GTMRx News Brief Archive

Most payers have outcomes-based contracts with PBM About 58% of payers had at least one outcomes-based drug contract with a PBM in 2022, according to an Avalere Health survey. Of the payers that had at least one outcomes-based contract, over 35% had more than 10. The top therapeutic areas were cardiology and endocrinology. Most (74%) of plans with at least one outcomes-based contract said that they prefer contracts with both claims-based and clinical outcomes. In fact, 53% said they don’t…

New drug shortages skyrocketing Drug shortages are growing dramatically. For example, children's flu medications, common antibiotics, and ADHD treatments are getting harder to buy, according to a report from the Senate Homeland Security and Governmental Affairs. It finds that the number of new drug shortages rose by 30% between 2021 and 2022, an increase that has had "devastating consequences" for patients and doctors. Towards the end of 2022, nearly 300 individual drugs were considered in short supply, affecting treatment for…

Practice Transformation Look out, drug chains: Mark Cuban has only just begun Mark Cuban wants to lower drug prices even further and expand his online pharmacy's customer base. These plans could pose a major threat to CVS and Walgreens, TheStreet reports. And he’s in it for the long run. "Our goal isn't to make a lot of money or sell the company," Cuban tells TheStreet. "Our mission is to be the low-cost provider of every medication we are allowed to sell. That's not…

Practice Transformation MyChart message fees passed on to patient? Cleveland Clinic began billing for certain Epic MyChart messages in November; now, at least seven other health systems have followed suit. But, as Becker’s Hospital Review reports, what remains uncertain is how long Medicare will cover these charges and whether most commercial insurers will pay at all. Ge Bai, PhD, of Johns Hopkins says the price for commercially insured patients likely depends on the health plan. Some patients could pay as much as…

Practice Transformation Americans give health care cost and equity low scores A plurality of Americans gives the U.S. health care system overall a poor or failing grade, and most rank affordability and equity the same way, according to the West Health-Gallup 2022 Healthcare in America Report. Care quality scored somewhat better. In all, 21% of U.S. adults grade the health care system with an "A" or a "B," 34% with a "C," and 44% with a "D" or an "F." Grades…

Practice Transformation AMA to take on senior polypharmacy Following up on recommendations from the AMA Senior Physicians Section, AMA delegates recently adopted “Reducing Polypharmacy as a Significant Contributor to Senior Morbidity.” It directs the AMA to work with appropriate stakeholders such as pharmacists, EHR vendors, PhRMA and AARP to, among other things, encourage physicians and their teams to initiate discussions with patients on improving their medical care through the use of only the minimal number of medications needed to optimize their…

Practice Transformation Team-based care begins with the patient In a Pharmacy Times interview, Michael S. Barr, MD, MBA, MACP, FRCP, Executive Physician Advisor, GTMRx Institute, discussed the importance of collaboration among physicians, other clinicians and pharmacists in delivering comprehensive medication management. “It starts with the person needing the care…[and] includes understanding that well organized team-based care is the best way to approach patient needs, especially those who have challenging situations or complex clinical conditions.” Such an approach begins with each member acknowledging their respective…

Practice Transformation Underappreciated CMM is the missing ingredient to value-based models Comprehensive medication management is the missing ingredient in value-based models, but despite evidence supporting its effectiveness and value, it remains underappreciated and underused, a group of GTMRx leaders write in Health Affairs Forefront. They highlight the evidence for CMM, including how it supports all five elements of the Quintuple Aim—including the newest aim, equity. Their a call to action: Align on the standardized definition of CMM “to promote well-defined CMM…

Practice Transformation Amazon to shutter Amazon Care Say “goodbye” to Amazon Care. The virtual and in-home health service, initially created for Amazon employees will be gone by the end of 2022. Amazon Care currently has six corporate customers including Hilton, Silicon Labs and Amazon-owned Whole Foods. Workers were told the service was shutting down because those customers did not see the value in the service, the Washington Post reports. Modern Healthcare notes that the decision comes just weeks after the company said it would…

Practice Transformation To improve population health, invest in primary care Investing in primary care is the key to improving population health and reducing disparities, according to the authors of a Health Affairs Forefront post. ”Strengthening primary care benefits everyone by improving overall health and lowering health care costs. By improving how the health care system connects with patients, generalists and specialists can support the patients who need them most, when they need them the most. This will make our health care system…

Practice Transformation Texas NAMI head: End nonmedical switching Health insurers and PBMs are making the current mental health crisis through “nonmedical switching”—moving stable patients from their current medication to one that may not work as well for them, writes Greg Hansch, LMSW, of the National Alliance on Mental Illness of Texas. “As a result, a patient with a mental health disorder who was stable on his or her current medication may be forced to switch to a different medication regardless of…

Practice Transformation Safety-net providers worry about loss of 340B discounts Hospitals and clinics that serve low-income patients say drug manufacturers have threatened their financial stability by dramatically cutting back participation in the 340B federal discount program. “They are killing health centers,” said Jangus Whitner, who runs the pharmacy program for PrimaryOne Health, a multisite community health center. PhRMA spokesperson Nicole Longo disagrees: “There is very little to no evidence that 340B is helping patients access medicines, and that’s a big…

Practice Transformation NYC to offer Paxlovid, bypassing pharmacies New York City plans to start offering Paxlovid at "mobile test-to-treat sites" across the city, bypassing pharmacies; which is the fist of its kind, Bloomberg reports. Currently, people who test positive for COVID-19 and are eligible for Paxlovid can fill their prescriptions at the nearest pharmacy. Mayor Eric Adams said the service targets inequity in getting Paxlovid, according to Bloomberg. A recent study found that the drug is inaccessible to more than 26 million people…

Practice Transformation Can Oracle create a national EHR database? Just after closing the deal to acquire Cerner, Oracle—or more specifically, board chair and chief technology officer Larry Ellison–said the company would create a national health records database. “We’re building a system where all American citizens’ health records not only exist at the hospital level, but they also are in a unified national health records database.” Health IT experts have been expressing doubts, however, pointing out that for decades, public and private…