The Compass
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The Compass is the place for us to share our thoughts and opinions about market access, health economics, and policy issues.
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Medicare Part B Drug Trends and Payment Dynamics
In 2021, Medicare spending for Part B drugs was $43 billion and Part B drug spending has grown 9% per year on average since 2009. These trends have come to the attention of The Medicare Payment Advisory Commission (MedPAC), an independent congressional agency established to advise the US congress on issues affecting the Medicare program. […]
FDA Proposes a Change in Biosimilar Switching Study Requirements
The US Food and Drug Administration (FDA) has proposed that manufacturers of biosimilar drugs seeking the agency’s interchangeable designation will no longer be required to perform switching studies. Current Biosimilar Interchangeability Dynamics The FDA’s initial guidance to industry Considerations in Demonstrating Interchangeability With a Reference Product was published in May 2019. Under this guidance, biosimilar […]
The Economic Impact of Cognitive Impairment and Negative Symptoms in Schizophrenia: A Targeted Literature Review With a Focus on Outcomes Relevant to Health Care Decision-Makers in the United States
Research on positive symptoms of schizophrenia is well documented; however, cognitive, and negative symptoms of the illness have no approved therapies. Attaining clinical stability is of paramount importance. Nevertheless, outcomes beyond those assessed in clinical trials are also relevant. To better gauge the economic impact of cognitive impairment and negative symptoms of schizophrenia on outcomes […]
Medicare Part D Drug Price Negotiation Update
Overview Health & Human Services announced on August 15 that the Center for Medicare and Medicaid Services (CMS) reached final agreements for new and lower drug prices for the initial ten Medicare Part D drugs selected for price negotiation as part of the Inflation Reduction Act (IRA). The Medicare Part D drugs selected for the […]
Update – CY 2025 Final Rule for the Medicare Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems
CMS recently released proposed Contract Year 2025 Medicare payment rates for hospital outpatient and ambulatory surgical center sites of care. The 60-day comment period is now open, and interested parties have until September 9 to comment on the proposed payment rates. For additional information on the proposed payment rates and related new policies, please click […]
Proposed 2025 Medicare Hospital Inpatient Prospective Payment System Update
On April 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2025 Medicare hospital inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) proposed rule. This proposed rule outlines the policies and payment rate updates that will govern Medicare reimbursement for inpatient hospital services […]
BluePath Solutions Acquires Qualia Bio, LLC
BluePath’s initial acquisition expands its product and service offerings in the biopharmaceutical commercialization services sector. BluePath Solutions, a Los Angeles based health economics and value communication consulting firm announced today that it has acquired Qualia Bio, LLC. Qualia Bio is a specialty healthcare consulting firm with a focus on healthcare policy, market access, and reimbursement. […]
Out-of-pocket cost by cancer stage at diagnosis in commercially insured patients in the United States
Patients diagnosed with cancer may face significant financial toxicity, specifically out-of-pocket (OOP) costs related to medical care. Diagnosis and treatment of cancer at earlier stages may reduce this burden. To better understand the potential impact of earlier diagnosis on patient OOP, our colleagues recently published an analysis using integrated claims-clinical data to estimate OOP costs […]
Post-infusion Costs Associated with Idecabtagene Vicleucel Treatment for Patients with Relapsed/Refractory Multiple Myeloma in the KarMMa Trial
In a recently published microcosting analysis using trial healthcare resource utilization data, our colleagues estimated post-infusion costs with the chimeric antigen receptor (CAR) T cell therapy, idecabtagene vicleucel (ide-cel), for relapsed/refractory multiple myeloma patients over a 2-year period. Findings suggest most costs were incurred in the initial treatment period of the first month post-infusion and […]
Estimating the Lifetime Medical Cost Burden of an Allogeneic Hematopoietic Cell Transplantation Patient
Allogeneic hematopoietic cell transplantation (allo-HCT) has the potential for curative outcomes in a variety of hematologic malignancies but are often associated with adverse events, specifically chronic graft versus host disease (GVHD) that results in significant financial toxicity for the payer, provider and patient. Despite several economic evaluations, there is limited evidence on the lifetime burden […]
