A drug cost stat falls out of favor

The ideas and innovators shaping health care

Mar 09, 2023 View in browser   By Ben Leonard, Erin Schumaker and Ruth Reader WASHINGTON WATCH Rodgers says QALYs discriminate. | Francis Chung/POLITICO Government agencies would lose one tool aimed at measuring the cost-effectiveness of drugs and medical treatments if a House bill becomes law. Lawmakers say they’re close to a bipartisan deal on legislation to ban the use of quality-adjusted life years in federal programs. The metric assesses a drug’s impact on health outcomes and quality of life. Proponents of banning QALYs say the statistic discriminates against people with disabilities by undervaluing how much treatments help them. State of play: On Wednesday, the House Energy and Commerce Health Subcommittee approved a bill by full committee Chair Cathy McMorris Rodgers (R-Wash.), Ways and Means Chair Jason Smith (R-Mo.) and others to implement the ban. The sponsors have a key ally across the aisle in Rep. Anna Eshoo (D-Calif.), the ranking member of the Energy and Commerce Health Subcommittee, who said during the panel’s bill markup that legislators are “extremely close” to an agreement. The deal is notable because the full committee’s ranking member, Rep. Frank Pallone (D-N.J.), has previously expressed opposition to the bill for fear that it would broadly bar attempts to measure the cost-effectiveness of drugs and undermine upcoming Medicare drug price negotiations. Pallone said that changes to the bill have allayed some, but not all, of his concerns. Why it matters: The Inflation Reduction Act enacted last year will, for the first time, allow Medicare to negotiate prices for a limited number of drugs. Cost-effectiveness measures could help the government negotiate lower prices. Rodgers said the government should be able to measure cost-effectiveness while barring the use of quality-adjusted life years. “The federal government can evaluate the effectiveness of treatments and cures without devaluing the lives of seniors and people with disabilities,” Rodgers said. QALYs are used by drug companies, consultants and some federal policymakers, and are the “academic standard” in health economics, Steven Pearson, president of the Institute for Clinical and Economic Review, a nonprofit research organization, previously told Future Pulse.   DOWNLOAD THE POLITICO MOBILE APP: Stay up to speed with the newly updated POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need, reimagined. DOWNLOAD FOR iOS– DOWNLOAD FOR ANDROID.     WELCOME TO FUTURE PULSE Great Sand Dunes National Park & Reserve, Colo. | Shawn Zeller This is where we explore the ideas and innovators shaping health care. Some tough news for people with allergies: allergy season is getting longer, according to a new study, thanks to climate change. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, your host Ruth talks with Adam Cancryn about the most notable health care priorities in President Joe Biden’s budget proposal, which doesn't include significant new Covid funding, the latest sign that the White House is preparing to wind down its emergency response operation later this year. Listen to today’s Pulse Check podcast FOLLOW THE MONEY Private equity firms continue to show interest in buying dental practices. | John Moore/Getty Images Eye-popping health care services deals led by private equity firms tailed off a bit in 2022, according to the latest data from PitchBook, the Seattle firm that tracks market data. But while 2021 was “bananas” in the view of PitchBook senior health care analyst Rebecca Springer, with 1,013 deals in the U.S. and Canada, 2022’s estimated 863 transactions indicate that investment firms continue to see potential in health care services like dentistry, behavioral health, home health care, primary care and cardiovascular services. Headwinds: Rising interest rates that make it more difficult to secure financing, as well as volatility in the markets, mean health care services deals will struggle to rebound in 2023, Springer expects. “I think we are in for at least another quarter or two of pretty quiet deal activity,” Springer said of the short-term outlook, adding, “I think we’re going to see a lot of small deals.” What to watch: Despite headwinds, private equity is bullish on health care services investment over the long term, according to Springer. “The buzziest area is cardiovascular right now.”   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     DANGER ZONE Colorado Attorney General Phil Weiser wants social media firms to crack down on drug sales on their sites. | Getty Images Ordering drugs — including fentanyl — on social media platforms is almost as easy as calling an Uber or ordering food delivery, according to Colorado Attorney General Phil Weiser. A new report produced by the Democrat with outside researchers found that searching social media sites using simple terms brought users to dozens of results for drug-buying groups. “We will use all tools at our disposal to address this crisis, including pressing the federal government to address the flow of such deadly drugs into our community and calling on social media companies to do more,” Weiser said. The report called for:  — Social media companies to take up a common set of practices to stop drug sales — Colorado to mull legislation requiring companies to disclose their drug activity policies — Federal laws to mandate more transparency for social media platforms — Giving a federal agency oversight power over social media platforms — More funding to promote treatment access and social media literacy Zooming out: Regulators and lawmakers are calling out social media companies for their alleged role in facilitating the sale of illegal drugs online. The FDA has pushed social media sites and internet service providers to help crack down on rogue online pharmacies. Lawmakers, including Rep. Cathy McMorris Rodgers (R-Wash.), the chair of the Energy and Commerce Committee, have called on them to do more to stop the sale of fentanyl. In a January roundtable of committee Republicans, lawmakers honed in on Snapchat. At the time, a Snapchat spokesperson said it uses “cutting-edge” technology to “proactively” crack down on drug dealers and block search results for terms relating to drugs.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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