Real Chemistry’s Post

🌟 Exploring Medicaid Coverage for #GLP1 Treatments Across the U.S. 🌟 A recent analysis by Real Chemistry provides an in-depth look at state Medicaid programs covering GLP-1 receptor agonists for obesity—a condition affecting over 40% of U.S. adults. These drugs, originally for #Type2diabetes, have proven effective for #weightloss, but costs can exceed $1,000 monthly, making #insurance coverage crucial. 🔍 Key Findings: - Coverage Variability: 36 states cover at least one #FDA-approved GLP-1 for obesity, like #Wegovy or #Zepbound. However, coverage levels vary significantly. - Spending Surge: #Medicaid spending on these treatments has skyrocketed, with $3.5 billion spent over the past year. California leads with $1.4 billion in expenditures. - Policy Implications: With the Biden administration’s proposal to expand coverage, understanding current state policies and spending is essential. 🏥 This analysis underscores the need for broader access to obesity treatments, highlighting disparities and potential growth in Medicaid spending. As health policies evolve, ensuring #equitableaccess remains a critical challenge. 📈 For more insights, read the full analysis on Real Chemistry's website. #Healthcare #ObesityTreatment #HealthPolicy #RealChemistry

A Terrific Presentation on the #IRA: A Policy of “Pointless Destruction”? I really, really enjoyed participating in this Blue Fin Group-sponsored presentation on the #InflationReductionAct at #BIO. William Roth, Albert Thigpen, and our fearless moderator, Stephen Morales, offered a thoughtful, practical, sobering perspective on the moves and countermoves that stakeholders are likely to take in implementing the #IRA—and I was pleased to be along for the ride. The Consensus: IRA implementation, at least in year 1, is a bit of a potential train wreck unfolding in slow motion in front of us. Pointlessly Destructive: In my remarks, I offered a perspective as a #raredisease #patient—and I’m worried. For me, the IRA threatens to be, as I said there, “pointlessly destructive” of the selected products—a huge “whack to innovators and #innovation without an #affordability benefit” corresponding to the “negotiation” authority. Measuring Success: As I have recently written, my prism on any issue, as a rare disease patient, is how a given policy either supports innovation or improves affordability, measured by both the cost to the patient and the health care system. Some disincentive to innovation is worth a significant enough gain in affordability; additional cost is warranted by innovation that matters—that brings clinical benefit to the patient. My Thoughts about the IRA: What I laid out in my presentation was my growing concern that the IRA “negotiation” provision, at least in year 1, is the definition of a policy disaster—a significant hit to innovative products that does virtually nothing to improve affordability—and that may actually increase costs. I just don’t see how #MedicareAdvantage plans and #PBMs can possibly respond to the IRA, at least in year 1, by doing anything else than pushing patients from selected drugs to high list/high rebate alternatives, where they can secure rebate dollars. Increased utilization management, favoring non-selected drugs, could be an effective engine to switch patients. The result? The needless crippling of those selected drug franchises with the government likely paying as much—or more—for NON-selected drugs and patients paying MORE in #costsharing than they would on the selected drugs. That friends fails BOTH sides of my “prism” test. To be sure, the $2,000 cap and smoothing provision (assuming smoothing can be implemented effectively—that’s its own separate discussion) are very important “affordability” wins. Without doubt. But as I’ve said elsewhere, I think we could have paid fir those changes with alternatives to the “negotiation” provision. Here’s hoping I’m wrong about year 1. Thanks, again, Blue Fin Group, an IntegriChain Company, for including me. #lifesciences #healthcare #drugpricing

If lawmakers truly want to reform healthcare, they should focus on tangible issues, including PBMs' shady practices and misuse of the 340B program. #IRA "pill penalty" and price setting are not the answers. Read more on our blog: https://lnkd.in/e9hkk67f

💥 Enough is Enough! 💥 The FTC is finally taking action against Pharmacy Benefit Managers (PBMs) who have profited off of the suffering of millions of patients. These PBMs have played games with insulin rebates, driving up the cost of this life-saving drug while patients struggle to afford it. It’s time for accountability. This lawsuit could finally bring justice for those who have been exploited by this broken system. PBMs should not be allowed to cause more suffering for patients. #HoldPBMsAccountable #HealthcareGreed #InsulinCostCrisis #PatientExploitation #PharmacyBenefitManagers #DrugPricingReform #JusticeForPatients https://lnkd.in/ew2Z5dbZ

🚀 Big news! 🎉 Medicare will now cover Wegovy, a GLP-1 drug, as preventative care for heart attacks and strokes in obese patients! 🏥💊 Learn more about this monumental desicsion in the must-read article below. #MedicareCoverage #Wegovy #PreventativeCare" Read more: https://lnkd.in/gXQS7QH9

CDER Annual Report Highlights Communication Efforts to Strengthen Public Trust: In its first annual report, the CDER Office of Communications pointed to its three main goals, all of which focus on supporting the public’s faith in the FDA to protect public health. #fda #financial #lifesciences

A new brief report in JHEOR explores the impact of the Inflation Reduction Act's Medicare Drug Price Negotiation Program on patient out-of-pocket costs.

Drug Cost Planning Is About More Than Choosing Plans In our ThinkAdvisor article, CEO Ron Mastrogiovanni lists five takeaways for 2025, including insights on Medicare Advantage and potential legislation with the new presidential administration. https://lnkd.in/eC3HheVE

Real people, real results! Discover how GLP-1 medications can transform your weight loss journey. With MediFit, it's not just about shedding pounds—it's about gaining a whole new outlook on life. Join us and start seeing the benefits today! 🚀 #MediFit #WeightLossTransformation #GLP1 #HealthJourney #RealResults

Earlier this year, the FTC brought legal action against the 3 largest legacy PBMs, accusing them of abusing their market power to inflate insulin prices and make it harder for patients to afford their meds. Around 30% of Americans struggle with drug affordability, with low-income, uninsured, and minority patients often hit the hardest. A recent article by Thomas Waldrop, a healthcare policy fellow at The Century Foundation, examines how legacy PBMs and drug companies drive up prices through tactics like rebate capture, spread pricing, and patent evergreening. Waldrop argues Congress should: - Require legacy PBMs to be transparent, limit spread pricing, and pass on all savings - Reform the patent system to prevent anticompetitive practices. The consequences of unaffordable prescriptions are very real—patients skipping doses, rationing their care, and risking their health. This crisis demands bold solutions. Everyone deserves access to the treatments they need, and SmithRx members already know we're committed to making that a reality. Article linked here, sources in the comments: https://lnkd.in/gjV_g9ZP