" class=\"graf--li graf-after--li\">How it increases the quality or length of life\u003c/li>\n\u003cli id=\"5c88\" class=\"graf--li graf-after--li\">The “unmet need” in the drug market\u003c/li>\n\u003c/ul>\n\u003cp id=\"cc5b\" class=\"graf--p graf-after--li\">The price of the drug also accounts for the cost of developing other drugs and the high risk that a particular drug won’t make it to market, VanderVeer said. Only 12 percent of drugs that go through clinical trials get approved, according to PhRMA.\u003c/p>\n\u003cp id=\"ef58\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“Because of that high rate of failures there would be no innovative incentive for companies to continue to try to invest” if they could not recoup costs and make a profit, VanderVeer said.\u003c/p>\n\u003cp id=\"93ab\" class=\"graf--p graf-after--p\">Finally, she added, the sticker price doesn’t reflect the final price paid for the drug, which can be heavily discounted through negotiations or because of mandated rebates for Medicaid programs.\u003c/p>\n\u003cp id=\"b00f\" class=\"graf--p graf-after--p\">\u003c/p>\u003cp>\u003c/p>\u003cp>Drugmakers are following the money, said Joel Hay, professor of pharmaceutical economics and policy at USC. Companies invest in specialty drugs that target a small population because their high price tags can be spread over a large insurance pool, he said.\u003c/p>\n\u003cp id=\"02e0\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">Even though specialty drugs are \"ridiculously expensive per treatment episode,\" Hay said, the cost for each member in a health plan is \"just a few cents.” Raising 10 cents on a diabetes drug, for example, would have a bigger budget impact, he said, because more people have diabetes than cystic fibrosis.\u003c/p>\n\u003cp id=\"14f9\" class=\"graf--p graf-after--p\">Hay says manufacturers are now less inclined to invest in drugs that treat millions of people, because there is more pushback on price.\u003c/p>\n\u003cp id=\"de1b\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“Drug companies are for-profit companies obligated to make money for their stockholders,” Hay said. “They’re not virtuous charitable organizations.”\u003c/p>\n\u003cp id=\"708f\" class=\"graf--p graf-after--p\">Drugmakers are also investing more in treating uncommon illnesses because there is less competition and therefore more opportunity for profit, said Dr. Helene Lipton, professor of health policy at the School of Pharmacy and Institute for Health Policy Studies at UC San Francisco.\u003c/p>\n\u003cp id=\"f652\" class=\"graf--p graf-after--p\">The high price of the drugs affects patients, she noted, because health plans put controls on the drugs so that they’re used as a last resort.\u003c/p>\n\u003cp id=\"ed3c\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“That may mean going through two or more rounds of care with other medications before being able to use the specialty drug,” Lipton said.\u003c/p>\n\u003cp id=\"063c\" class=\"graf--p graf-after--p\">It’s not just specialty drugs that are straining health plans’ budgets, said Steve Miller, chief medical officer at Express Scripts, a pharmaceutical benefits manager that negotiates drug prices for 7.5 million Californians.\u003c/p>\n\u003cp id=\"0f47\" class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">“The price of drugs is just continuing to go up,” said Miller, explaining that the trend is due to both new high-cost drugs coming on the market, and mark-ups of old drugs.\u003c/p>\n\u003cp class=\"graf--p graf--startsWithDoubleQuote graf-after--p\">There’s been an explosion of drugs costing $100,000 a year over the last decade, for things like cystic fibrosis and cancer, Miller said. And there was a 127 percent price increase of branded drugs that had been on the market between 2008 and 2014, he says.\u003c/p>\n\u003cp id=\"0c65\" class=\"graf--p graf-after--p\">Limiting the cost of pharmaceuticals is the basis of a California ballot initiative scheduled to go before voters this November that would limit the amount the state pays for a drug to no more than the lowest price paid for the same drug by the U.S. Department of Veterans Affairs.\u003c/p>\n\u003cp id=\"9370\" class=\"graf--p graf-after--p\">We’ll be exploring how a specialty drug’s cost affects patient access. If you are a chronic disease patient who is having difficulty getting specialty drugs, we’d like to hear from you. \u003ca class=\"markup--anchor markup--p-anchor\" href=\"https://twitter.com/pbartolone\" rel=\"nofollow\">Tweet\u003c/a> or \u003ca class=\"markup--anchor markup--p-anchor\" href=\"mailto:Pauline@Calmatters.org\">email\u003c/a> us.