Another Year, Another Misleading Insurance Company Report

Once again, Blue Cross Blue Shield is out with a report attempting to stoke fear and confusion about prescription drug costs. And once again (because we've chronicled it before) what the major insurance company has to say is contradicted by its own pharmacy benefits manager.

These drug cost middlemen, also known as PBMs, manage prescription drug benefits on behalf of health plans. It just so happens that Blue Cross Blue Shield plans own one of the largest PBMs in the country – Prime Therapeutics. One should expect that the report released by Blue Cross Blue Shield would be reflected in the data put forward by its own PBM. But it's not.

Here is what Prime Therapeutics has said this year about the trend of prescription drug costs:

• In February, Prime announced "the second consecutive year of outstanding trend results." What made them so outstanding? Prime's "numerous management tools" led to a 0.2 percent drop in the drug trend for commercial health plans.
• Prime also noted a drop a -0.8 percent and -5.4 percent drop for Medicare and Medicaid, respectively.
• Prime's chief clinical officer said they were "thrilled drug expenditures for our clients declined in 2017."

It's always important to note that what PBMs report reflects what health plans are actually paying. The same can't be said for the Blue Cross Blue Shield report. As even they have to admit – in a note buried on page 11 of its report – the prices they point to "do not include the impact of drug rebates." That's unfortunate because the impact is significant. Drugmakers negotiate rebates to help lower costs and expand access. In 2017, these rebates totaled more than $150 billion. Is there any wonder why Blue Cross Blue Shield failed to include them?

As Dr. Adam Fein – one of the nation's top experts on pharmaceutical economics – has noted before:

"Clearly, drug spending is not spinning out of control. Pharmacy benefit costs are growing much more slowly than is growth in other part of the U.S. healthcare system, such as hospital spending and physician salaries."

That's the reality reflected in most of the data put out by a wide range of health care stakeholders. Of course, that's never the reality insurance companies want the public to see. Prime's President's and CEO Jim DuCharme noted earlier this year:

"Our close alignment with 22 Blue plan clients – 18 of whom are owners – allows us to see the complete pharmacy and medical drug picture to help us drive total cost of care outcomes."

Such a close alignment should ensure both Blue Cross Blue Shield and its PBM are singing from the same song sheet when it comes to the facts about prescription drug costs. But apparently not.

Muslim concern about vaccine fuels Thai measles outbreak

Islam prohibits eating pork and vaccine sometimes use a pork derived ingredient.

You May Not Like Gmos, but Our Planet Sure Does

In a new blog post at the GMO Answers Medium page, GMO Answers volunteer expert Dr. Elizabeth Hood details the benefits of GMOs for growers, consumers and the environment. She explains how genetically engineered crops help not just farmers and consumers, but the planet, too.

She writes

The first GE plants had new characteristics that made them resistant to environmental conditions. One of the very first improved crops through genetic engineering saved the papaya industry in Hawaii.

Anyone who has ever been to Hawaii has been introduced to this wonderful, orange, creamy-fleshed fruit. However, if not for genetic engineering, this fruit would not be available.

and

Another example of how GE can help the environment (and farmers and consumers) is through control of insects.

Organic farmers use a bacterium to combat insects by sprinkling the bacterium on the leaves of their plants. Genetic Engineers took this a few steps further by taking the bacterium's genes (called Bt genes) that kill insects and putting them directly into the plant. The bacterium has more than 50 genes that kill insects.

By learning which ones kill which insects, scientists can make the plant resistant to their most damaging predators. Bt genes in corn, cotton, soybeans and eggplant (as well as other traits) have removed 6 million tons of pesticides from the environment.

To learn more about how GMOs help the environment, please visit the GMO Answers Medium page, and the GMOs and the Environment section on the GMO Answers website.

Patient and Health Advocacy Summit: Ensuring Patient Access and Affordability

In a world of continual innovation in biopharmaceuticals, how do we ensure patients have access to the medicines that work to meet their individual needs?

On Day 1 of BIO's Patient and Health Advocacy Summit, a group of health care stakeholders joined Merck's Dr. Julie Gerberding for a discussion about the importance of understanding policies that may stand between patients, and the treatments they need. Panelists included:

• Carl Schmid, The AIDS Institute
• Donna Cryer, Global Liver Institute
• Alan Balch, Patient Advocate Foundation and National Patient Advocate Foundation
• Anna Hyde, Arthritis Foundation

The group touched on topics ranging from the acceleration of high patient cost-sharing and barriers to patient assistance programs, including co-pay accumulators, to the adoption of utilization management tools like step-therapy, and the drive toward using cost-effectiveness analyses in coverage decisions.

