On this episode of the podcast, Terry and Bob argue that every patient should get the same high-value care that President Trump received to successfully treat his Covid-19. Here’s the list of medications that Trump received:
- Regeneron monoclonal antibody “cocktail”
- Famotidine (Pepcid)
- Vitamin D
Terry and Bob point out that while patients already have access to many of these treatments, they often can’t access them unless they have more serious cases than Trump. His treatment approach should be the standard of care for everyone. Such treatment can offer Americans a bridge to a vaccine and allow us to once again see our physicians and our parents.
Bob interviews Dr. Mark Fendrick, the director of the University of Michigan’s Value-Based Insurance Design, who explains the impact of value-based insurance design on lowering patient costs and improving outcomes. Dr. Fendrick advocates for the development, implementation, and evaluation of innovative health benefit plans that reduce out of pocket costs for high-value therapies. His research focuses on how clinician payment and consumer engagement initiatives impact access to care, quality of care, and health care costs.
Dr. Fendrick explains the need for value-based insurance design and summarizes what it is in a paper in Health Affairs:
When faced with the need for higher out-of-pocket spending, patients often make poor choices. In some cases, high out-of-pocket spending reduces the use of high-value services, which in turn leads to inferior health outcomes and possibly higher overall costs. In other situations, low out-of-pocket spending requirements may lead to the overuse of services that provide little or no clinical value.
A value-based insurance design program that couples cost-sharing reductions for high-value services with cost-sharing increases for services not identified as high value could both improve quality and control spending. It would do so by increasing the use of highly effective interventions while decreasing the use of ineffective services.
He explains on the podcast that U.S. healthcare’s Flintstone delivery model must catch up to its space-age drug development. He is particularly concerned about growing deductibles, which impose major costs on patients every time January rolls around. According to his research, prescription drugs account for 35 percent of public health’s impact on lengthening life expectancies.
In contrast to Dr. Fendrick’s approach, Bob points out that ICER’s definition of high-value care is anything that will save the healthcare system money. That’s not to say that no barriers whatsoever should be put in place to access drugs, argues Dr. Fendrick, it’s just that patients shouldn’t be penalized for doing the right thing clinically.
Patient correspondent Kate Pecora speaks with Carly Flumer, who recounts her efforts to advocate for all cancer patients, including those like herself with so-called “good” cancers. Carly tells her story of her thyroid cancer diagnosis and her subsequent ordeals. She argues that there is no such thing as a good cancer. Yet, she also points out that cancer has given her a purpose in life to advocate for patients in similar situations as her.