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp id=\"f877\" class=\"graf--p graf-after--p graf--last\">\u003cem class=\"markup--em markup--p-em\">CALmatters is a nonprofit journalism venture dedicated to explaining state policies and politics. Pauline Bartolone wrote this article while participating in the \u003c/em>\u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\" rel=\"nofollow\">\u003cem class=\"markup--em markup--p-em\">California Data\u003c/em>\u003c/a>\u003cem class=\"markup--em markup--p-em\"> \u003c/em>\u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://www.centerforhealthjournalism.org/event/2015-california-health-data-journalism-fellowship\" rel=\"nofollow\">\u003cem class=\"markup--em markup--p-em\">Fellowship,\u003c/em>\u003c/a>\u003cem class=\"markup--em markup--p-em\"> a program of the \u003c/em>\u003cem class=\"markup--em markup--p-em\">\u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://www.centerforhealthjournalism.org/\" rel=\"nofollow\">Center for Health Journalism\u003c/a> \u003c/em>\u003cem class=\"markup--em markup--p-em\">at USC’s Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/145149/how-high-cost-specialty-drugs-impact-california","authors":["byline_stateofhealth_145149"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_2650","stateofhealth_2519"],"featImg":"stateofhealth_145168","label":"stateofhealth"},"stateofhealth_144625":{"type":"posts","id":"stateofhealth_144625","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"144625","score":null,"sort":[1454435109000]},"guestAuthors":[],"slug":"another-7-2-million-pow-email-highlights-from-turing-pharmaceuticals","title":"'Another $7.2 Million. Pow!' Highlights from Turing Pharmaceuticals Email Dump","publishDate":1454435109,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{},"content":"\u003cp>A memo from congressional investigators sheds new light on the inner workings of Martin Shkreli's Turing Pharmaceuticals after the company jacked up the prices of a decades-old drug used to treat AIDS patients.\u003c/p>\n\u003cp>The House Committee on Oversight and Investigations is looking into Turing and other drug companies' price increases. This memo, released Tuesday, includes excerpts from the company's internal documents and emails.\u003c/p>\n\u003cp>It paints a picture of the now-disgraced \"pharma-bro\" Martin Shkreli giddily rubbing his palms together at the prospect of all the money Daraprim will generate for his fledgling company. The drug is the only cure for toxoplasmosis, a disease that strikes people with suppressed immune systems, including those with AIDS or cancer.\u003c/p>\n\u003cp>Turing bought Daraprim last year and jacked up the price 5,000 percent, from $13.50 to $750 a pill.\u003c/p>\n\u003cp>Here are a few highlights from the data dump.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When Turing agreed to buy Daraprim, company officials went into celebration mode:\u003c/p>\n\u003cblockquote>\u003cp>\"Very good. Nice work as usual. $1bn here we come.\" – Turing Chairman Ron Tilles email dated May 27, 2015.\u003c/p>\n\u003cp>\"I think it will be huge. We raised the price from $1,700 per bottle to $75,000 ... So 5,000 paying bottles at the new price is $375,000,000 - almost all of it is profit and I think we will get 3 years of that or more. Should be a very handsome investment for all of us.\" – Martin Shkreli email dated Aug. 27, 2015.\u003c/p>\n\u003cp>\"Another $7.2 million. Pow!\" — Tina Ghorban, senior director of business analytics, reacting to a purchase order for 96 bottles at $75,000 a bottle, on Sept. 17.\u003c/p>\u003c/blockquote>\n\u003cp>The company thought it could handle blowback from AIDS activists and doctors:\u003c/p>\n\u003cblockquote>\u003cp>\"HIV patient advocacy may react to price increase ... we still come out ahead if we can frame this issue within the HIV/AIDS community as a fight between a drug company and insurance companies. As long as everyone who needs Daraprim can get it as soon as they need it, regardless of ability to pay, the community should have no issue. There is no love lost between HIV/AIDS activists and insurance companies, and they certainly don't want to be manipulated by them to fight on their behalf.\"\u003c/p>\n\u003cp>\"Cost and coverage are not obstacles to treatment today ... physicians do not report high out-of-pocket costs, required prior authorizations, or other access barriers to toxo medications.