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Five Key Principles Pelosi Ignores For Sound Prescription Medication Pricing Reform [Opinion]

An honest opinion from a doctor…

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Congress and policy makers in Washington are intently focused on how to optimally manage the cost of prescription medications. Many proposals have already been released and it is likely that this focus will continue well into the 2020 elections and beyond. This focus is appropriate given the importance access to medications plays as a cornerstone of the management of most medical conditions. It is also likely that over the next several months and years there will be a myriad of legislative and regulatory proposals floated, debated, and voted on or enacted.

Given the profound impact these policy changes will have on the efficacy of health care in the United States and, most importantly, the well-being of patients across the country, Men’s Health Network strongly urges public sector policy makers and regulators as well as private sector payers, benefit managers and PBM executives to adhere to the following principles to ensure that proposed reforms are focused on ultimately benefiting patients and optimizing the costs associated with adhering to prescribed medical therapies.

Five Key Principles to Sound Prescription Medication Pricing Reform:

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Prioritize Straightforward and Effective Reforms

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-Instead of overhauling systems or creating more complexity and confusion in an already complicated health system, policymakers should create systems and procedures that are simple, transparent, understandable and effective. This is of paramount importance to restoring the faith of patients in the system that has been lost as the processes have become mysterious, veiled in secrecy and overly complex and convoluted.

Ensure Cost Reductions Are Passed to Patients

-Any reforms must honor the tenant that was at the forefront of establishing the current system by returning the lion’s share of cost savings – whether they be from contract-rates, rebates, price concessions or whatever – to the patient. Further, the goal of reform should be to reduce patient out-of-pocket expenditures for prescription medications from current levels, rather than just holding the line on costs which are already problematic for many. Returning cost savings to insurance companies and PBMs (most of which are interlaced) or any other entity other than the patient is wrong.

Protect Access to Care

-Pricing reforms and caps on out-of-pocket expenditures for medications make sense only if they do not impede access to treatments. A “rob Peter to pay Paul” strategy where short term caps are imposed at the expense of significantly higher premiums or more restrictive access has not worked. If caps are instituted, they should be designed in a way to reduce out-of-pocket expenses without compromising other core elements of prescription care or access.

Preserve the Provider/Patient Relationship

-Access to the full spectrum of medications and innovative therapies should not be restricted by limited formularies or an undue trial-and-error process. The selection of therapeutic alternatives must honor the wishes and values of patients within a system that keeps the patient-healthcare provider relationship as the focal point of treatment decision making.

Allow Markets (Not Government) to Reduce Prices

-Pricing models and mechanisms should be market based, not dictated by government or policies. Establishing arbitrary price targets using reference standards that are not applicable to the needs, wishes and way of life of American patients undercuts fundamental principles of free markets.

These five principles have one commonality – keeping the long-term best interests of patients in focus. In the end that will fulfill the ethical and social obligations of providers, government and health benefit managers and enhance the care of patients.

As part of our work educating and providing advocacy opportunities for men, boys and their families, Men’s Health Network will continue to explore these principles in more depth in the coming weeks. Please check back here on our blog to follow the series or reach out on social media to engage, ask questions, and learn more about the policies that impact men’s health.

Dr. Salvatore J. Giorgianni, PharmD is Sr. Science Adviser, Men’s Health Network

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Southern Restaurant Scorched After Refusing to Serve Unvaccinated People

The unvaccinated are quickly becoming second class citizens in America.

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In these late-stages of the pandemic, there are a number of emerging plot lines that almost seem more controversial than those that we experienced at the beginning of this fiasco, and it makes us wonder if some of it isn’t just for show. For instance, in the restaurant industry, where just about every businesses owner is struggling mightily, there are a number of different approaches to dealing with this latest “delta” variant of COVID-19.  This is of particular note now that many establishments had reopened during the lull in cases, and are now hanging on for dear life during “delta”. But one restaurant in the deep south has thrown their prosperity aside, and are making the controversial decision to serve only vaccinated customers. An Atlanta restaurant is making the bold decision to serve only customers who are fully vaccinated. Argosy Restaurant and Bar, located in East Atlanta Village, is one of the first businesses in Georgia to mandate with signs that say “No Vax, No Service.” The company owner made the decision earlier this week after he and several of his employees, who were all fully vaccinated, contracted the virus as breakthrough cases. The owner has suggested that these breakthrough cases were worse for business than treating the unvaccinated as though they are second class citizens. “We did it strictly as a business decision after multiple staff members tested positive,” said restaurant owner Armando Celentano. “We had to close down during a busy weekend, losing out on tens of thousands of dollars.” The decisions certainly stirred up a great deal of conversation on social media, where the restaurant received both praise and criticism for its decision.

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US Women’s Soccer Team Skips Representing U.S.A. at Opening Ceremony

The ultra-woke U.S. women’s soccer team — big losers thus far — decided to skip representing the U.S.A. during the Olympics opening ceremonies.

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The ultra-woke U.S. women’s soccer team — big losers thus far — decided to skip representing the U.S.A. during the opening ceremonies at the Tokyo Olympics Friday. The famously anti-American soccer team claimed that they could not attend because they were scheduled to attend practice during the opening event, according to WXIA-TV. “Obviously we can’t be there, I don’t know who scheduled us to practice at this time,” chief anti-American team star Megan Rapinoe told the media. The women’s soccer team was all about protesting against the U.S.A. during its first Olympics game this week but lost to New Zealand in a crushing 3-0 final. Rapinoe added that this year’s gams are different than past games. “It looks quite different and feels quite different than in the past, but all of us are thrilled to be here,” she said. Team members Abby Dahlkemper and Rapinoe enacted a lame “private parade” and posted it to Twitter: https://twitter.com/USWNT/status/1418557013739536390 The America-hating women’s soccer team was not the only American team that skipped the opening ceremonies. Both the women’s and the men’s U.S. gymnastics teams also skipped the ceremonies. They similarly held their own version of the parade” https://twitter.com/InsideGym/status/1418539840564572160 Follow Warner Todd Huston on Facebook at: facebook.com/Warner.Todd.Huston.

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