Breaking Rx News: Paying for Quality; High-value Maternity Care; Advance Care Planning Event Coming Soon!

June 28, 2016

The Weekly Buzz: How Some States are Tackling Prescription Drug Pricing 

Proposals For Change Cover“As angst mounts over prescription drug costs, a new survey finds that most health plans would like to pay for many of the highest-priced medicines based on patient outcomes. The findings suggest that insurers hope to get tougher with drug makers as prescription medicines account for more than one-fifth of overall health care costs.” The interest is especially high for Hepatitis C and oncology drugs, though recent evidence suggests plans are broadening their focus to non-specialty areas as well, according to Avalere Health, A consulting firm that last year polled 42 U.S. health plans, representing 161 million people.

Related and Interesting News
Diabetes: Five Rx Trends to  Explore Ahead of ADA ’16

For the fifth consecutive year, diabetes is the costliest traditional therapy class for payers. Plans spent an average $77.60 per member per year (PMPY) on diabetes medications in 2015, a 14% increase from 2014, driven equally by increases in use and cost of medications in the class.

Don’t Miss Out! Add These Dates to Your Calendar:


National Expert on High-value Maternity Care Presents at June Member Meeting

Pregnant WomanHigh-value maternity care was the topic of discussion during The Action Group’s June 22 member meeting. Brynn Rubinstein, senior manager for transforming maternity care at the Pacific Business Group on Health, shared recommendations from their Purchaser Value Network’s (PVN) brand-new guide to help business coalitions and purchasers promote high-value maternity care.

Members may view the meeting presentations in the Member Center. PVN materials and toolkits are available to the public.

Related and Interesting News From Consumer Reports:
11 Hospitals to Avoid If You Don’t Want a C-Section Birth

Three Important Events Open to Members and Non-Members! 

July 21, 8 a.m.-4:30 p.m.: Honoring Choices Minnesota: Sharing the Experience

Advanced Care PlanningRegistration is open for the July 21, 2016, advance care planning event, Honoring Choices Minnesota: Sharing the Experience. Attendees will  learn how they can lead the way in supporting employees and their family members by providing the advance care planning resources needed to take action.

To view the Advance Care Planning Statewide Call to Action, click here.

July 27, 5:30 p.m.-7 p.m.: Minnesota Bridges to Excellence Recognition Reception

bridge-2016-smTo honor the clinics and medical groups across Minnesota that are committed to closing health care quality gaps, the Minnesota Health Action Group and the Minnesota Bridges to Excellence (MNBTE) Champions of Change will be hosting a recognition reception. Recognized clinics qualified for incentive payments by meeting performance criteria for either achievement or improvement by delivering optimal care to their patients with diabetes, vascular disease, and/or depression. To learn more about MNBTE, or to view last year’s rewarded clinics, click here. Details about the Recognition Reception are posted here, along with a registration link.

August 11, 8 a.m.-10 a.m.: Community Dialogue: Improving the Value of Specialty Drugs by Getting the 5 Rights, Right

prescription-drug-costsThe Action Group’s Specialty Pharmacy Action Network members have been hard at work for more than a year identifying the issues surrounding the high cost of specialty drugs, developing possible solutions, and learning what actions need to be taken to reshape the marketplace. On August 11, 2016, we will be bringing together all interested stakeholders to share perspectives, knowledge and ideas about this important topic affecting the U.S. economy, public and private purchasers, individuals with chronic and serious conditions, and all taxpayers. You do not need to be a member of The Action Group or the Specialty Pharmacy Action Network to attend. To learn more or to register, click here.

Thought for the Week

“Variation in a health care procedure can be an indicator of a quality improvement opportunity, signaling overuse of the procedure that is at best not medically indicated, or at worst, harmful to patients.”