PCP @BrighamWomens, researcher @PORTAL_Research studying 💊💰📈. Alum @BrighamMedRes @harvardmed @HarvardChanSPH @BrownUniversity. Views my own.
Boston, MA
Joined December 2011
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📺 Tune in at 2PM as I talk with the House @WaysMeansCmte Health Subcommittee about high drug prices, PBMs, and rebates! 💊💵
gop-waysandmeans.house.gov/e… – at Capitol Hill, Washington
Ben Rome retweeted
Really nice work @DrHussainL @bnrome!
One quick point of reflection:
It’s crazy how complicated it is in our country for so many people to figure out how to get help affording their meds…
💊 New study in JAMA provides clear steps busy clinicians & staff can take to help patients struggling to afford their prescription drugs!
We include an algorithm based on the patient's health insurance status & drug type (brand vs. generic).
READ: jamanetwork.com/journals/jam…
Ben Rome retweeted
Important new piece from @DrHussainL @bnrome and the @PORTAL_Research team.
The incredibly high cost of prescription 💊💊 has huge #Pharmacoequity implications given the unequal distribution of wealth in the US and globally.
Useful strategies outlined.
jamanetwork.com/journals/jam…
Ben Rome retweeted
Analysis led by Dongzhe Hong in @Health_Affairs examined the patient & prescriber factors impacting US #biosimilar use from 2013-2022, including geography, patient age, prescriber type, & where the drug was administered.
healthaffairs.org/doi/10.137…
Ben Rome retweeted
In their new Forefront article, @suhas_gondi, @bnrome + @WillShrank from @BrighamWomens + @Humana argue that, as regulators consider how mergers involving PBMs affect competition, they should also consider the clinical and financial benefits for patients. bit.ly/3WvYEzt
I didn’t realize a new season of @succession was coming out so soon!
nytimes.com/2024/07/24/busin…
Ben Rome retweeted
Analysis: U.S. Patent Office software mistakes extend patent life for drugs statnews.com/pharmalot/2024/…
Ben Rome retweeted
In @JAMAHealthForum, Catherine Hwang, @DrHussainL & @bnrome discuss state efforts to set drug spending targets. They outline the limitations of using this policy to address high drug spending, absent a more robust approach to improve affordability.
jamanetwork.com/journals/jam…
Hmm, not sure Peter Rheinstein actually read the @CMSGov ref’s on this. I get that @statnews is wants a diverse group of options, but something like this should still be fact checked.
statnews.com/2024/07/15/medi…
I don't think cost control should be the responsibility of individual prescribers. Docs and patients should make decisions agnostic of cost. That means it's up to payers (and PBMs) to say no sometimes when things are too expensive. Tension between docs and payers is inevitable.
Yes, totally agreed. You could go work at the VA where the formulary is clear. But then your arsenal would be a lot more limited. I think transparency would help a lot to alleviate this prior auth whiplash.
Totally agree. But inevitably formulation placement is how you negotiate. VA does the same thing. They sign longer term contract so their formulary doesn't change as often. But that means not all drugs are covered.
At least for Medicare Part D, nearly 100% of rebates are passed back to the government: gao.gov/assets/gao-19-498.pd…
Might be lower for commercial plans. But it's clear that employers/plans choose the PBM with the lowest net cost even with fees/PBMs keeping a portion of rebates.
So unless we come up with a robust alternative, eliminating rebates will lead to massive increases in spending on brand name drugs.
We saw that when Trump proposed removing safe harbor.
Other countries don’t have PBMs… but they have national health care systems with a centralized HTA process to negotiate formulary coverage. We don’t.
And more fundamentally, what leverage do payers and PBMs have to negotiate discounts/rebates from drug manufacturers? Formulary coverage & preferred status is all they’ve got.