\"\u003c/p>\u003c/blockquote>\n\u003cp>They were wrong:\u003c/p>\n\u003cblockquote>\u003cp>\"Given your company's recent move to raise the price of pyrimethamine over 5,000% to an incredible $750 a pill, I have decided not to meet with representatives from Turing. ... I am also urging my colleagues here at UNC, as well as at Duke, ECU, Wake Forest and other clinical centers across our state to do likewise, until Turing announces a reasonable and ethical reduction in the price of this important medication — a drug we rely on most to treat toxoplasmosis.\" – an associate professor at the University of North Carolina, Oct. 1.\u003c/p>\n\u003cp>\"After over a week of trying to secure Daraprim for an uninsured patient requiring Daraprim at Massachusetts General Hospital, I need immediate assistance with expediting this case. ... We have been provided with inaccurate/misleading information by the dedicated Daraprim Team. ... This is a critical matter, visible at the highest levels of our Infectious Disease Department.\" – Complaint from doctor at Massachusetts General Hospital, Oct. 8.\u003c/p>\u003c/blockquote>\n\u003cp>So Turing went into crisis mode, trying out discount programs and struggling with PR:\u003c/p>\n\u003cblockquote>\u003cp>\"I think we are acting a little like a deer in the headlights, and need to take some action steps now. If a hospital like Mass General is having issues we are in trouble.\" – Ed Painter, head of investor relations, Oct. 8.\u003c/p>\n\u003cp>\"Is there an annual price reduction commitment that would discourage generics from entering the market? What if we headlined ...Turing Pharmaceuticals commits to an out of pocket cost to individuals of less than $20.\" – Painter, Sept. 26.\u003c/p>\n\u003cp>\"I don't think so. Re reductions — Think it's best we don't PR something like that unless its something we're willing to commit to doing.\" – Patrick Crutcher, director of business development, Sept. 26.\u003c/p>\n\u003cp>\"FYI, we are 'blowing through' copay dollars very fast. ... My opinion is that with the current state of affairs that we should continue to provide to patients, but we'll need to ultimately evaluate this program and understand the effect on margin.\" Jon Haas, director of patient access, Sept. 29.\u003c/p>\n\u003cp>\"As early as next week, the Board should remove Martin as CEO. ... the price drop has to be significant and tied to something. ... this cannot be seen as something that appears to be as arbitrary as the price hike in the first place.\" — Outside PR consultant, Oct. 8.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>On Dec. 16, Shkreli was arrested on securities fraud charges. He resigned from Turing the following day.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=+%27Another+%247.2+Million.+Pow%21%27+A+Peek+Inside+Turing+Pharmaceuticals+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n","blocks":[],"excerpt":"Congressional investigators have pried loose emails showing how Turing executives anticipated huge profits from a 5,000 percent drug price increase. They were blindsided by the blowback.","status":"publish","parent":0,"modified":1454461778,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":831},"headData":{"title":"'Another $7.2 Million. Pow!' Highlights from Turing Pharmaceuticals Email Dump | KQED","description":"Congressional investigators have pried loose emails showing how Turing executives anticipated huge profits from a 5,000 percent drug price increase. They were blindsided by the blowback.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"'Another $7.2 Million. Pow!' Highlights from Turing Pharmaceuticals Email Dump","datePublished":"2016-02-02T17:45:09.000Z","dateModified":"2016-02-03T01:09:38.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"144625 http://ww2.kqed.org/stateofhealth/?p=144625","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/02/02/another-7-2-million-pow-email-highlights-from-turing-pharmaceuticals/","disqusTitle":"'Another $7.2 Million. Pow!' Highlights from Turing Pharmaceuticals Email Dump","source":"NPR","nprImageCredit":"Paul Taggart","nprByline":"Alison Kodjak","nprImageAgency":"Bloomberg via Getty Images","nprStoryId":"465284148","nprApiLink":"http://api.npr.org/query?id=465284148&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/02/02/465284148/-another-7-2-million-pow-a-peek-inside-turing-pharmaceuticals?ft=nprml&f=465284148","nprRetrievedStory":"1","nprPubDate":"Tue, 02 Feb 2016 12:25:00 -0500","nprStoryDate":"Tue, 02 Feb 2016 12:14:00 -0500","nprLastModifiedDate":"Tue, 02 Feb 2016 12:25:07 -0500","path":"/stateofhealth/144625/another-7-2-million-pow-email-highlights-from-turing-pharmaceuticals","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A memo from congressional investigators sheds new light on the inner workings of Martin Shkreli's Turing Pharmaceuticals after the company jacked up the prices of a decades-old drug used to treat AIDS patients.