Axios Vitals: Drug price secrecy

Plus, the very different COVID paths of America and Europe | Monday, December 06, 2021

Open in app View in browser   Presented By UnitedHealth Group   Axios Vitals By Tina Reed ·Dec 06, 2021 Happy Monday, Vitals readers. Today's newsletter is 894 words, or a 3-minute read. Situational awareness: The House Committee on Oversight and Reform will hold a hearing Thursday examining findings from the committee's drug pricing investigation.     1 big thing: Inside a drug pricing coalition Illustration: Aïda Amer/Axios   One of the largest drug pricing coalitions in the country makes it almost impossible for employers to understand whether they're getting a good deal, Axios' Bob Herman reports. Why it matters: Documents provided to Axios reveal a new layer of secrecy within the maze of American drug pricing, and the difficulty employers can have obtaining their own drug data. How it works: Big consulting firms work with pharmacy benefit managers to organize drug pricing coalitions, pulling Fortune 500 companies and other large employers into purchasing agreements that, in theory, maximize negotiating power. Zoom in: Aon, a major global consulting firm, runs a coalition with more than 400 large companies and 2.4 million insured people, according to coalition documents provided to Axios. Aon works exclusively with the three dominant PBMs: Express Scripts, CVS Caremark and OptumRx. Employers paid between $20,000 and $300,000 in 2020 to be part of Aon's coalition, depending on their size, according to the documents. Details: The Aon coalition documents place tight limits on employers' ability to access information about their drug costs — and on their ability to analyze that data, if they can get it. A confidentiality agreement between Aon and third-party vendors stipulates that if employers hire vendors to audit the coalition's data, vendors "shall never include [a drug's average wholesale price], ingredient cost, or member cost share or any other information that could be used to derive the [coalition's] proprietary pricing information" in reports they provide to employers. What we're hearing: Several people who work in the industry, who asked not to be named due to the confidential nature of coalitions, said most employers, regardless of how big they are, have no idea what they're giving up when they enter coalitions. "PBMs and consultants will work very hard to convince employers they have employers' best interests at heart — until you ask for data," a longtime drug benefits expert said. What they're saying: Executives at Aon and Express Scripts declined several interview requests. Aon said in a statement that members of its coalition saved, on average, 18% on their drug costs in 2020, but did not address Axios' questions about the documents or data rights. After Axios first reached out to Aon about the documents, an outside law firm hired by Express Scripts sent a cease-and-desist letter demanding that Axios identify the source of the leaked documents and destroy all such documents. The bottom line: Secretive contracts, which are nothing new in health care, are blocking employers from understanding whether they are paying reasonable drug prices. Go deeper.     2. Two very different vaccine mandate paths Illustration: Sarah Grillo/Axios   European countries are doubling down on pressure campaigns to get people vaccinated just as Republicans continue to wage war — often successfully — against vaccine mandates in the U.S., Axios' Caitlin Owens reports. Why it matters: The starkly different approaches create a sharp contrast between the regions' approaches to vaccination, even as the Omicron variant rapidly spreads around the world. Driving the news: President Biden's federal vaccine mandates are getting pummeled in court. The other side: Germany announced this week that unvaccinated people will not be allowed in nonessential shops or cultural and recreational venues, AP reports. France, Italy and Austria have also announced that unvaccinated people will be largely prohibited from visiting bars, restaurants and arts, sports and entertainment venues, the Wall Street Journal reports. In France, the unvaccinated must present a negative test — which the government no longer subsidizes — taken within the previous three days to access such venues. In Greece, only people older than 60 are required to be vaccinated against COVID, per the WSJ. Related: Fauci: U.S. reevaluating African travel restrictions "daily"     3. Two years of COVID Data: Our World in Data; Chart: Axios Visuals Two years ago Wednesday, the first case of a mysterious new respiratory disease was discovered in Wuhan, China, Axios' Dave Lawler writes. Now, the Omicron variant has deepened concerns about just how much longer the coronavirus pandemic will last. The big picture: More than 5 million people have died since that first case. Most people on earth have lived through some form of lockdown. 54% of the global population has had at least one vaccination, though the shots have been distributed unevenly. We know much more about the disease and how to treat it, but the end still isn't in sight. See the timeline.     A message from UnitedHealth Group How UnitedHealth Group is minimizing its impact on the environment     Recognizing the role of climate change on people's health, UnitedHealth Group is strengthening its commitment to environmental health. We are committed to: Achieving net zero operations by 2035. Working towards a paperless consumer and provider experience in the next 2-3 years.     4. 1 big number: Medicare's telehealth use soars Illustration: Aïda Amer/Axios   There were nearly 52.7 million fee-for-service telehealth visits by Medicare beneficiaries last year, up from only 840,000 in 2019, according to data released by the Centers for Medicare and Medicaid Services. That is a 63-fold jump year over year. Between the lines: Massachusetts, Vermont, Rhode Island, New Hampshire and Connecticut had the highest use of telehealth in 2020. Tennessee, Nebraska, Kansas, North Dakota and Wyoming saw the lowest use in the same time period. Overall health care utilization dropped by 179 million visits in 2020, an 11.4% drop from 2019, even accounting for the increased telehealth visits.     5. ICYMI: America's pandemic eating Illustration: Sarah Grillo/Axios   Take supply chain disruptions and worker shortages, mix them with a dash of the major tech changes already underway before the pandemic and you've got a recipe for a food revolution, according to Axios' latest Deep Dive: Pandemic Eating.     6. While you were weekending Illustration: Aïda Amer/Axios   J&J booster works well for people who had Pfizer originally, study finds. (New York Times) Cruise ship COVID outbreak: Louisiana officials find "probable" Omicron case. (Axios) Hawaii is no paradise if you need medical care. (Wall Street Journal) University of Washington researchers to test psilocybin in healthcare workers affected by pandemic. (GeekWire)     A message from UnitedHealth Group Working to build a more sustainable health system     Decarbonizing the U.S. health care sector can help limit the harmful effects of climate change and its impact on marginalized communities. See how UnitedHealth Group is partnering with the National Academy of Medicine to reduce the carbon footprint of the U.S. health system.   📫 Did someone forward this email to you? Here's how to subscribe. Like this email style and format? Learn more about Axios HQ. It'll help you deliver employee communications more effectively.   Axios thanks our partners for supporting our newsletters. If you're interested in advertising, learn more here. Sponsorship has no influence on editorial content. Axios, 3100 Clarendon B‌lvd, Suite 1300, Arlington VA 22201   You received this email because you signed up for newsletters from Axios. Change your preferences or unsubscribe here.   Was this email forwarded to you? Sign up now to get Axios in your inbox.   Follow Axios on social media: