The Daily Rise: Tuesday, April 26

Does Value-Based Care Deliver Neither?

The organized campaign on behalf of “value frameworks” has shifted into high gear. On Monday, the self-styled “Campaign for Sustainable Rx Pricing” launched their effort that we believe will result in curtailing patient access to life-saving treatments with a press conference to tout their political agenda.

If you’ve taken the time to read Jennifer Hinkel’s recent piece at Medium, you know that value frameworks actually threaten value to patients. They restrict patients access to care and, in the long run, increase the costs of our health care system by forcing patients to use less effective treatments.

While cost-effectiveness of different treatments is one parameter, it is not the only issue when it comes to giving patients the treatments they deserve. We need to deliver medical care based on fact-based information, not half-truths and misdirection. That’s why Jonathan Wilcox, our policy director at Patients Rising, was on hand to ask tough questions and share the patient’s side of the story.

We need to come together to improve our health care system and deliver the best treatments that medical innovation has to offer.

“We need our doctors to wear white coats, not accountants’ green eyeshades,” says Robert Tufts, multiple myeloma patient and former Major League Baseball pitcher who is now a college professor in New York. “As patients we pay the insurance premiums, taxes and medical co-pays. We want to have a say in our medical care, not merely be told that we are a financial burden to society.”

Let’s start with progress where all sides can agree:

  • We need to streamline the research and development process to help reduce the tremendous costs involved with bringing a new, innovative therapeutic to market.
  • We need to modernize the regulatory system to avoid lengthy, redundant and expensive clinical trials that often just delay access to new therapies.
  • We need to untangle the maze of insurance practices that add hundreds of billions of dollars to the cost of health care, burden doctors and are barriers to patient access to the right treatment at the right time. Some of these insurance practices are actually illegal.

For more, check out Dr. Robert Goldberg’s recent post at LinkedIn.

Fact Check: Trading Health

Will the Trans-Pacific Partnership impact your health care decisions? Opponents of the landmark trade deal are asking that question in the hopes of derailing the agreement.

The Washington Post recently addressed that topic, editorializing that many of the hyperbolic claims and sound bites aren’t telling the whole story.

“In short, the biggest compilation of information so far suggests that trade deals do not drain national drug budgets and that the public-health threat from the TPP may be overblown,” the Washington Post contends. “Indeed, the United States already has free trade, including some pharmaceutical patent provisions, with six of the 11 prospective TPP nations, so it would not change the status quo with them much.”

The public policy debate over our health care system should stay focused on facts. The Post correctly cuts through the political motivation behind the health care-themed attacked on TPP. This trade deal may be good or bad for other reasonss, but it’s not altering our health care system.

“The United States and the world need medical innovation, but it costs money — billions of dollars sometimes — to develop a drug,” the Post continues. “One way to spur investment is to offer innovators a temporary government-guaranteed monopoly on commercial exploitation. Fundamentally, critics are quarreling with that system as much as with the trade deal itself. The data we’ve seen so far don’t support their worst-case scenarios.

State Spotlight: Oral Parity in Michigan

A proposal in Michigan would make it easier for cancer patients to gain access to oral medications.

Caroline Powers with 9 &10 News reports that proposed legislation, Senate Bill 625, would make it easier for patients to choose oral chemotherapy in lieu of IV treatments by lowering the monthly our-of-pocket costs.

“The prices of some of these drugs are just not really reachable out of pocket for a lot of the patients,” Dr. Zachary Hector-Word, medical oncologist, explains. “If we can’t figure out a way to get them some help with the cost of the drug then they just can’t take it. We want them to have the best available therapy.”

An Idea Worth Exploring

Proper training can improve care. Yet, the people who most frequently provide care — our friends and family members — receive minimal or no training.

Enter caregiver training laws. The Times Union reports on New York’s implementation of the Caregiver Advise, Record, Enable Act (CARE Act). Across the country, 24 states now have laws that require hospitals to ask patients if they wish to designate a caregiver upon being discharged.

“The majority of all long-term care in New York is done by family caregivers,” explains Bill Ferris, the state legislative representative for AARP New York, which supported the bill.

The law helps to make sure that hospital staff take the time to teach the 4.1 million New Yorkers that provide unpaid support how to properly care for a patient at home.

We believe this is an idea worth exploring.

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