Healthcare Tuesday

Happy election day. We'll be focused on the elections throughout the day, but check out Healthwatch for breaking news on other healthcare related topics as well. 

The big storyline for the midterms will of course be how the Democrats who voted for the new law fared, and how many of the 34 centrists who voted against the law end up getting tossed anyway. Another emerging theme: How many pro-life Democrats will get canned for their vote?

Keeping tabs on the states: Voters in three states will cast ballots today on the new healthcare law's individual mandate to buy insurance. Arizona and Oklahoma are expected to pass the state constitutional amendment, but it faces an uphill battle in Colorado.

Here's how the measure polls:

In Arizona, Proposition 106 had the support of 38 percent of respondents in a mid-October Rocky Mountain News poll. Those opposed and undecided polled at 31 percent each.

Colorado's Amendment 63 fared much worse, according to a 9 News/Denver Post poll from mid-October: 24 percent of respondents were in favor, versus 36 percent opposed and 40 percent undecided. The measure is the only one of five citizen-generated measures that's not rejected by a majority of those polled.

Meanwhile, Oklahoma's State Question 756 is almost sure to pass, garnering the support of 66 percent of respondents in a Tulsa World poll last week (only 23 percent were opposed, and 11 percent were undecided).

Another repeal pledge? The Independent Women's Voice has its own repeal pledge, with 115 candidates of all parties and more than 80,000 people signing on online. The group says it's not working at cross-purposes with other repeal efforts, and in fact Heritage Action for America and Revere America have both signed on as sponsors on the group's homepage.

The pledge goes further than other similar efforts by having candidates pledge: "I would now and will in the next Congress endorse and vote for all measures, including discharge petitions, leading to its defunding, deauthorization, and repeal."

Biosimilars workshop starts today: The Food and Drug Administration begins a 2-day public hearing today to obtain input on specific issues and challenges associated with the implementation of the Biologics Price Competition and Innovation Act of 2009, part of the healthcare reform law. The law for the first time creates an approval pathway for generic versions of biologic drugs, which are medications and other medical products created through biological processes rather than chemistry.

The trade group Biotechnology Industry Organization will focus its remarks on four key issues: Biosimilarity, Interchangeability, Patient Safety and Pharmacovigilance, and Incentives for Innovation. BIO wants the Health and Human Services Secretary to issue guidance governing the review and approval of biosimilars, with the understanding that such guidance should be "specific to product types" because of "the wide variety among biologics." 

Meanwhile, the co-founder of the Global Healthy Living Foundation is excepted to testify that the proposed path to approval for biosimilars is "the vehicle for making money by disregarding the standards and practices that have created the biologics miracle." The 42,000-member patient advocacy organization supports a physician’s right to override health insurers’ policies of dictating which prescription medicines can be prescribed.

"Biosimilars, as they are currently proposed, represent another opportunity for health insurers to practice good economics by not allowing physicians to practice great medicine," argues Seth Ginsberg. "Our members are already subject to health insurers’ bottom-line-oriented policies which override doctors’ judgment by requiring a patient to fail first on a medicine preferred by a health insurer before that patient is allowed to succeed on the prescribed medicine. Biosimilars would extend this practice."

Healthcare costs still rising: A national survey of U.S. chief financial officers by Grant Thornton LLP found that nearly one-third (30 percent) are targeting healthcare cutbacks for their workforce. A vast majority (84 percent) cited employee benefits as their greatest pricing pressure, up from 68 percent six months earlier.

Keeping patients on their meds: Insurance plans that reduced or eliminated co-payments for medications have seen an increase in the number of people following their prescriptions, according to two studies in this month's issue of Health Affairs journal. The theme for the November issue is "designing insurance to improve value in healthcare." The two studies examined the effects of value-based insurance design, which typically reduces cost sharing for services that have strong evidence of improving patients' health.