\u003c/p>\n\u003cp>The House Committee on Oversight and Investigations is looking into Turing and other drug companies' price increases. This memo, released Tuesday, includes excerpts from the company's internal documents and emails.\u003c/p>\n\u003cp>It paints a picture of the now-disgraced \"pharma-bro\" Martin Shkreli giddily rubbing his palms together at the prospect of all the money Daraprim will generate for his fledgling company. The drug is the only cure for toxoplasmosis, a disease that strikes people with suppressed immune systems, including those with AIDS or cancer.\u003c/p>\n\u003cp>Turing bought Daraprim last year and jacked up the price 5,000 percent, from $13.50 to $750 a pill.\u003c/p>\n\u003cp>Here are a few highlights from the data dump.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When Turing agreed to buy Daraprim, company officials went into celebration mode:\u003c/p>\n\u003cblockquote>\u003cp>\"Very good. Nice work as usual. $1bn here we come.\" – Turing Chairman Ron Tilles email dated May 27, 2015.\u003c/p>\n\u003cp>\"I think it will be huge. We raised the price from $1,700 per bottle to $75,000 ... So 5,000 paying bottles at the new price is $375,000,000 - almost all of it is profit and I think we will get 3 years of that or more. Should be a very handsome investment for all of us.\" – Martin Shkreli email dated Aug. 27, 2015.\u003c/p>\n\u003cp>\"Another $7.2 million. Pow!\" — Tina Ghorban, senior director of business analytics, reacting to a purchase order for 96 bottles at $75,000 a bottle, on Sept. 17.\u003c/p>\u003c/blockquote>\n\u003cp>The company thought it could handle blowback from AIDS activists and doctors:\u003c/p>\n\u003cblockquote>\u003cp>\"HIV patient advocacy may react to price increase ... we still come out ahead if we can frame this issue within the HIV/AIDS community as a fight between a drug company and insurance companies. As long as everyone who needs Daraprim can get it as soon as they need it, regardless of ability to pay, the community should have no issue. There is no love lost between HIV/AIDS activists and insurance companies, and they certainly don't want to be manipulated by them to fight on their behalf.\"\u003c/p>\n\u003cp>\"Cost and coverage are not obstacles to treatment today ... physicians do not report high out-of-pocket costs, required prior authorizations, or other access barriers to toxo medications.\"\u003c/p>\u003c/blockquote>\n\u003cp>They were wrong:\u003c/p>\n\u003cblockquote>\u003cp>\"Given your company's recent move to raise the price of pyrimethamine over 5,000% to an incredible $750 a pill, I have decided not to meet with representatives from Turing. ... I am also urging my colleagues here at UNC, as well as at Duke, ECU, Wake Forest and other clinical centers across our state to do likewise, until Turing announces a reasonable and ethical reduction in the price of this important medication — a drug we rely on most to treat toxoplasmosis.\" – an associate professor at the University of North Carolina, Oct. 1.\u003c/p>\n\u003cp>\"After over a week of trying to secure Daraprim for an uninsured patient requiring Daraprim at Massachusetts General Hospital, I need immediate assistance with expediting this case. ... We have been provided with inaccurate/misleading information by the dedicated Daraprim Team. ... This is a critical matter, visible at the highest levels of our Infectious Disease Department.\" – Complaint from doctor at Massachusetts General Hospital, Oct. 8.\u003c/p>\u003c/blockquote>\n\u003cp>So Turing went into crisis mode, trying out discount programs and struggling with PR:\u003c/p>\n\u003cblockquote>\u003cp>\"I think we are acting a little like a deer in the headlights, and need to take some action steps now. If a hospital like Mass General is having issues we are in trouble.\" – Ed Painter, head of investor relations, Oct. 8.