PHARMACY

Senate Finance Committee passes Baucus healthcare bill

BY Allison Cerra

WASHINGTON The Senate Finance Committee passed a long-awaited $829 billion healthcare bill Tuesday by a 14-9 vote.

Sen. Olympia Snowe, R-Maine, whose vote was crucial to Democrats, was the only Republican to support the Democratic legislation.

The total cost of the Senate proposal – aimed at overhauling the nation’s health system and broadening health coverage – would be $829 billion over the next 10 years, according to a CBO report issued Oct. 7. That cost includes $345 billion in additional spending for Medicaid and the Children’s Health Insurance Program, as well as federal outlays of $461 billion to help lower-income Americans buy insurance if they can’t afford it under the mandatory coverage plan advanced in the Senate and Obama health proposals.

Despite those costs, the Congressional Budget Office projected the Senate plan will cut long-term health costs. The reform bill, hammered out over the summer with the strong support of Finance Committee chairman Max Baucus, D-Mont., would lower the federal deficit by $81 billion while extending insurance benefits to another 29 million Americans, congressional budgeters predicted. The savings would come largely by slowing the projected rise in Medicare spending – in particular by shaving $117 billion in payments to privately run Medicaid Advantage plans – and by taxing high-cost insurance policies.

The advance of the so-called America’s Healthy Future Act out of committee drew praise – and a hopeful reaction – from the independent pharmacy lobby. The bill, noted the National Community Pharmacists Association this afternoon, “includes several provisions ensuring the ability of community pharmacies to continue providing critical services to patients.”

In a statement, NCPA EVP and CEO Bruce Roberts commended the Finance Committee and the leadership of its chairman, Montana Democrat Max Baucus. “Chairman Baucus understands the significant role community pharmacies play, and we appreciate his support,” said Roberts.

Among the bill’s pharmacy-friendly elements, he noted, was language that gives pharmacies a somewhat more generous reimbursement for dispensing generic drugs to patients covered by Medicaid. Under a formula supported by Baucus, Medicaid would pay pharmacies 175% of the weighted average of the average manufacturer’s price of the generic.

Roberts called that provision “a very good start to protecting beneficiary access to community pharmacies while avoiding severe cuts that would do the opposite.

“We want to continue to work with the Senate and the Congress to assure that the level remains high enough for community pharmacies to continue to keep their doors open and provide pharmacy services to Medicaid patients,” added NCPA’s top manager.

Roberts also lauded the bill’s exemption of small-scale pharmacies from Medicare’s durable medical equipment accreditation regulation, which pharmacy leaders have long opposed as an unwarranted burden on their business and professional practice. “Pharmacists are already state-licensed and other health care providers are exempted,” he argued, adding that the Baucus bill “preserves seniors’ access to diabetes testing supplies and other essential goods.”

NCPA also strongly supports an amendment from Senator Maria Cantwell, D-Wash., that was added to the legislation before its passage by the Finance Committee. That amendment, Roberts said, “will lead to transparency regarding the deals pharmacy benefit managers…reach with drug manufacturers.”

The PBM industry strongly opposes the Cantwell amendment. Other provisions, including a plan to tax premium, high-cost insurance benefits provided by employers, have also drawn opposition from the insurance industry and other interest groups.

That opposition promises to make the road to passage of any health reform bill, including the Baucus plan, a rocky one in the coming weeks. “Now our attention turns to the melding of the separate Senate Finance and HELP committee bills into one bill that will be considered by the full Senate,” said Roberts. “While some portions of the bill do raise concerns for community pharmacies, we urge the Senate leadership to keep these and other pharmacy-friendly provisions in that bill, because they are also patient-friendly, and that’s what everyone should be striving for if America’s health care system is truly going to be reformed for the better.”

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IMS Health forecasts growth in U.S., global pharmaceutical markets

BY Alaric DeArment

NORWALK, Conn. Strong near-term growth in the U.S. pharmaceutical market will drive growth in the global pharmaceutical market, according to a forecast by market research firm IMS Health.

In its IMS Market Prognosis report, the firm forecasted market growth of 4% to 6% on a constant dollar basis next year, exceeding $825 billion, with an expansion of up to 7% through 2013, when the total market value will expand to at least $975 billion. Growth in the United States, likely to be 3% to 5% in 2010, is expected to drive global growth.

“Overall, market growth is expected to remain at historically low levels, but stronger-than-expected demand in the U.S. is living both our short- and longer-term forecasts,” IMS SVP healthcare insight Murray Aitken said in a statement. “The economic climate will continue to be a dampening influence in most mature markets, particularly in those countries with rising budget deficits and publicly funded healthcare systems.”

Blockbuster drugs that generate $137 billion in sales a year – particularly Pfizer’s Lipitor (atorvastatin calcium), GlaxoSmithKline’s Seretide (fluticosone propionate and salmeterol xinafoate) and Plavix (clopidogrel bisulfate), by Sanofi-Aventis and Bristol-Myers Squibb – will lose patent protection over the next five years and face generic competition. At the same time, new drugs that treat diseases such as cancer, osteoporosis and multiple sclerosis are unlikely to generate the same sales as the blockbuster drugs. These two factors will combine to dampen growth prospects, according to IMS.

Still, growth prospects in the United States have improved, the report said. Pharmacy chains have more tightly managed their inventory levels based on expectations of patient demand, which has increased purchasing volatility but also created higher-than-expected sales growth in first quarter 2009. Meanwhile, papers have sought to limit price increases and boost the use of generic drugs.

“In the U.S., pricing flexibility and inventory management actions are contributing to much higher growth than anticipated earlier this year and are the main reasons for the upward adjustment to our five-year forecast,” Aitken said.

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Sanofi Pasteur: H1N1 shot boosts immune response

BY Michael Johnsen

LYON, France Sanofi Pasteur, the vaccines division of the Sanofi-Aventis Group, on Thursday announced that a single dose of influenza A (H1N1) 2009 monovalent vaccines, Panenza (15 mcg dose, non-adjuvanted) or Humenza (3.8 mcg dose, adjuvanted), administered to children (3 years of age and older) and adults just one time induces a robust immune response that is considered protective in 93% or more of adults 18 to 59 years old and in 83% or more of adults 60 years of age and older, according to results from clinical trials conducted in Europe.

In children 3 years of age through 17 years of age, 94% or more of study participants achieved seroprotective antibody response.

“These significant clinical data concerning Sanofi Pasteur’s pandemic influenza vaccines will help build public confidence in the vaccine and will support efforts by health authorities to face the challenge posed by pandemic influenza,” stated Wayne Pisano, president and CEO of Sanofi Pasteur.

The results are based on interim analysis following the first vaccination dose from clinical trials conducted in France and Finland. No serious adverse events have been observed to date in these clinical trials. Local injection site (redness, swelling and pain) and systemic complaints of mild fever, headache and fatigue were reported.

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