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Medicaid Expansion: Divided we Stand

May 31, 2013  /  ACA Weekly Roundup

20 states and the District of Columbia are sure bets to expand Medicaid. With the remaining states withholding commitments at this point, odds are that on January 1, 2014 the nation will divide into two fundamentally different healthcare systems. (1) States that expand Medicaid will absorb large numbers of younger and minority patients into their […]

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Game Changer: Medicaid Expansion via State Exchanges

March 11, 2013  /  ACA Weekly Roundup

Is the Arkansas deal with HHS a sign of where Medicaid is headed? A seemingly routine meeting between a state governor and HHS to discuss implementation issues related to the Affordable Care Act (ACA) may have created a new path forward for Medicaid Expansion. Preliminary reports indicate that Arkansas has secured a deal that allows […]

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Is Pharma Ready for Healthcare Reform?

February 23, 2013  /  ACA Weekly Roundup

In August 2012 Sanofi launched Zaltrap for the treatment of metastatic colorectal cancer at twice the cost of Avastin.  When oncologists at Memorial Sloan Kettering said that they would not prescribe the drug because the cost differential was not worth the additional 1.4 months survival gain, Sanofi promptly cut the price by 50%.  Sanofi feared […]

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OHIO, OHIO, OHIO and Medicaid Expansion

February 8, 2013  /  ACA Weekly Roundup

With governor John Kasich’s decision to expand Medicaid, 6 GOP governors (OH, MI, ND, AZ, NV, NM) are now onboard.  Michigan’s Rick Snyder followed Kasich right after his announcement. The remaining states opposing Medicaid Expansion are faced with not only the political conundrum of having coverage available for residents with higher incomes than the poorest […]

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Biosimilars: Pharma resurrects a new “Narrow Therapeutic Index Strategy”

January 31, 2013  /  ACA Weekly Roundup

Andrew Pollack’s article in yesterday’s New York Times about Biosimilars reminded me that some things never change-they just get reinvented. As big Biotech rushes legislation to statehouses to limit therapeutic substitution of Biosimilars, it reminded me of the many battles between generic manufacturers and pharma with drugs like warfarin and cyclosporine, so-called NTI drugs because  […]

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Which State Exchanges will have the greatest impact?

January 24, 2013  /  ACA Weekly Roundup, Opinion

(1) California The state’s decisions thus far open the insurance market to intense competition with the selection of Kaiser as the Exchange Benchmark Plan, the requirement that any plan offered in the Exchange must be offered in the private commercial market and the receipt of $674 mm in federal grant funds for infrastructure and marketing. […]

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Medicaid Expansion: Coverage and Consequences

January 18, 2013  /  ACA Weekly Roundup

22 states have now signed on to Medicaid Expansion with Governor Jan Brewer of Arizona the latest to do so.  The challenge facing remaining states who are reluctant to do so is the “fairness gap” that could result in 2014 when State Exchanges are in place.  In states that do not expand Medicaid, premium subsidies […]

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