health care inc.
The ACA architect turned investment banker fighting merger scrutiny
Peter Orszag was instrumental in crafting the Affordable Care Act. Now, he wants federal antitrust authorities to ease up on their sharp scrutiny of health care transactions that he acknowledges the law has encouraged — and that make a lot of money for his investment bank, STAT's Bob Herman writes.
The Lazard CEO has lamented, a few times this year, how Biden administration antitrust reviewers are increasingly thwarting or stalling deals that have proliferated since the law went into effect in 2010. Many of those are "vertical integration" mergers that Orszag and the companies argue will hasten lower-cost, higher quality health care services.
Others are more skeptical, arguing that we haven't seen that in practice — and in fact after a number of high-profile vertical deals, saw higher prices. More from Bob on Orzsag's next chapter and the antitrust battle.
drug pricing
Three drugs account for half of savings from Medicare negotiation
Enbrel, Stelara, and Eliquis account for more than half of the savings from the first 10 drugs subject to Medicare price negotiation, according to a report by Brookings Institution's Center on Health Policy.
The Biden administration announced last week that if Medicare negotiation had been in place in 2023, the government would've saved $6 billion. Brookings' research came to a similar conclusion, though it noted that actual savings are lower. For example, drugs chosen for negotiation are exempt from the 10% to 20% discounts that they otherwise would be subject to in Medicare Part D. The $6 billion figure doesn't account for those lost discounts.
But both the administration's and Brookings' savings estimates account for the rebates that insurers were already negotiating, according to John Wilkerson. They both found that Medicare negotiated prices that are 22% lower than what insurers were negotiating – insurers can negotiate prices down from Medicare-negotiated levels in at least some instances.
The biggest price concessions were obtained from drugs that were not already heavily rebated before Medicare negotiation.
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