Trump prescription drug plan claims to save $300 billion a year — Daily Rise: Monday, February 22

Campaign 2016: Trump’s “truly absurd” drug promise

The Washington Post’s Glenn Kessler annihilates GOP presidential candidate Donald Trump’s “truly absurd claim” that he’ll save $300 billion a year on prescription drug spending by negotiating drug prices.

Trump’s promise: “We are not allowed to negotiate drug prices. Can you believe it? We pay about $300 billion more than we are supposed to, than if we negotiated the price. So there’s $300 billion on day one we solve.”

Over the past month, Trump has repeated versions of that line – that he’ll save $300 billion per year by negotiating prescription drug prices — at campaign rallies in New Hampshire. The Post’s fact checker explains the big problem with the numbers.

“Well, for one thing, total spending in Medicare Part D (prescription drugs) in 2014 was $78 billion. So Trump, in effect, is claiming to save $300 billion a year on a $78 billion program. That’s like turning water into wine.”

Even if you give Trump the benefit of the doubt and assume he “would force government-led pricing on all prescription drugs,” Kessler explains why that doesn’t add up either.

“In fact, depending on the source you consult, total annual spending on prescription drugs in the United States is between $298 billion a year to $423 billion. So that would mean Trump is claiming that he can eliminate virtually any cost to prescription drugs. It would suddenly be free!”

Negotiating drug prices is a complicated issue with real trade-offs for patients. No one is served by lies, misinformation and impossible-to-deliver campaign promises.

Hard Truth in Numbers

While Trump’s busy repeating pie-in-the-sky numbers, Yale University’s Howard Forman brings us right back to Planet Earth with his cold, hard look at health care spending. In a piece for the Wall Street Journal, Forman calls for the nation to “Start Putting a Price on Human Life.” His controversial thesis considers the unsustainable cost of health care if applied to all 320 million Americans.

“At $10,000 per person, the net cost would be $3.2 trillion. That sum is not loose change; it is close to the total federal budget… At $100,000 per person, the cost would be $32 trillion. Now we are looking at a figure twice our total national output (GDP). Even if we could amortize this sum over an 80-year lifespan, the cost would still be $400 billion per year. That’s almost three times the cost of the Affordable Care Act.”

Forman’s trying to encourage a more nuanced dialogue about health care spending and treatments. We welcome that conversation and agree that it’s the first step to limiting rising health care costs. Like Foreman, we don’t believe the rising cost of health care will be solved by limiting patients’ access to treatments.

“Many drugs…are incredible for patients. The solution here is not to slow our development of cures for destructive diseases. There is no questioning whether life is priceless. It is.”

Quote of the Day:

“I think most patients are not thinking value, they are thinking ‘How do I fix this? How do I survive?” ~ Jack Whelan, Cancer Survivor and Patient Advocate

Dr. Surabhi Dangi-Garimella’s recap of the webinar, Value vs. Cost: Understanding the Difference in the Oncology Market

Jack Whelan goes on to say we need to look at the whole cost of treating the patient, not just the pharmacy cost.

Breakthrough Alert

Novartis joins Roche and AstraZeneca last week with a breakthrough therapy designation (BTD) for PKC412 (midostaurin), an investigational treatment indicated in adults for newly-diagnosed AML.

The treatment options for AML have been stagnant for 25 years until now.  350,000 people around the world have leukemia and 25% of those (87,500) suffer from AML. Roughly 29,000 of those diagnosed with AML carry the FLT3 gene mutation.

This is what targeted therapy looks like and we hope to see a lot more of it across all disease types.

Form a Monopoly? Cut Services? Get ACA Government Bonus!

Finally, as part of today’s look at the numbers, check out Robert Book’s piece at Forbes.com on the perverse incentives within the Affordable Care Act (ACA).

Under lesser-known provisions of the ACA, the federal government pays bonuses to physicians and hospitals “if they deny health care to seniors and the disabled – and even encourages them to form local monopolies to make it harder for them to find alternative sources of care.” The Medicare Shared Savings Program allows health care providers, such as hospitals and physicians, to join together as Accountable Care Organizations (ACO) to obtain bonus payments.

“One might ask how an ACO is supposed to reduce patients’ utilization of health care in a fee-for-service system in which patients are, in principle, free to obtain services whenever they want from any Medicare fee-for-services providers… if an ACO controls a large percentage of the available providers, it gets a lot easier to reduce patient utilization.”

Book argues that through monopolies, “it becomes a lot easier to guide patients to the level and type of utilization desired – which is, for purposes of the Medicare Shared Savings Program, always less utilization.”

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