Forget the practice of doctors buying Part B drugs, Health and Human Services Secretary Alex Azar said earlier this week. The Trump administration has a better idea. The White House also is stepping up its anti-abortion efforts. And a busy week also saw the president announce his latest pick to head the Department of Veterans Affairs.
Get Docs Out of Drug-Buying Business, HHS Chief Urges
Currently, physicians who administer drugs paid for under Medicare Part B — which covers drugs administered in the physician’s office — pay for the drug themselves up front and then are reimbursed at the average sales price plus a 6% markup. This system “gets into the notion of physicians or facilities making money off the arbitrage between acquisition price and reimbursement,” Azar explained at a briefing with reporters following a speech he gave on President Trump’s plan to lower the cost of prescription drugs.
Instead, the administration is proposing a “competitive acquisition program” for Part B drugs.”The concept of the competitive acquisition program is not to have physicians take title to the medications they’re administering, but rather, have a competitive program where those drugs would be purchased and the capital outlay would occur elsewhere,” so the doctor doesn’t have to buy the drug “and the physician is paid … a fair, appropriate level of reimbursement for their services in administering the drug,” Azar said.
Trump Picks Wilkie as VA Secretary
Among those surprised: Wilkie, currently the department’s acting secretary as well as the Defense Department’s undersecretary for personnel and readiness. Trump said Wilkie didn’t know the announcement was coming, CNN reported.
Wilkie, a lawyer by training who spent some 20 years on Capitol Hill as an aide to various Republican congressmen, has been in the acting role at the VA since late March, when Trump fired David Shulkin, MD.
FDA Tries Shaming Drugmakers that Block Generic Competition
The FDA
released a list Thursday of brand-name drug companies it says are blocking the development of generic drugs by refusing to give generic drugmakers access to samples of brand-name products for use in clinical trials needed for approval.
“We hope that this increased transparency will help reduce unnecessary hurdles to generic drug development and approval,” FDA Commissioner Scott Gottlieb, MD,
said in a statement.
The list’s release was part of the
Trump administration’s plan to lower prices for prescription drugs. “As stressed by the President and [Health and Human Services] Secretary [Alex] Azar last week, one of the Administration’s highest priorities is advancing policies that increase competition as a way to help make drugs more affordable and improve access,” Gottlieb said.
White House Proposes Restrictions on Family Planning Clinics
The Trump administration is reportedly moving closer to issuing a regulation that would
require clinics that accept federal funds to maintain complete separation of facilities and finances related to abortion services from those providing other services supported by the federal monies.
Officials at Planned Parenthood, which receives the largest share of Title X funds of any organization ($50 to $60 million, according to
reports), said they wouldn’t comply with the physical separation requirement.
Senators Focus on Hospital Drug Discount Program
Although the Health Resources and Services Administration (HRSA), which oversees the program, has taken some important steps to improve oversight, “a number of important issues remain,” said Debra Draper, PhD, director of the healthcare team at the Government Accountability Office, during a hearing Tuesday of the Senate Health, Education, Labor, & Pensions (HELP) Committee.
These issues include “whether the intent of the program is still relevant today given the vastly changed healthcare landscape and the 340B program environment, and the continued lack of specificity in program guidance, most notably the definition of patient and hospital eligibility criteria,”said Draper, whose agency released a
2011 report on the program’s problems. “Until these issues are resolved, there will continue to be questions about the integrity of the 340B program and HRSA’s ability to provide effective oversight.”
Second Bundle of Opioid Bills Passes House Committee
The same House Energy and Commerce Committee passed 25 other opioid-related bills last week, bringing the total to 57 bills, which now advance to the House.
Many of the measures discussed on Thursday moved handily through the committee, but members wrestled with a few with controversial elements.
These included a bill to relax confidentiality standards around substance use disorders; a bill to temporarily reverse the ban on Medicaid paying for inpatient treatment in certain facilities; and a bill — rewritten as an amendment — which would have permanently let certain non-physicians such as nurse midwives prescribe medication-assisted treatment.
“It’s laudable to try to expand treatment, but we need to do that very carefully,” said Rep. Larry Bucshon, MD (R-Ind.) in response to the idea of nonphysicians prescribing MAT.
Next Week
On Monday,
Research!America and the American Society for Microbiology will examine vaccine survey data.
On Tuesday,
The Hill will host a briefing on preventing opioid addiction in young people.
And
The Atlantic will explore the issue of finding treatment for pediatric cancers.
On Wednesday
The Atlantic will host a second briefing, this time, on patient access to care and affordability.
And the
Senate HELP Committee will examine the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018.