\u003c/p>\n\u003cp>\"Is there an annual price reduction commitment that would discourage generics from entering the market? What if we headlined ...Turing Pharmaceuticals commits to an out of pocket cost to individuals of less than $20.\" – Painter, Sept. 26.\u003c/p>\n\u003cp>\"I don't think so. Re reductions — Think it's best we don't PR something like that unless its something we're willing to commit to doing.\" – Patrick Crutcher, director of business development, Sept. 26.\u003c/p>\n\u003cp>\"FYI, we are 'blowing through' copay dollars very fast. ... My opinion is that with the current state of affairs that we should continue to provide to patients, but we'll need to ultimately evaluate this program and understand the effect on margin.\" Jon Haas, director of patient access, Sept. 29.\u003c/p>\n\u003cp>\"As early as next week, the Board should remove Martin as CEO. ... the price drop has to be significant and tied to something. ... this cannot be seen as something that appears to be as arbitrary as the price hike in the first place.\" — Outside PR consultant, Oct. 8.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>On Dec. 16, Shkreli was arrested on securities fraud charges. He resigned from Turing the following day.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=+%27Another+%247.2+Million.+Pow%21%27+A+Peek+Inside+Turing+Pharmaceuticals+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/144625/another-7-2-million-pow-email-highlights-from-turing-pharmaceuticals","authors":["byline_stateofhealth_144625"],"categories":["stateofhealth_13"],"tags":["stateofhealth_2650"],"featImg":"stateofhealth_144626","label":"source_stateofhealth_144625"},"stateofhealth_143168":{"type":"posts","id":"stateofhealth_143168","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"143168","score":null,"sort":[1453942583000]},"guestAuthors":[],"slug":"california-doles-out-millions-to-insurers-for-hepatitis-c-drugs","title":"California Doles Out Millions to Insurers for Hepatitis C Drugs","publishDate":1453942583,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>In an unusual funding arrangement, California is paying private health plans hundreds of millions of dollars in supplemental payments to cover the high price of hepatitis C drugs for patients in Medi-Cal managed care plans.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Dollars that were intended for a wide array of medical services started being gobbled up by just one drug.'\u003ccite>Charles Bacchi, California Association of Health Plans\u003c/cite>\u003c/aside>\n\u003cp>While Medi-Cal is California's program of health insurance for people who are low income, nearly 80 percent of beneficiaries are in managed care plans run by private health insurance companies. The companies are paid a flat rate per member each month to cover all health care needs.\u003c/p>\n\u003cp>The funding agreement was reached after health plans raised \"alarm\" over the high cost of new hepatitis C drugs and plans had to dig into reserves because of the drugs' cost, says Charles Bacchi, president of the California Association of Health Plans, an industry trade group.\u003c/p>\n\u003cp>“Dollars that were intended for a wide array of medical services started being gobbled up by just one drug,” Bacchi said.\u003c/p>\n\u003cp>A spokesperson for the state's Department of Health Care Services says it's the first time the state has paid health plans a supplemental money just to cover the high cost of a drug. Specifically, Sovaldi, a hepatitis C drug retailing at $1,000 per pill, has sent \u003ca href=\"http://www.wsj.com/articles/gileads-1-000-hep-c-pill-is-hard-for-states-to-swallow-1428525426\" target=\"_blank\">treatment prices soaring.\u003c/a> The drug is made by Gilead Sciences in Foster City.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Although the members of Bacchi’s trade group directly benefit from the supplemental payments, he says the additional money is not a “sustainable” solution to the underlying problem of high-priced drugs.\u003c/p>\n\u003cp>Here are some of the details about the supplemental government funding stream to Medi-Cal plans:\u003c/p>\n\u003cul>\n\u003cli>Health plans invoiced California for $387.5 million for hepatitis C drugs between July 2014 and November 2015, according to the California Department of Health Care Services. The payments come from a mix of federal and state dollars.\u003c/li>\n\u003cli>During that time period, 3,624 Medi-Cal managed care members with hepatitis C were treated.