PHARMACY

At PAC breakfast, Kondracke reviews health reform

BY Jim Frederick

WEST PALM BEACH, Fla. The ambitious agenda set by the new Obama administration and a Democratic Congress on health reform and other issues is running into some bitter opposition from Republicans.

But the White House likely is to emerge with some form of expanded health coverage for Americans and an overhaul of the healthcare network that could thrust community pharmacies into a more prominent role as local centers for prevention, wellness and patient intervention. That was the prediction from political analyst and journalist Morton Kondracke at Monday morning’s NACDS Political Action Committee breakfast meeting.

Kondracke, executive editor and columnist for the Capitol Hill newspaper Roll Call and a regular commentator for “Fox News,” gave a wide-ranging talk that addressed the current polarized political landscape and the changing healthcare system.

“Except for the Tea Party crowd, Obama is enjoying fairly high popularity ratings,” said Kondracke, with an average approval rating of 61%. What’s more, he opined, “The mainstream media has gone gaga over the president.”

However, added the “Fox News” pundit, the president’s activist agenda and aggressive efforts to stimulate the economy through massive federal outlays have angered many right-leaning voters and opened a wide rift between Republicans and Democrats. “Since 1994, we have not had an all-Democratic government,” said Kondracke.

The strong Democratic majorities, particularly in the House of Representatives, are fueling the very activist tone apparent in the early days of the Obama administration, as Congress and the White House tackle health reform, the budget, education, the environment and other issues, Kondracke added. But they’ve also spawned a vocal and determined backlash on the smaller-government side of the political divide. “The Republicans cannot stop the House from doing anything, but they can make a lot of noise about what the Democrats are doing — and they are doing that,” Kondracke said.

The resulting polarization, he said, likely will slow many White House initiatives — including moves to overhaul health care, cut out-of-control health spending and broaden health coverage to the more than 45 million uninsured Americans. “The noise out of Washington — and it’s not just from Rush Limbaugh and Sean Hannity — is that a lot of Republicans are branding a lot of what Obama is doing as socialism, or at least European social democracy. So even though Obama said we were going to move into a post-partisan era … everything of importance that Congress has passed so far … [has] all passed on a strict party-line vote.”

In addition, the gap between Democrats’ and Republicans’ approval of the president is now the largest in history at this stage in a new administration, Kondracke said. “That’s the heavily polarized partisan climate that Obama … has not been able to overcome,” he added.

Nevertheless, Kondracke predicted that the movement for health reform and expanded coverage of the uninsured this year will be almost unstoppable. “The Obama administration and the Democrats want to pass a healthcare reform bill this year so badly,” he said, that they may be willing to compromise on issues of concern to Republicans, who consider a single-payer, government-run health plan anathema, and who insist that the White House must get a grip on rising Medicare and Medicaid costs.

Employers also continue to raise concerns about the insurance costs they could incur under any health system overhaul. Nevertheless, Kondracke told NACDS PAC contributors, both Democrats and Republicans generally do agree on some elements of health reform. “One is investment in health [information technology]. And it’s broadly agreed to that we should move from ‘paid from procedure’ medicine, where doctors get reimbursed on the basis of how long they spent with a patient … to being paid for performance and keeping the patient healthy. How we’re going to get to that nobody has quite figured out, but somehow everybody agrees that that’s the way to go,” he said.

With roughly 70% of all healthcare expenses going to the care of chronic diseases, said Kondracke, a broad consensus also has emerged on the importance of preventing and managing chronic disease, rather than simply treating illness and critical conditions after they’ve occurred. Given that shift in emphasis from critical care to prevention, he added, “There’s a real chance for drug stores to be at the center of healthcare reform … and for drug stores and pharmacists to be ‘medical homes’ for health care. “Somebody needs to be responsible for organizing [patients’] meds and their treatment, and drug stores would be an ideal place to participate in that kind of system,” he noted, particularly if another 45 million patients end up with health coverage and overwhelm the nation’s primary care physicians.

