Happy Thanksgiving

David Ermer–Uncategorized–

In today’s healthcare merger and acquisitions news —

  • Reuters reports that CVS Health advised that closing on its acquisition of health insurer Aetna will occur after Thanksgiving as the parties await approval from New York and another state, and 
  • The Wall Street Journal reports that 

Drugstore owner Walgreens Boots Alliance Inc.  and health insurer Humana Inc. are in preliminary discussions to take equity stakes in each other, according to people familiar with the matter, as health-industry players scramble for tie-ups that will help them compete in a rapidly evolving environment.

The companies, which already have a partnership focused on serving seniors from two Walgreens locations, are having wide-ranging talks that also include the possibility of expanding that venture, the people said. Details of the talks couldn’t be learned and there’s no guarantee there will be any new deal between the companies.

The Boston Globe’s STAT informs us that

In a long-awaited move, a federal advisory panel is recommending that doctors be encouraged to offer an HIV prevention pill, a step that would quickly expand insurance coverage for a medicine that has been difficult for some people to access due to its cost.

In explaining its decision, the U.S. Preventive Services Task Force determined there is “high certainty” that using the pill would provide a “substantial” benefit for people at a high risk of becoming infected with HIV, the virus that leads to AIDS. The independent panel of experts noted that it found “adequate epidemiologic data” on risk factors that can be used to identify people who are at a high risk of acquiring HIV. 

The preliminary favorable decision — available here — is open for public comment. 
Health plans are covering this drug now with enrollee cost sharing. NPR explains 

Since brand-name Truvada was approved for HIV prevention six years ago, its average wholesale price has increased by about 45 percent. Now, the drug — which rakes in billions of dollars in annual global revenue for its manufacturer, Gilead Sciences — carries a list price of close to $2,000 for a 30-day supply.
Most insurers cover treatment with the pill, also known as pre-exposure prophylaxis, or PrEP. It has been shown to be more than 90 percent effective in HIV prevention when the medicine is taken daily, according to the Centers for Disease Control and Prevention.
But patients can get stuck with out-of-pocket costs that make the medicine unaffordable.

Pursuant to the Affordable Care Act, “New or updated [final USPSTF] recommendations are required to be covered without [enrollee] cost-sharing beginning in the plan year that begins on or after exactly one year from the latest issue date. 
A Wall Street Journal editorial points out yesterday that American reliance on generic drugs is saving a lot of money for insurers thanks to improved Food and Drug Administration policies. 

For all the talk of wondrous European health-care systems, the American generics system is the envy of the world. Nine in 10 prescriptions in the U.S. are cheaper generics, which saved $265 billion last year. Compare that with 70% in Canada and less than half in many European countries. The U.S. pays big for breakthroughs but eventually prices fall as competition arrives. Europe enjoys less price discipline.

That’s is what is happening with Truvada as the Food and Drug Administration this summer approved a generic version of that drug. The FEHBlog is happy to learn about this drug. Happy Thanksgiving.