“The future of the pharmaceutical industry is not with Medicaid, but rather will be in developing direct relationships with providers and payers that target specific disease populations.”
JAMES ALLEN, PA HEALTHCARE EXPERTAmy Lotvan
PA’s James Allen, life sciences and healthcare expert, talks to Inside Health Reform about the Supreme Court of the United States’ (SCOTUS) Medicaid decision. James says that the decision is likely have a neutral impact on the drug industry.
In the article, James admits that before the SCOTUS decision he had considered the Medicaid expansion a “mixed blessing.” James points out that, although the decision increased drug companies' Medicaid business, that's not necessarily "good business." This is due to low reimbursement rates as well as the increased exposure to the rebates.
James explains that the situation also puts pressure on insurance plans to design products that would be affordable to people earning between 100 and 138 Federal Poverty Level even with the subsidies.
James believes that “the future of the pharmaceutical industry is not with Medicaid, but rather will be in developing direct relationships with providers and payers that target specific disease populations.”
James says: “Collaborating with integrated entities to improve medication adherence and patient outcomes will be crucial, especially when it comes to participation in shared savings programs.”
Subscribers to Inside Health Reform can view the article online here.