Opening the PAC event, NACDS chairman Andy Giancamilli and president Steve Anderson recapped the highlights of recent fundraising activities undertaken on behalf of the NACDS membership. “We achieved the goals that were set,” said Giancamilli. “The NACDS PAC contributed $325,000 to the campaigns of more than 100 candidates. We also were effective in raising an additional $200,000 through fundraising. Sixty percent of the money went to the Democratic candidates and 40% went to the Republicans,” continued NACDS’ chairman, adding, “96% of the candidates that we supported are today serving in office: 115 of 120.”

Giancamilli renewed his call for continued activism and support from chain pharmacy leaders as NACDS goes back to Congress this year to lobby for a seat at the healthcare reform table. “It’s important that our story be told, and that we have the resources to do this,” he said.

The need is made more acute, added Anderson, by the lack of expertise about healthcare issues among most lawmakers on Capitol Hill. “Even though there are 535 members of Congress … there are only a few people who really understand health care in Congress and take the lead.” Among them, he said, are Senate Finance Committee chairman Max Baucus, D-Mont., and Rep. Frank Pallone, D-N.J., who chairs the House Energy and Commerce Subcommittee on Health. Pallone, who Anderson said “has become a great friend over the last few years of NACDS,” will make an unscheduled, but welcome, appearance at the final NACDS Annual meeting business program Tuesday morning, the chairman revealed, to discuss health reform efforts and legislation affecting retail pharmacy. The business session will be followed by a private discussion between Pallone and NACDS retail members.

“We need you to be there,” Anderson admonished members at the PAC breakfast. “It will be extremely helpful in what we do as we move forward.”

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Express Scripts reports record lows in prescription trends

BY Alaric DeArment

ST. LOUIS One of the country’s largest pharmacy benefit managers said Monday that prescription drug cost trends decreased to record lows last year.

Data from Express Scripts indicated that the trend resulted from greater use of generic drugs and low-cost branded drugs, the PBM said. The overall pharmacy cost trend for clients of the company was 3% for 2008, down from 5.5% the year before.

The company calculated the data by evaluating total prescription costs for traditional and specialty drugs, including patient copays and payments by plan sponsors such as health plans and employers.

“Using generic drugs that are safe and effective can help lower costs while still driving value for patients and employers,” stated Steven Miller, Express Scripts chief medical officer and SVP . “Our results indicate that cost control is achievable through careful management of appropriate use of drugs and delivery channels, without shifting costs to consumers.”

The company said that additional opportunities for savings remain. Consumers wasted an estimated $42 billion in 2008 by not finding appropriate, lower-cost alternatives to expensive branded drugs. The researchers based the estimate on potential savings for the total U.S. population in 13 drug-therapy classes, using a sample size of 3 million people.

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GSK to acquire Stiefel Labs to create specialist dermatology business

BY Alaric DeArment

LONDON Days after it announced a plan to combine its HIV business with that of Pfizer, GlaxoSmithKline said Monday that it will acquire another company to create a specialist business for developing skin medications.

GSK will acquire Stiefel Labs for $2.9 billion, as well as $400 million in debt that it will incur at the closing of the deal, and a further $300 million in cash depending on future performance. GSK will combine its existing dermatology business with that of Stiefel, which will continue to operate under the Stiefel name within GSK.

“As part of our strategy to grow and diversify GSK’s business, we are continuing to make new investments through targeted acquisitions,” GSK CEO Andrew Witty said. “This transaction will create a new world-leading, specialist dermatology business and re-energize our existing dermatology products.”

The British drug maker announced last week that it and Pfizer would spin off their HIV divisions and form a new company to develop and market HIV drugs. The Stiefel acquisiton comes amid a wave of large-scale acquisitions among drug companies, including Pfizer’s purchase of Wyeth, Merck & Co.’s acquisition of Schering-Plough and Roche’s acquisition of Genentech.

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