Practice Rounds: EpiPen Saga Reaches a Fever Pitch

Welcome to Practice Rounds, our new weekly column exploring what's being covered in the larger world of healthcare.

EpiPen CEO Blames Healthcare System for Price Increase

The controversy over the price hike of the EpiPen, used to inject people who are having life-threatening allergic reactions, reached a fever pitch this week when Hillary Clinton, members of Congress, the AMA, and many others lashed out at Mylan Pharmaceuticals, which manufactures the pen. Mylan, which has increased the price by $500 since 2007, said it would reduce the out-of-pocket costs for certain patients by 50 percent in response the backlash. Heather Bresch, CEO of Mylan, also went on CNBC to defend the company in the wake of criticism, and said the "broken healthcare system" was causing the price of medications to increase. "This isn't an EpiPen issue. This isn't a Mylan issue. This is a healthcare issue. The system incentivizes higher prices, this is the conversation no one has wanted to have," Bresch said to CNBC.

HHS Says ACA Will Be OK

In a recent conference call with reporters, representatives from the Department of Health and Human Services (HHS) downplayed the recent exits by major insurers, such as Aetna, from healthcare exchanges created through the Affordable Care Act. "We are confident that the marketplace will continue to bring coverage to millions of Americans next year," said Ben Wakana, a spokesman for HHS, according to The News Press. Officials from HHS released a report to buttress the call, which highlights the successes of the ACA. Specifically, it said that 73 percent of consumers could find coverage for $75 a month or less and 78 percent of consumers could find it for $100 or less.

Wisconsin Dealing with Shortage

The physician shortage may be more prominent in the State of Wisconsin than previously anticipated, according to the Biz Times. Citing a study from the Wisconsin Council on Medical Education & Workforce, the site says the state could face a shortage of 4,000 doctors by 2035. Originally, it was estimated that there would be a shortage of 2,100 doctors by 2030 unless the state added 100 doctors each year for the next 15 years. However, because high numbers of physicians are retiring and fewer doctors are attending medical school to replace them, the need for physicians in the state has gone up.

Countering Rising Drug Prices

It's not just the EpiPen that is seeing significant price hikes. With the cost of many generic drugs rising by as much as 10.5 percent, Ascension Health in St. Louis monitors this information in as close to real time as possible, Managed Healthcare Executive reports. In response to rapidly rising drug costs, the health system aims to find cheaper alternatives that are just as effective. Through this approach the health system has saved $1.5 million. Another health system, Advocate in Illinois, has taken a similar approach. It uses the EHR to give clinicians information on alternative, more cost-effective medications. If the clinician wants to use a non-protocol drug, there are pop-ups that illustrate appropriate usage of the drug.

Quote of the Week:

How Close is Too Close with Patients?

"The litmus test for determining the ideal balance in the physician-patient relationship is what I term the 'Waiting Room Rule.' Simply put: Don't do anything in your relationships with your patients that you wouldn't want gossiped about in your waiting room; or publicized on the 6 o'clock news for that matter; or heaven forbid, plastered across social media."

Mary Christ, MD,