Medicare to pay for hep C screenings for baby boomers

Jun 4 2014

The decision comes amid controversy surrounding the costs of new drugs to treat the blood-borne virus. Meanwhile, two studies find that Medicare could save billions if doctors switched from an expensive eye medication to a similar, much cheaper one and, also, if Part D plans were selected based on the actual drugs patients take. The Fiscal Times looks at how spending on new specialty drugs is forecast to skyrocket.

Modern Healthcare:  CMS Targets Boomers, Those At High Risk, For Hep C Screenings
The CMS has finalized its coverage decision to reimburse for hepatitis C virus screenings for two target populations, including baby boomers. That decision comes amid controversy surrounding the costs of treatment that could result from screening, since screening may identify asymptomatic people who carry the virus but may not need to be treated (Dickson, 6/2).

USA Today: Cheaper Eye Drug Could Save Medicare $18 Billion
Switching from an expensive eye medication to a similar, much cheaper medication could save Medicare $18 billion over the next decade, a report released Monday finds. Lucentis to Avastin are used to treat wet macular degeneration and diabetic macular edema. Avastin costs $55 per treatment, and Lucentis costs $2,023 per treatment. Both are made by Genentech, a subsidiary of health care company Roche. The medications made headlines recently when Medicare released its provider-payment data for 2010 and showed that one Florida doctor was paid $21 million by Medicare for his use of Lucentis (Kennedy, 6/2).

Kaiser Health News: Capsules: Medicare Could Save Billions By Scrapping Random Drug Plan Assignment
If Part D plans were selected based on the actual drugs patients take, it could save those patients hassle and money, and potentially save the government billions of dollars, according to a study by researchers from the University of Pittsburgh (Rovner, 6/2).

In other news related to drug costs -

The Fiscal Times: Get Ready For A Surge In Costly Specialty Drugs
In recent years, spending in just about every area of the nation's health care system remarkably has slowed. U.S. health care costs rose by just 3.7 percent in 2012, according to a report by the Centers for Medicare and Medicaid Services (CMS), marking the fourth consecutive year of slow growth. Even spending  on prescription drugs has continued to slow over the past several years, largely because of the rise of cheaper generic drugs – and the expiration of patents of several big-name drugs including Lipitor and Plavix. That allowed cheaper generics to enter the market. The one exception, however, has been spending on new innovative specialty drugs that are being rapidly cranked out by pharmaceutical companies to treat multiple sclerosis, rheumatoid arthritis, leukemia, and osteoporosis – even erectile dysfunction (Pianin, 6/3).