Wednesday, October 25, 2017

VA Responds To Concerns About Collaboration With ICER

VA Responds To Concerns About Collaboration With ICER
C. Bernie Good ,Tom Emmendorfer, Michael Valentino
October 25, 2017

On June 27, 2017, the nonprofit Institute for Clinical and Economic Review (ICER) announced that it was collaborating with the Department of Veterans Affairs (VA) Pharmacy Benefits Management (PBM) Services to “support VA coverage and price negotiations with pharmaceutical companies to promote access to high-value drugs.” This announcement has generated quite a bit of interest---some enthusiastic, and others, not so much....

Regardless of the nuances regarding formulary status, the real question should be whether veterans have access to medically necessary medications, as part of the VA’s overall medical care system. And the fact is, veterans generally get similar or better care compared to other health care systems, as reported by a recent independent RAND Corporation study. Consider the case of hepatitis C drugs. The VA has most of these drugs included on the VA National Formulary, and the maximum prescription copayment for any veteran is $11 per month. Compare that to Medicare Part D beneficiaries, whose annual average copayment for the hepatitis C drug Harvoni can exceed $7,000. As of August 2017, 66 percent of veterans with hepatitis C have been treated with these new and effective drugs---almost certainly a far higher percentage than any other health care system in the United States....

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