Oral anticoagulants…who needs ‘em?

Patients with atrial fibrillation do! According to a new study, hundreds of thousands of patients aren’t receiving them each year. Folks with AFib are at a very high risk for stroke, and guess what? Oral anticoagulants—a.k.a. blood thinners—can reduce the risk by two-thirds and direct oral anticoagulants (DOACs) are proven to be just as effective, if not more so. No, this isn’t a groundbreaking new therapy. Quite the opposite. DOACs have been available since 2010. 655,000 patients were evaluated in the study and the data show that over a seven-year period, only 6 out of 10 patients with high stroke risk were prescribed these potentially life-saving meds. This guy sums it up best.

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The road to America’s opioid epidemic is paved with good intentions

A study published in Pediatrics last week demonstrated that many teens who abuse opioids start out being prescribed them for legitimate medical use. The bad side of that is pretty obvious, but there’s a good side to this revelation as well—knowing that physicians are integral to an important piece of this problem means that we can go about designing effective solutions for it. Like those “careful prescribing practices” we keep hearing about. Some more good news, this study and another published last week both report a decline in opioid misuse among youth. Keep fighting the good fight docs, and one day we’ll celebrate that the kids are alright.

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2. The war on drug stores heats up

Recent power plays in the prescription drug industry make J.R. Ewing’s actions seem like child’s play. If you don’t track the specialty pharmacy market, you should. This is a $100B industry that is growing rapidly. Think high-priced drugs used to treat Hep C and Cystic Fibrosis. According to the New York Times, large PBMs might be trying to force out independent specialty pharmacies. In Alabama, BCBS recently told patients that they cannot have their prescriptions filled at CVS. This is a big deal. It means patients have to sever long-standing relationships with pharmacists, especially difficult with specialty indications. This is all part of an emerging trend to narrow networks. Look it up. You will be glad you did and you’ll be smarter.

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4. Pharma’s countdown to November

The election is coming! The election is coming! With Novartis’ CEO Joe Jimenez playing the role of Paul Revere (though without a horse and much less urgency), he told the Financial Times that pharma will feel the pressure from the new president’s administration. In that article, Jimenez said, “We believe that, no matter which candidate wins, we will see a more difficult pricing environment in the U.S.” He also said that Europe would certainly be affected, and drug makers “will be in trouble” if they are not quick to change. Look for companies to develop strategies in the coming months for how to deal with a sudden change in pricing models.

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1. Forecast calls for scattered drug hoarding

Providing notice of drug price increases sounds reasonable, right? “Not so simple,” say opponents of proposed California drug pricing legislation that calls for a 60-day notice of price increases.  Opponents of the bill contend this could hang small pharmacies out to dry as larger pharmacies might be motivated to hoard drugs to avoid the higher prices to come. This could leave areas with fewer hospitals and pharmacies in danger of not being able to obtain drugs for patients with chronic illnesses. The bill could set a precedent in a movement to open up transparency across the health care system. But it could also lead to some nasty unintended consequences. Ugh.  Healthcare is hard.

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