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The Affordable Care Act is Here to Stay

April 25, 2013
The Patient Protection and Affordable Care Act (ACA) of 2010 includes provisions that could lead to new and improved treatments, cures and cost savings for patients. All of these changes, however, will impact the biotechnology industry and the future of patient access to needed medicines. In an expert panel at the 2013 BIO International Convention moderated by BioCentury’s Steve Usdin, multiple stakeholders addressed key elements of the ACA focused on both the value the ACA will offer as well as practical issues surrounding implementation.

Usdin was joined by Jonathan Blum, Director, Center for Medicare, Centers for Medicare and Medicaid Services; Marc Boutin, Executive Vice President & COO, National Health Council; Scott Carmer, Head, US Specialty Care, AstraZeneca; Kristine Peterson, CEO, Valeritas; and Meena Datta, Partner, Sidley Austin LLP.

In starting the discussion, Usdin asked Blum to comment on what the ACA will mean for people who turn science into medicine.  Blum noted that the ACA had two goals, expanding coverage as well as changing how we deliver care in order to lower the cost of care.  He pointed out that the ACA seeks to build a stronger system of care that focuses - not just on specific episodes - but on the entire patient journey.

When discussing what is top of mind for patients, Boutin explained that while the patient community is engaged in access to care issues, there is also concern about implementation issues, including delivery system issues, comparative effectiveness and essential health benefits.  Boutin added that the community must also be cognizant of the impact the ACA will have on development of new treatments.

As the discussion moved to how the ACA might affect the creation of new drugs, Peterson said there is concern that the government’s level of reimbursement could impact innovation down the line in 2020 or 2025.  She noted that although it is difficult to grasp now, there will be an impact on company investment.  Carmer added that with innovation comes inherent risk and when you take away the reward for pursuing that higher risk, companies will pull away.

Multiple concerns were voiced on the panel about the Independent Payment Advisory Board (IPAB) created by the ACA, with Peterson questioning how transparent the process will be and Datta noting that many are questioning how much time a company will have between a decision being handed down by the IPAB and implementation.  Datta added that many are also questioning the constitutionality of the boards.

Blum weighed in, meanwhile, explaining that there have been a lot of misperceptions related to the IPAB.  He stressed that the IPAB would only be making recommendations to Congress.  Congress will have ultimate decision making authority, Blum said.

In closing each of the panelists agreed that as we move forward with implementation of the ACA, it will be important for all stakeholders to be engaged and participate in an open dialogue.