\u003c/li>\n\u003cli>By CALmatters' calculations, the payments amount to $106,926 per patient. The number reflects other drugs used to treat hepatitis C, and isn’t solely the price of Sovaldi and Harvoni, another new, pricey drug to treat hepatis C.\u003c/li>\n\u003cli>Payments to plans are expected to continue in the next fiscal year. The California Department of Health Care Services has budgeted $303.4 million for health plans for 2016–17.\u003c/li>\n\u003c/ul>\n\u003cp>While California will receive some money back from drugmakers in the form of rebates, the ultimate price the state pays for the drugs is confidential, according to the Department of Health Care Services.\u003c/p>\n\u003cp>Limiting the cost of pharmaceuticals is the basis of a \u003ca href=\"http://www.sos.ca.gov/administration/news-releases-and-advisories/2015-news-releases-and-advisories/new-measure-eligible-californias-november-2016-ballot3/\" target=\"_blank\">ballot initiative\u003c/a> expected to be before California voters this November. The proposal would limit the amount the state pays for a drug to no more than the lowest price paid for the same drug by the U.S. Department of Veterans Affairs.\u003c/p>\n\u003cp>The state health care agency says its payments to insurers of Medi-Cal patients for hepatitis C drugs are a “very unique” solution, one that they may use for other high-cost drugs in the future. The state says the current hepatitis C payments may be reassessed in a year or two as it expects the price of the drugs to go down.\u003c/p>\n\u003cp>“As the prescribing of the drugs levels off, as the population and the overall nature of who’s getting it settles down, we may get to a point where we look at carving that responsibility back into the plans’ … rate,” said Jennifer Kent, director of the California Department of Health Care Services.\u003c/p>\n\u003cp>But California’s spending on hepatitis C drugs doesn’t end there.\u003c/p>\n\u003cp>For the rest of the Medi-Cal population — the 2.7 million people who are not in a private managed care plan and whose health care services are directly reimbursed by the state — a \u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://www.finance.senate.gov/ranking-members-news/wyden-grassley-sovaldi-investigation-finds-revenue-driven-pricing-strategy-behind-84-000-hepatitis-drug\" target=\"_blank\" rel=\"nofollow\">U.S. Senate Finance Committee\u003c/a> reports the following for the year 2014:\u003c/p>\n\u003cul>\n\u003cli>California paid almost $22 million to treat 280 hepatitis C patients with Sovaldi.\u003c/li>\n\u003cli>California paid more than $2.8 million for 57 Harvoni prescriptions.\u003c/li>\n\u003c/ul>\n\u003cp>According to the U.S. Senate report, 237,000 people in Medi-Cal are infected with hepatitis C. So, doing the math between the 3,624 managed care patients and the 337 covered directly by the state, means less than 2 percent of those infected have been treated with the new drugs -- at a cost of hundreds of millions of dollars already.\u003c/p>\n\u003cp>“In order for taxpayers of the state of California to afford to provide people the necessary treatments,” says Bacchi, “we have to have drug pricing society can afford to pay.”\u003c/p>\n\u003cp>At CALmatters, \u003ca href=\"https://medium.com/california-s-legal-drug-dilemma/the-obscurity-of-drug-spending-in-medi-cal-4ccf1df97392#.ii6y9pxr6\" target=\"_blank\">we’re exploring how a drug’s cost affects patient access.\u003c/a> If you are a hepatitis C patient, or other chronic disease patient who is having difficulty getting drugs, we’d like to hear from you.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca class=\"markup--anchor markup--p-anchor\" href=\"https://twitter.com/pbartolone\" target=\"_blank\" rel=\"nofollow\">Tweet\u003c/a> or \u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://pauline@calmatters.org/\" rel=\"nofollow\">email us\u003c/a>.\u003c/p>\n\n","blocks":[],"excerpt":"The state says it's a first -- supplemental payments to cover drugs that can cost $1,000 per pill.","status":"publish","parent":0,"modified":1453946033,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":865},"headData":{"title":"California Doles Out Millions to Insurers for Hepatitis C Drugs | KQED","description":"The state says it's a first -- supplemental payments to cover drugs that can cost $1,000 per pill.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California Doles Out Millions to Insurers for Hepatitis C Drugs","datePublished":"2016-01-28T00:56:23.000Z","dateModified":"2016-01-28T01:53:53.