Author: Matt Arnold, Principal Analyst
- Healthcare Policy Chaos 2017: Will they or won’t they kill the ACA? Repeal and Delay has given way to Repeal and Replace. Or Just Repeal. Or just Delay. Or perhaps Repair? An initial Obamacare “repeal” vote passed the Senate, 51-48, last month, and President Trump issued an amorphous executive order commanding his agencies to begin dismantling the law, but prospects for even partial repeal are looking far from certain, with a number of prominent Republican Senators, a key voting bloc in the House, conservative policy hands and the President himself seemingly getting cold feet. They’re caught between a rock – promises made, again and again, over six years – and a hard place (they’ll own the impact on constituents’ coverage), and they’re facing rowdy town hall meetings that mirror the Tea Party uprising of 2010, only this time with angry ACA supporters.
- Regardless of the fate of the law’s insurance elements, the shift towards value- and qualitative reimbursement will almost certainly continue – even though presumptive HHS head Tom Price, an orthopedic surgeon, is not a fan (specialists are some of the biggest losers in the move from fee-for-service medicine). And Price is, um, unusually transactional, as they go. He steered policy and worked the refs to favor major donors in the device and biotech industries, according to a Kaiser Health News report.
- Incidentally, just before leaving office, President Obama was asked his greatest disappointment with the Affordable Care Act. To the surprise of everyone but physicians, he cited halting progress on EHR adoption and interoperability. Already it seems so strange that a president might actually know how the EHR market works.
- In other nominee no-no news, incoming Secretary of Defense Gen. James Mattis resigned from scandalized blood test 2.0 startup Theranos, which laid off half its employees last month.
- Pharma execs are hoping Scott Gottlieb is tapped for FDA commissioner. Gottlieb, a smart and thoughtful conservative think tank type who served as deputy commissioner under George W. Bush, is up against several candidates of a more radical libertarian bent, whose proposals to, for example, do away with establishing efficacy as a precondition for marketing approval, might undermine public confidence in prescription medications.
- FDA is reexamining the question of how pharmas can communicate through character-limited media like Twitter and stay consistent with fair balance rules. PhRMA is making the case for allowing links to risk info, and AbbVie suggests the use of alternate formats such as GIFs on Twitter.
- More Healthcare Policy Chaos 2017: Trump and pharma – enemies, frenemies or besties? First, a few weeks ago, the Tweet-Shamer-in-Chief blasted the pharma industry for manufacturing products abroad and suggested that Medicare should negotiate prices directly with manufacturers, conjuring “Big Pharma’s nightmare” and putting a damper on the opening of the big JP Morgan pharmapalooza out west. Then, last week, he served up a word salad at PhRMA which some interpreted as a climb down from his earlier threat to impose price controls. Now, nobody’s quite sure where the industry stands with POTUS. Status quo ante, then.
- PhRMA plans a big PR push arguing for pay-for-performance deals as an alternative to government intervention on drug pricing, though there is broad skepticism that value-based pricing schemes can bend the cost curve or are executable in many conditions, like depression or cancer, where measuring effectiveness of a treatment on an individual patient can be tricky.
- Among the more prominent value-based pricing deals in recent years are a pair of risk-sharing contracts between Merck and Aetna for Merck’s type 2 diabetes drugs Januvia and Janumet. MM&M has a look at the arrangement and the thinking of the partners.
- PhRMA is also splashing out on a big ad campaign meant to improve the industry’s public image, which typically languishes in reputational polls alongside Big Oil and Wall Street. PhRMA CEO Stephen Ubl says it’s an effort to cast the industry as “less hoodie (read: Shkreli), more lab coats.” Shkreli has a few things to say about this.
- Bipartisanship! Trump and RFK, Jr. appear to have found common ground despite the hyperpartisan times – and it’s their shared vaccine skepticism. They’re not the only ones – Cleveland Clinic suffered a “PR nightmare” after one of its doctors penned an opinion piece giving credence to vaccine-skeptic views.
