The Daily Rise: Thursday, June 16

Does the DrugAbacus have value in the healthcare economy?

We talk a lot about value frameworks, formularies and clinical pathways. Basically we talk about any measurement of value that might be used to deny patients access to the treatments they may need, especially innovative ones. In our view these are all methods to ration care and they can produce roadblocks for patients getting the right treatment, right now.

Here is another video recently produced by the American Journal of Managed Care discussing the value of Peter Bach’s DrugAbacus, which we have written about a few times — here and here.

Bruce A. Feinberg, DO; Michael Kolodziej, MD; and Ted Okon, MBA, evaluate the potential of the DrugAbacus tool, which was developed by Dr Peter Bach of Memorial Sloan Kettering Cancer Center to help determine appropriate pricing for cancer drugs.

If you are at all interested in learning more about this debate, watch here.

Know Your Jargon: Biosimilars

As part of this week’s Know Your Jargon entry, we’re talking biosimilars. What are they and why should you care?

What They Are Not: They are not generics. Generics are small molecule products that contain the same active ingredient as the original — basically they are an identical product. A bioequivalent.

What They Are: They are almost like a medication … but not quite. They are similar to the ‘reference product’. Biosimilars are biologics which are derived from a living organism. Basically, a scientist takes the original biologic and breaks it down and rebuilds it creating a similar product. They will only be approved by the FDA if it has the same mechanism of action as the original. There have only been two biosimilars approved in the United States since 2015, however Europe has been approving biosimilars since 2007 and has 20 on the market.

Are They Good For Patients?: From some, yes. Biosimilars, since they are not exactly the same as the original biologic, can represent a new treatment option for some patients. They generally hit the market 20-30% less than the list price of the original biologic. However, we caution that your pharmacist or insurance company should not be making the decision to switch to a biosimilar for you. Doctors and patients must really work together when switching to a biosimilar, closely monitoring adverse reactions and the effectiveness of the biologic for that particular patient.

Patient Advocate Spotlight: Jennifer Hinkel, MSc

Jennifer Hinkel is a Partner at McGivney Global Advisors, strategic consultants to biotech, pharma, diagnostics and health IT companies. Her areas of focus include payer and market access strategy for oncology products, innovative contracting and pricing strategies, forecasting market and revenue impact of policy and payer initiatives, value in oncology, and commercialization paths for health IT and mobile health. Areas of expertise include integrated delivery networks, oncology guidelines and pathways, physician reimbursement methods, 340B, payer messaging, patient assistance programs, and financial modeling. Ms. Hinkel has also been a partner/founder in a mobile health care technology startup, a lecturer in Health Systems and Health Economics at Penn State University and Arcadia University, and has health policy experience in Washington, DC and in the United Kingdom parliament.

Jennifer has a Master’s degree in International Health Policy with a focus on pharmaceutical economics from the London School of Economics; 10+ years of pharma and payer policy experience including roles at NCCN, Roche, and Genentech, and global experience in US, European, and Latin American markets. She is also a writer, speaker, competitive sailor, and cancer survivorship advocate.

She was diagnosed with Hodgkin’s Lymphoma in 1998 at the age of 17 and achieved a full remission after treatment with surgery and chemotherapy. Jennifer realized that while the cancer was gone, the physical and emotional effects of cancer and cancer treatment were not going to be instantly resolved. Dealing with cancer is not only a physically exhausting experience, but it is also traumatic, emotionally exhausting, and extremely disruptive to an individual’s life – from daily activities to long-term plans. Her cancer experience led to Resilience Racing, the first competitive sailing program specifically for cancer survivors.

In today’s Advocate Survivor Voice feature, we shine the spotlight on Jennifer M. Hinkel, a partner at McGivney Global Advisors. The health economist and cancer survivor founded Resilience Racing, the first cancer survivor sailing team.

We’re featuring her latest post on LinkedIn which reveals the problems with Medicare’s February 2016 announcement that it will “create a ‘demo project’ that can randomize how cancer doctors are paid depending on what ZIP code they are in.”

“If this demo project goes through, doctors in certain ZIP codes are likely to receive massive cuts to the payments they get for providing cancer care,” she explains. “As a result, where patients get treatment might start to dictate how much treatment they get, or even whether they get certain medications at all. Medicare claims this will lower costs.”

Read Hinkel’s entire piece to learn more about this “capricious gamble with the health of cancer patients.”

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