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Dear John,

The August issue of Health Affairs includes articles on prescription
drug price competition, the effects of OxyContin marketing, the
targeting of hospital COVID-19 relief funds, the effects of a nurse home
visiting program, and more.

Read The Issue
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Prescription Drugs

Sean Dickson and coauthors analyze the effect on prices
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net of rebates, for all instances when a new brand-name pharmaceutical
is introduced that competes with an existing therapy. Between 2011 and
2019, this type of competition "was associated with a 4.2 percent
decrease in annual net price growth and resulted in net prices that were
6.8 percent lower, on average, than net prices before competition."

Annabelle Fowler and coauthors track the prevalence and characteristics
of authorized generics
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approved drugs that are identical to their brand-name drug counterpart
but are sold without brand-name labeling.

A total of 854 authorized generics launched between 2010 and 2019, with
entry spiking in 2014. The authors find that authorized generics are
introduced "when the threat of generic entry is heightened after the
first traditional generic is approved for the authorized generic's
brand-name drug."

Julia Dennett and Gregg Gonsalves examine the long-term effects of the
initial marketing of OxyContin
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in 1996.

They find that states with higher levels of exposure to initial
OxyContin marketing had significantly increased rates of fatal synthetic
opioid-related overdose; increased incidence of acute hepatitis A, B,
and C; and increased rates of infective endocarditis-related mortality
compared to states with lower levels of exposure to early OxyContin
marketing.

James Robinson's Policy Insight offers an analysis of industrial
policy opportunities
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within the three principal sectors of the life sciences. Among other
policies, Robinson advocates for the support of start-ups and the
strengthening of public procurement for pharmaceutical and medical
technologies.

In Perspectives, J. Stephen Morrison and Michaela Simoneau caution that
an industrial policy-based approach to the life sciences requires
heightened geopolitical awareness
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significant public funding, and bipartisan support, and Thomas Bollyky
critiques Robinson's global competition lens
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arguing that "the US needs an industrial policy for global health."

Read More
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Hospitals

Congress allocated $178 billion to the Provider Relief Fund (PRF) in
2020, to offer financial support to hospitals and providers during the
COVID-19 pandemic.

Anuj Gangopadhyaya and coauthors assess how these funds were distributed
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and find both that PRF funding was "appropriately targeted" and that the
most financially vulnerable hospitals received payments.

Mark Meiselbach and colleagues compare hospital prices negotiated in
commercial health insurance
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and Medicare Advantage (MA) plans by the same insurer.

When considering prices paid in the same hospital for the same services,
they estimate that "commercial prices are, on average, two to three
times higher than MA prices" and that commercial plans at times pay more
than five times what MA plans pay for the same service.

Vivian Ho and coauthors analyze claims data in five states from 2012 and
2019
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and find that price increases were the primary drivers of increased
emergency department spending in four of the five states examined
(Colorado, North Carolina, Ohio, and Texas), with upcoding playing a
significant but smaller role.

Read More
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Equity

Rebecca Gourevitch and coauthors report the results of a randomized
controlled trial of a nurse home visiting program
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for Medicaid-eligible pregnant people in South Carolina.

The authors "found little evidence of statistically significant changes
in health care use, use of guideline based prenatal care, or prenatal
health" and little effect for socially vulnerable or non-Hispanic Black
program participants.

Jun Li and coauthors explore adoption of the standard medical deduction
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(SMD), designed to reduce administrative barriers to accessing the
Supplemental Nutrition Assistance Program (SNAP), and find that
"reducing administrative barriers through the SMD is likely an effective
tool to increase SNAP participation."

Corwin Rhyan and coauthors conduct a cost-benefit analysis of
Michigan's recently revised Lead and Copper Rule
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which "requires water utilities to inventory existing water service
lines by 2025 and replace all lead-containing lines by 2041."

The authors estimate that these policies, in addition to protecting
hundreds of thousands of children, and particularly those who are low
income or children of color, would generate $1.91 billion in net
savings.

Joshua Mak and coauthors calculate the return on investment
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(ROI) for the introduction of a four-dose malaria vaccine for the period
2021-30 in twenty sub-Saharan African countries.

Using two different models, they estimate ROIs of 0.42 and 2.30,
respectively, indicating that although there is room for improvement,
there is a "modest positive ROI for the integration of malaria vaccines
in pediatric immunization schedules."

Accountable Health Communities

The Center for Medicare and Medicaid Innovation's Accountable Health
Communities (AHC) Model, launched in 2017, connects eligible Medicare
and Medicaid beneficiaries with community services to address
health-related social needs.

Presenting interim findings of an external evaluation, William Parish
and coauthors conclude that beneficiaries
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received navigation assistance
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had lower rates of emergency department visits than those in the control
group, but the effects of receiving navigation assistance on other
outcomes were not statistically significant.

Jeanette Renaud and coauthors assess whether the AHC Model adequately
addresses beneficiaries' health-related social needs
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through navigator facilitated connections to community service
providers.

After analyzing survey results, the authors find that although the AHC
Model effectively engaged participants, with more than 75 percent of
beneficiaries opting in to receive navigation, "the assistance-track
intervention did not significantly increase the rate of community
service provider connection or the rate of health-related social needs
resolution."

Order The Issue
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Join Health Affairs Unlimited to access our current and past issue
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premium newsletters and virtual events.

 

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This month, join us for the following events:

* August 22: Journal Club: Home
<[link removed]>Visits
With A Registered Nurse Did Not Affect Prenatal Care Use Or Pregnancy
Health Among Medicaid Enrollees
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Each week, our podcasts uncover the latest findings and insights in
health policy research.

In August, we'll host authors from the new journal issue.

Catch up on last month's episodes where Jane Zhu discussed seniors
navigating mental health care in
<[link removed]>Medicare
Advantage plans
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while Yanlei Ma reviewed dual-eligible special needs plans.
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Check out our podcasts, and subscribe on Spotify
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or wherever you prefer to listen.

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mailto:[email protected]

About Health Affairs

Health Affairs is the leading peer-reviewed journal
<[link removed]> at the intersection of health,
health care, and policy. Published monthly by Project HOPE, the journal
is available in print and online. Late-breaking content is also found
through healthaffairs.org <healthaffairs.org>, Health Affairs Today
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Update <[link removed]>.  

Project HOPE <[link removed]> is a global health and
humanitarian relief organization that places power in the hands of local
health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

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