Hospitals face specialty pharmacy challenges with insurer competition

Health systems are increasingly opening their in-house specialty pharmacies to drive better patient outcomes and bolster potential revenue, but they face stiff competition from payers who also see the same opportunity and have the power to keep their members’ costly and complex drugs within subsidiaries and affiliates.

That’s the case at the University of Illinois Health Sciences System, where Matthew Rim works in a team of three pharmacists to run their in-house operation, managing complex and very expensive drugs for conditions like rheumatoid arthritis, cancer and Hepatitis C. He said they end up only being able to fill the prescriptions of about half of their patients on specialty drug treatments.

“We are actually losing patients to those vertically-integrated payers, or PBM-owned specialty pharmacies, because we are not able to get contracted with them, and there are restrictions that we have to transfer care to whatever pharmacy is owned by them,”

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COVID lockdown empties Delhi streets amid deadly surge

Transmission electron microscope image of SARS-CoV-2, the virus that causes COVID-19, emerging from human cells. Credit: NIAID

New Delhi led major cities across India into a weekend lockdown Saturday as the country confronts a fierce new coronavirus wave, with more than 230,000 fresh daily cases and families clamouring for drugs and hospital beds.

Hopes that South Asia might have beaten the pandemic have been dashed with India seeing over two million new cases this month alone and Bangladesh and Pakistan also imposing shutdowns.

India added another record 234,000 cases Saturday to pass 14.5 million overall and 1,341 deaths took its pandemic total to 175,649 deaths.

The per-capita rates remain low by international comparison, but the speed at which cases are rising led the international Red Cross to call the South Asian surge “truly frightening”.

India now has three times the daily cases of the United States, the world’s worst-hit country.

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Biden admin throws out Texas Medicaid waiver

The Biden administration on Friday unwound a 10-year extension of Texas’ Medicaid waiver, arguing that the Trump administration should not have approved its more than $100 billion request without going through the usual notice and comment period.

Texas asked CMS to fast-track an extension of its Medicaid waiver, which mostly covers uncompensated care costs, in November. At the time, the state said it needed an exemption from the usual public comment period to ensure financial stability for providers and the state’s Medicaid program during the COVID-19 public health emergency.

But CMS Acting Administrator Elizabeth Richter said Texas’ request didn’t meet the standard for emergency approval because it had already been approved through Sept. 2022, making an early extension unnecessary. Several leading healthcare organizations, advocacy groups and think tanks made a similar argument shortly after the Trump administration approved the extension in January.

“The erroneous initial determination to approve an

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Pfizer to send more COVID vaccines to Canada as Moderna jabs delayed

Credit: Unsplash/CC0 Public Domain

Prime Minister Justin Trudeau on Friday assured Canadians that the country’s turbulent COVID-19 vaccine rollout remains on track after Pfizer agreed to boost shipments just as Moderna deliveries hit a snag.

“We are well on track to reaching in the upper of 40 to 50 million doses by the end of June,” Trudeau told a news conference, adding that by that date “most Canadians will have been able to receive a first dose of the vaccination.”

He also renewed his government’s commitment that “all Canadians who want a vaccine will be able to be vaccinated by the end of September.”

Earlier, Procurement Minister Anita Anand announced that Moderna would cut almost in half its next shipment, expected by month’s end, to 650,000 doses.

However Trudeau said Canada has secured an additional eight million Pfizer-BioNTech doses to more than make up for the Moderna shortfall.

Canada will

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