October 24
IN THIS ISSUE / October 24, 2018
- Drug shortages affecting your patients? Tell the FDA.
- When dealing with payers, the data can speak for itself
- Are you smarter than DataDerm™?
- Adalimumab biosimilar launches in 28 countries
- President Trump signs legislation prohibiting gag clauses
- HHS calls for drug prices in television ads
Drug shortages affecting your patients? Tell the FDA.
The American Academy of Dermatology Association (AADA) is conducting a survey of Academy members about the effects of drug shortages on dermatology patients. The AADA plans to share the results with the FDA and other policymakers on the federal and state legislative levels. Take the survey here.
The AADA has been engaging with stakeholders — including manufacturers, suppliers, the FDA, and Congress — to facilitate access for patient care. Bruce Brod, MD, deputy chair of the Academy’s Council on Government Affairs and Health Policy, recently participated in an FDA listening session with other medical specialties on the clinical and economic impacts of drug shortages. The listening session comes on the heels of the creation of the FDA’s new Drug Shortages Task Force that will address the causes of drug shortages and develop long-term solutions.
Where do things stand with drug shortages and what else is the Academy doing to address the problem? Read more in Dermatology World.
Related Links:
- What local anesthesia use is supported by evidence? – Dermatology World (March 2016)
- Running on empty – Dermatology World (July 2012)
When dealing with payers, the data can speak for itself
Dermatology World talks with Howard Rogers, MD, chair of the Academy’s Patient Access and Payer Relations Committee, about how data can make the case to payers about the value of dermatology.
Dermatology World: What type of information or data do private payers have and use when determining cost and quality of care?
Dr. Rogers: Unfortunately, insurers basically have one blunt tool for determining physician quality, and that’s cost ― either the total cost of the physician’s services, or how much it costs on a per-patient, per month basis. For example, insurers right now can only measure quality of skin cancer care based off of the claims data. If one dermatologist decides to treat an aggressive facial skin cancer with a destruction, that’s definitely going to be less expensive than doing Mohs surgery. Basing quality decisions on cost, that physician will appear to be a more efficient or “higher quality physician” to insurers than a Mohs surgeon. However, that clinical decision may not result in the best outcomes.
DW: What type of information/data are needed to demonstrate to insurers that dermatologists manage conditions of varying risk and severity, and consequently, cost?
Dr. Rogers: We can use some of the data we have already to show that dermatologists deal with an incredibly vast array of different skin conditions ― many of them much more severe than our non-dermatology colleagues deal with — and that we deal with them in a cost-effective manner. We need to show payers that, for example, their in-network dermatologists dealt with one million psoriasis patients and it wasn’t just regular run-of-the-mill psoriasis. It was psoriasis that was head to toe and that’s why these patients needed biologics. Even though it seems like dermatologists might be expensive based on non-risk adjusted claims data, they’re actually treating patients in an appropriate manner that follows clinical guidelines.
DW: What specific data do dermatologists need to show in order to make the case to payers that expensive treatments and sub-specialty physicians should be included in network?
Dr. Rogers: For skin cancer, for example, we need precise localization, size, histologic subtypes, depths of invasion, reoccurrence status (whether it had been treated before unsuccessfully and had come back), and the patient’s immunosuppressed status. All of those things play into how much it costs to treat any particular skin cancer. Those are all data that you can’t really get from claims data. DataDerm will definitely have the ability to seamlessly pull that data out and allow us to report it.
DW: What are your thoughts on the need for dermatologists to participate in the AAD’s DataDerm™?
Dr. Rogers: I think that, in general, being part of a clinical data registry really helps dermatologists on a yearly basis fully participate with the government mandates associated with MIPS. From that standpoint, I think it’s a no-lose situation.
Also, having every dermatologist participate in DataDerm is incredibly important because it increases the richness and sophistication of the data. We don’t want that just the few dermatologists who enter data into DataDerm define how dermatology is practiced. We should have everyone participating in that. In terms of payers, they’d fall all over themselves to have access to these clinical data. It would be very valuable to dermatology in advocacy efforts with payers.
Are you smarter than DataDerm™?
- MIPS reporting in 2018 – Dermatology World (February 2018)
- Dr. Henry Lim: The value of data – Dermatology World (January 2018)
- AAD product: 2018 MIPS Reporting Module
- AAD web: MACRA Resource Center
Adalimumab biosimilar launches in 28 countries
A biosimilar to adalimumab (Amgevita) has launched in 28 countries that are members of the European Union. It is also approved in Norway, Iceland, and Liechtenstein. The biosimilar is indicated for the treatment of adults with moderate-to-severe chronic plaque psoriasis, moderate-to-severe hidradenitis suppurativa, and several other inflammatory conditions. The drug is also approved for severe chronic plaque psoriasis in patients four years and older.
Where do things stand in the United States with biosimilars? Keep an eye out for the November issue of Dermatology World for a breakdown of the existing hurdles for the biosimilars market in the U.S.
- Taking aim at psoriasis – Dermatology World (November 2017)
- Are HS patients at increased risk for CV events? – Dermatology World (February 2017)
- Patient resources: Psoriasis & Psoriatic Arthritis Pamphlet
President Trump signs legislation prohibiting gag clauses
President Trump has signed legislation into law that would prohibit pharmacy benefits managers (PBMs) and private payers from including gag clauses in contracts with pharmacists that forbid them from telling patients a drug may be cheaper out-of-pocket rather than going through their insurance. The Know the Lowest Price Act applies to drug plans under Medicare Part D and Medicare Advantage and the Patient Right to Know Drug Prices Act applies to group health plans and individual market exchange plans. The American Academy of Dermatology Association lobbied in support of this legislation.
Improving access to medications is just one of many issues potentially in play for dermatology following the midterm elections. Read more about how the outcomes of the midterm elections will affect health care policy in this month’s issue of Dermatology World.
Related Links:
- ‘Tis the season for getting involved! – Dermatology World (October 2018)
- AADA 2018 Advocacy Priorities
HHS calls for drug prices in television ads
The U.S. Department of Health and Human Services has issued a proposed rule that would require pharmaceutical companies to disclose the list price for a 30-day supply of any drug that is covered through Medicare and Medicaid and costs more than $35 per month in television ads for the drug. “Sometimes it takes government to make the first move, to disrupt a broken system, and to lay down new rules of the road,” said HHS Secretary Alex Azar in a speech for the National Academy of Medicine regarding the proposal.
Why do drug prices fluctuate so much? Find out in Dermatology World.
