Healthcare Stories: UK Rejects More Cancer Drugs as too Costly, Cost/Benefit Coming to US, and Tough Implementations not New

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UK NICE Rejects Three More Cancer Drugs
Nature Reviews Drug Discovery reports that NICE will be rejecting Bristol Myers-Squibb’s (BMY) Sprycel, Novartis’ (NVS) Tasigna, and UCB’s Cimzia. NICE would be open to additional comparative benefit studies combined with risk sharing by the pharmaceutical companies.

Cost/Benefit is Included Healthcare Reform
Bloomberg’s “Health Law Surprise Is Page 1,617 Demanding Which Drugs Work” reports that $500M or more will be allocated annually to comparative-effectiveness research. $1.1B has been allocated in total. Unlike the UK, the power of this research is only to influence – not dictate. Still Medicare, Medicaid and most insurers will probably listen. Now that the Independent Medicare Advisory Board can call for an up or down vote on cost savings recommendations, this research could have even more teeth.

Big Changes are Never Easily Accepted
New Yorker’s “Now What?” reports that the implementation of Medicare was not our romanticized fantasy. The AMA fought implementation with the Ohio Medical Association declaring a boycott. Southern hospitals refused Medicare certification because racial integration was required. The furor of 1965 makes the Tea Party protests seem pale in comparison.

President Johnson was forced into some appeasements for the doctors while strong arming the hospitals to gain access for seniors. Fortunately insurers, hospitals and doctors are too dependent on government to have to the same level of power on the current executive branch. With Congress now out of the picture, the balance of power has shifted from the health industry to the government.

The Wall Street Journal reports: “Insurers Say They Will Accept Pre-Existing Conditions After Dispute on Timing, Warn of Higher Prices.” In the first test of the HHS Secretary’s wide interpretation of the new healthcare law, she proved her metal. Insurers backed down in acknowledgement that federal regulators won’t be the pushover that state regulators have been.

HHS Secretary Kathleen Sebelius has been relatively quiet during much of the debate leading up to this month’s bill signing. This led the industry to underestimate her rigor. I believe the cat and mouse games will continue with regulation being 90% of the law. Don’t be surprised to see Sebelius make the most of the legal framework she has to work with. The new reality is that insurers will really have to behave to get a seat at the regulatory table. Sebelius controls both the carrot and the stick; lobbying Congress will do no good.

The Washington Post’s “Under shadow of 1957, Arkansas stays out of health-care fight” reports Governor Mike Beebe likens the states fighting healthcare reform to the fight against school integration: "I think you got to tell people the truth. And if I understand the law, the truth is the federal government can't just be defied by the state governments."

Sergeant Armey’s Lonely Hearts Club Band
The New York Times video “Why I Joined the Tea Party” portrays a disgruntled older couple who needed a little love after the husband lost his job and they found out that their modest suburban Philadelphia home was $30K under water. The cult has enticed them to spend until their savings run out on Tea Party rallies and organizing activities. Expending most of their free time and being recognized for their efforts gives them a sense of satisfaction they have been unable to achieve outside the cult.

FreedomWorks Chairman Dick Armey likened the Tea Party movement to the Reserves in the video; they will quiesce after the healthcare battle settles down but could be called up when needed. That’s not likely. The movement primarily recruits based on emotion. The participants have little or no knowledge of the issues that they are protesting. The couple in the video is on Medicare and had no idea what to do about healthcare, but is happy to push FreedomWorks talking points.

Hints of underlying anger surfaced when the husband complained about changes in their neighborhood, and the wife felt it was necessary to quit her retail job to dedicate her life to the cult. The sad part is that they don’t know what they’ll do when the money runs out; they cannot sell their house.

The Times left the impression the movement will dissolve when the economy improves and people feel better about their lives.

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