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"143168 http://ww2.kqed.org/stateofhealth/?p=143168","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/01/27/california-doles-out-millions-to-insurers-for-hepatitis-c-drugs/","disqusTitle":"California Doles Out Millions to Insurers for Hepatitis C Drugs","nprByline":"Pauline Bartolone, CALmatters","path":"/stateofhealth/143168/california-doles-out-millions-to-insurers-for-hepatitis-c-drugs","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In an unusual funding arrangement, California is paying private health plans hundreds of millions of dollars in supplemental payments to cover the high price of hepatitis C drugs for patients in Medi-Cal managed care plans.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Dollars that were intended for a wide array of medical services started being gobbled up by just one drug.'\u003ccite>Charles Bacchi, California Association of Health Plans\u003c/cite>\u003c/aside>\n\u003cp>While Medi-Cal is California's program of health insurance for people who are low income, nearly 80 percent of beneficiaries are in managed care plans run by private health insurance companies. The companies are paid a flat rate per member each month to cover all health care needs.\u003c/p>\n\u003cp>The funding agreement was reached after health plans raised \"alarm\" over the high cost of new hepatitis C drugs and plans had to dig into reserves because of the drugs' cost, says Charles Bacchi, president of the California Association of Health Plans, an industry trade group.\u003c/p>\n\u003cp>“Dollars that were intended for a wide array of medical services started being gobbled up by just one drug,” Bacchi said.\u003c/p>\n\u003cp>A spokesperson for the state's Department of Health Care Services says it's the first time the state has paid health plans a supplemental money just to cover the high cost of a drug. Specifically, Sovaldi, a hepatitis C drug retailing at $1,000 per pill, has sent \u003ca href=\"http://www.wsj.com/articles/gileads-1-000-hep-c-pill-is-hard-for-states-to-swallow-1428525426\" target=\"_blank\">treatment prices soaring.\u003c/a> The drug is made by Gilead Sciences in Foster City.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Although the members of Bacchi’s trade group directly benefit from the supplemental payments, he says the additional money is not a “sustainable” solution to the underlying problem of high-priced drugs.\u003c/p>\n\u003cp>Here are some of the details about the supplemental government funding stream to Medi-Cal plans:\u003c/p>\n\u003cul>\n\u003cli>Health plans invoiced California for $387.5 million for hepatitis C drugs between July 2014 and November 2015, according to the California Department of Health Care Services. The payments come from a mix of federal and state dollars.\u003c/li>\n\u003cli>During that time period, 3,624 Medi-Cal managed care members with hepatitis C were treated.\u003c/li>\n\u003cli>By CALmatters' calculations, the payments amount to $106,926 per patient. The number reflects other drugs used to treat hepatitis C, and isn’t solely the price of Sovaldi and Harvoni, another new, pricey drug to treat hepatis C.\u003c/li>\n\u003cli>Payments to plans are expected to continue in the next fiscal year. The California Department of Health Care Services has budgeted $303.4 million for health plans for 2016–17.\u003c/li>\n\u003c/ul>\n\u003cp>While California will receive some money back from drugmakers in the form of rebates, the ultimate price the state pays for the drugs is confidential, according to the Department of Health Care Services.\u003c/p>\n\u003cp>Limiting the cost of pharmaceuticals is the basis of a \u003ca href=\"http://www.sos.ca.gov/administration/news-releases-and-advisories/2015-news-releases-and-advisories/new-measure-eligible-californias-november-2016-ballot3/\" target=\"_blank\">ballot initiative\u003c/a> expected to be before California voters this November. The proposal would limit the amount the state pays for a drug to no more than the lowest price paid for the same drug by the U.S. Department of Veterans Affairs.\u003c/p>\n\u003cp>The state health care agency says its payments to insurers of Medi-Cal patients for hepatitis C drugs are a “very unique” solution, one that they may use for other high-cost drugs in the future. The state says the current hepatitis C payments may be reassessed in a year or two as it expects the price of the drugs to go down.