Early in the discussion, Carl Schmid was asked about co-pay accumulator programs and the challenges they pose to patients and consumers. "These policies are usually buried in the plan documents, so people don't even know that they are being subject to this practice," he told the crowd.

As he explained, insurance plans and pharmacy benefit managers (PBMs) have started to implement these policies, which prevent funds provided by financial assistance programs offered by drug manufacturers, from applying to a patient's out of pocket maximum or deductible. This can leave patients with steep costs when the value of patient assistance is exhausted. "We're very concerned that it could impact adherence and lead to people not picking up their drugs," he concluded.

Next, Donna Cryer shared her concerns about step therapy and explained why this policy – often referred to as "fail first" – could be dangerous for patients. "Step therapy requires that you try a drug that is something different from what you and your doctor have agreed upon," Cryer explained while providing detail about this practice, which is used as a tool to drive a patient towards a lower cost treatment. "It is well documented in literature that patients who are subjected to step therapy or fail first utilization management tactics experience delays in care … and that is not appreciated," she added.

To close out the session, Dr. Gerberding initiated a discussion on the Trump Administration's American Patients First Blueprint. While the group agreed that the proposal is far from perfect, Dr. Alan Balch noted that we must "identify the pieces that we think are beneficial and will help patients, and then extrapolate … them across the board." Balch continued, "it's not enough to only give patients access to information about drug prices … it's their surgery costs, diagnostic tests, hospital costs" that need to be shared as well. "There must be a common denominator, so everyone is playing under the same set of rules."

Anna Hyde with the Arthritis Foundation echoed these comments, adding that "while we talk a lot about patient impact and patient centeredness, there is a shift in thinking that hasn't happened yet. Not enough people who develop and implement policy ask themselves the questions of 'What is the impact to the patient? Is this going to be a net benefit to the patient?'" On how to make that shift happen, Hyde concluded "every piece of the ecosystem" has to think about these questions, "not just the patient community, but the provider community, the pharmaceutical community, [and] the payer community … so that it becomes a more standard way of thinking."

To watch the full panel discussion, click here. To learn about other sessions that took place at BIO's Patient and Health Advocacy Summit click here.

It Starts with One-Presentation at BIO 2018 Leads to International Agreement

A recently announced agreement between the New Jersey Economic Development Authority and the Israel Innovation Authority is a fitting testament to the theme for the upcoming BIO 2019 International Convention: It Starts with One.  In the intensely innovative biotechnology space, one meeting; one interaction; one study, one partnership, one discovery, or one presentation can change the trajectory of progress.

On October 11, 2018, the New Jersey Economic Development Authority and the Israel Innovation Authority (IIA) signed a Memorandum of Understanding that was initiated from conversations held at the 2018 BIO International Convention in Boston.

The relationship began when Choose New Jersey CEO Jose Lozano attended a presentation given at the June Convention by long-term conference attendee, IIA, ROI reports. Impressed by the presentation, Lozano and his team connected with IIA staff before the end of the conference and the rest was history.

The October memorandum was signed days before New Jersey Governor Phil Murphy set out on a nine-day global economy mission with an important stop in Israel. The partnership encourages collaboration between New Jersey corporations and Israeli businesses- specifically it aims to strengthen research and development of the innovation economy, including the biotechnology and the life sciences industries.

In a press release on the memorandum, Governor Murphy noted,

"The Garden State and Israel both have economies deeply rooted in innovation as well as brilliant scientists, researchers, and academic minds doing ground-breaking work across a broad spectrum of high-growth sectors. The New Jersey-Israel relationship already generates more than $1 billion in annual shared economic activity and we hope that, as a result of this MOU, that number will double, if not triple, in the years ahead."

To read more about the partnership between New Jersey & Israel, visit:

• New Jersey & Israel Sign Agreement to Strengthen Economic Ties
• Innovation is the Theme of Governor Murphy's First Full Day in Israel

This is only one of the many cross-border collaborations that have stemmed from the educational, networking, and partnering opportunities at the BIO International Convention.

As the world's largest biotechnology event, the BIO International Convention attracts 16,000+ global biotechnology and pharma influencers for one week of intense networking to discover new opportunities and promising partnerships. Event attendees can connect with global counterparts in the industry to foster new breakthroughs in innovation that help us heal, fuel, and feed the world.

To engage in similar types of networking and collaborative partnerships, attend the 2019 BIO International Convention hosted in Philadelphia, PA. Click here to learn more.