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Medicare May Save Hundreds of thousands By Taking Cue from Mark Cuban’s On-line Pharmacy


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News Picture: Medicare Could Save Millions By Taking Cue from Mark Cuban's Online Pharmacy

TUESDAY, June 21, 2022 (HealthDay Information) – Medicare may need to pay attention to the pricing technique of a brand new on-line pharmacy run by tech entrepreneur and “Shark Tank” choose Mark Cuban if it needs to save lots of billions on prescription medicine, a brand new examine suggests.

Cuban’s Value Plus Drug presents sure generic medicine at cheaper costs by promoting them at a markup of 15% plus a $3 flat price. Sufferers pay for the drugs, which embody the blood stress drug Lisinopril and the antidepressant Prozac (fluoxetine), out of pocket as a result of Value Plus does not settle for insurance coverage. It additionally does not promote brand-name medicine.

The brand new examine discovered that if Medicare was paying the identical costs, it could have saved practically $4 billion in 2020.

“Medicare is overpaying for a number of the generic medicine,” examine creator Dr. Hussain Saleem Lalani, a researcher at Brigham and Girls’s Hospital in Boston, advised NBC Information. “And it is a conservative estimate, so the precise financial savings are probably greater.”

Medicare “might save much more cash if it had stricter insurance policies on the way it paid for medicine,” Lalani mentioned. “There’s much more reforms that may very well be finished to optimize the generic drug pricing system, and we must always actually think about doing these issues to decrease prices for sufferers.”

The analysis crew regarded on the costs of 89 generic medicine bought by Value Plus Drug in 2022, evaluating them to the costs for those self same medicine paid by Medicare Half D plans in 2020. Then, they adjusted for modifications in drug prices between the 2 years.

The examine discovered that Medicare paid greater than Value Plus for 77 generic medicine. The entire {dollars} spent was $8.1 billion in comparison with the $4.5 billion that it might have value. It is not clear if out-of-pocket prices would have been decrease for enrollees within the Medicare plan if the medicine have been cheaper.

Juliette Cubanski, deputy director of this system on Medicare coverage on the Kaiser Household Basis, advised NBC Information that the examine raised the query about whether or not Medicare plans are leaving cash on the desk.

Proper now, worth negotiation is “only a fully black field. There’s not quite a lot of transparency,” Cubanski added.

“We’re form of placing the burden on the sufferers to chase down decrease prescription drug costs versus form of discovering methods to make them broadly accessible,” she mentioned.

Cubanski did observe that the sorts of drugs sufferers sometimes have bother paying for are brand-name medicine, not generic ones. Democrats have referred to as for legal guidelines that may permit Medicare to barter on to decrease the costs of the costliest medicine.

“Saving $3.6 billion is definitely value pursuing if there’s a chance to get that quantity of financial savings,” Cubanski mentioned. However many of the {dollars} from Medicare “are going to higher-priced, model identify and specialty medicine.”

The examine’s limitations embody that researchers might solely evaluate pricing on the medicine coated by Cuban’s firm, which account for under about 25% of the medicine included in Medicare Half D’s $38 billion in spending in 2020.

Lalani referred to as for a better have a look at the prescription drug pricing system, which incorporates wholesalers, pharmacy profit managers, pharmacies and insurers.

The findings have been revealed Monday within the journal Annals of Inner Medication.

Extra info

Kaiser Household Basis has extra on public opinion on pharmaceuticals and their costs.

SOURCE: NBC Information

By Cara Murez and Robin Foster HealthDay Reporters

MedicalNews

Copyright © 2021 HealthDay. All rights reserved.





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