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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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Katie Hill Criticizes Paul Gosar For Epstein Tweets; Gosar Fires Back And Says ‘You Taught The Country What A ‘Throuple’ Was’

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Rep. Paul Gosar, Arizona, struck back at his former colleague Katie Hill after she ripped him for tweeting about the “suicide” of Jeffrey Epstein, a current hot topic and popular meme circulating around the Internet. Gosar’s burn was aimed at Hill’s recent controversy involving lewd photographs of her with a staffer who she had an inappropriate relationship with, noting that she taught the country what a “throuple” was. Here’s more from Fox News: Hill reprehended Gosar over a series of tweets that spelled out “Epstein didn’t kill himself,” a line that has been appearing in memes and on social media. Hill blasted him for “tweeting out real conspiracy theories.” “No[,] like this actually happened. Real members of Congress tweeting out real conspiracy theories. In an acrostic no less,” Hill tweeted. Gosar fired back, “You’re surprised by me? You single-handedly taught an entire country a new word. #throuple,” Gosar reacted. “And wth is up with that tattoo? Relax.” “Throuple,” which is a term to describe a three-person relationship, was the arrangement Hill reportedly had with her estranged husband and a female campaign staffer. Hill accused her estranged husband of leaking the nude photos as “revenge porn” amid their messy divorce. Hill’s attorneys also vehemently denied allegations made in a DailyMail story that one of the nude photos shows a “Nazi-era Iron Cross” tattoo. Gosar got a whole lot of attention on his Twitter account Wednesday after he let loose with a series of tweets he made in connection with the ongoing testimony of U.S. diplomat Bill Taylor and State Department official George Kent as the first witnesses in the impeachment hearings against President Trump. The first letter of each of the tweets spells out “Epstein didn’t kill himself.” Rather clever, wouldn’t you agree?

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First Day Of Public Impeachment Hearings Turns Up The Pressure On Moderate Democrats

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Much attention is now being cast toward moderate Democrats in the House, especially in swing districts, with the first day of public hearings in the impeachment inquiry into President Trump now under wraps. The day finished up without any major revelations coming to light, highlighting the weakness of the Democrats’ key witnesses in the case against the president. Many of these witnesses are relying on second-hand information, having not interacted even once with the president. Here’s more from Fox News: At one point in Wednesday’s hearing, Rep. Mike Quigley, D-Ill., even appeared to embrace hearsay testimony, claiming that “hearsay can be much better evidence than direct” and that “countless people have been convicted on hearsay because the courts have routinely allowed and created, needed exceptions to hearsay.” It was unclear which of those limited exceptions would apply to Wednesday’s testimony — and whether Quigley’s argument would persuade critical swing-vote Democrats. The House is now comprised of 431 members, meaning Democrats need 217 yeas to impeach Trump. There are currently 233 Democrats, so Democrats can only lose 16 of their own and still impeach the president. 31 House Democrats represent more moderate districts that Trump carried in 2016. Freshman Rep. Elissa Slotkin, D-Mich. — who flipped a GOP district in 2018 that Trump won by 7 points in 2016 — told Fox News that she was tentatively weighing all the evidence. “My constituents expect me to make an objective decision,” Slotkin said as the hearings concluded, “not one based on an hour of testimony.” https://twitter.com/RealSaavedra/status/1194710194166497281 There’s also a report floating around that is suggesting that if House Democrats impeach the president, Senate Republicans are going to hold a lengthy trial that will “scramble” the 2020 Democratic presidential primary by making it mandatory for several of the contenders to stay put in…

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