\u003c/p>\n\u003cp>“As the prescribing of the drugs levels off, as the population and the overall nature of who’s getting it settles down, we may get to a point where we look at carving that responsibility back into the plans’ … rate,” said Jennifer Kent, director of the California Department of Health Care Services.\u003c/p>\n\u003cp>But California’s spending on hepatitis C drugs doesn’t end there.\u003c/p>\n\u003cp>For the rest of the Medi-Cal population — the 2.7 million people who are not in a private managed care plan and whose health care services are directly reimbursed by the state — a \u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://www.finance.senate.gov/ranking-members-news/wyden-grassley-sovaldi-investigation-finds-revenue-driven-pricing-strategy-behind-84-000-hepatitis-drug\" target=\"_blank\" rel=\"nofollow\">U.S. Senate Finance Committee\u003c/a> reports the following for the year 2014:\u003c/p>\n\u003cul>\n\u003cli>California paid almost $22 million to treat 280 hepatitis C patients with Sovaldi.\u003c/li>\n\u003cli>California paid more than $2.8 million for 57 Harvoni prescriptions.\u003c/li>\n\u003c/ul>\n\u003cp>According to the U.S. Senate report, 237,000 people in Medi-Cal are infected with hepatitis C. So, doing the math between the 3,624 managed care patients and the 337 covered directly by the state, means less than 2 percent of those infected have been treated with the new drugs -- at a cost of hundreds of millions of dollars already.\u003c/p>\n\u003cp>“In order for taxpayers of the state of California to afford to provide people the necessary treatments,” says Bacchi, “we have to have drug pricing society can afford to pay.”\u003c/p>\n\u003cp>At CALmatters, \u003ca href=\"https://medium.com/california-s-legal-drug-dilemma/the-obscurity-of-drug-spending-in-medi-cal-4ccf1df97392#.ii6y9pxr6\" target=\"_blank\">we’re exploring how a drug’s cost affects patient access.\u003c/a> If you are a hepatitis C patient, or other chronic disease patient who is having difficulty getting drugs, we’d like to hear from you.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca class=\"markup--anchor markup--p-anchor\" href=\"https://twitter.com/pbartolone\" target=\"_blank\" rel=\"nofollow\">Tweet\u003c/a> or \u003ca class=\"markup--anchor markup--p-anchor\" href=\"http://pauline@calmatters.org/\" rel=\"nofollow\">email us\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/143168/california-doles-out-millions-to-insurers-for-hepatitis-c-drugs","authors":["byline_stateofhealth_143168"],"categories":["stateofhealth_2442","stateofhealth_13"],"tags":["stateofhealth_2650","stateofhealth_2519"],"featImg":"stateofhealth_143302","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png","officialWebsiteLink":"http://freakonomics.com/","airtime":"SUN 1am-2am, SAT 3pm-4pm","meta":{"site":"radio","source":"WNYC"},"link":"/radio/program/freakonomics-radio","subscribe":{"npr":"https://rpb3r.app.goo.gl/4s8b","apple":"https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519","tuneIn":"https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/","rss":"https://feeds.feedburner.com/freakonomicsradio"}},"fresh-air":{"id":"fresh-air","title":"Fresh Air","info":"Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.","airtime":"MON-FRI 7pm-8pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Fresh-Air-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/fresh-air/","meta":{"site":"radio","source":"npr"},"link":"/radio/program/fresh-air","subscribe":{"npr":"https://rpb3r.app.goo.gl/4s8b","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/Fresh-Air-p17/","rss":"https://feeds.npr.org/381444908/podcast.xml"}},"here-and-now":{"id":"here-and-now","title":"Here & Now","info":"A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. 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Updated Monday through Friday at about 3:30 p.m. PT.","airtime":"MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.marketplace.org/","meta":{"site":"news","source":"American Public Media"},"link":"/radio/program/marketplace","subscribe":{"apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=201853034&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/APM-Marketplace-p88/","rss":"https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"}},"mindshift":{"id":"mindshift","title":"MindShift","tagline":"A podcast about the future of learning and how we raise our kids","info":"The MindShift podcast explores the innovations in education that are shaping how kids learn. 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