The New Era of Healthcare Reform - Supporting Revenue Growth through Understanding and Adaptation

The New Era of Healthcare Reform - Supporting Revenue Growth through Understanding and Adaptation

Summary

After a hotly contested national debate, healthcare reform legislation was passed in the spring of 2010. The legislation contains many long-term benefits for the pharmaceutical industry, but the industry must continue to play an active role in legislation implementation to ensure those benefits are realized.

Through the new laws, there are both wins and losses for the pharmaceutical industry, such as changes effecting Medicare/Medicaid, health insurance coverage expansion & protection, taxation and patent protection. However, on balance most changes hold significant long-term potential for the industry.

While pharma played a very important role in promoting health reform during the debate over change, the work is not done. Many of the greatest potential benefits of the legislation – including extending healthcare coverage to 32 million more Americans – will come down the road. Thus, it is crucial for pharma to remain involved with the healthcare reform roll-out going forward.

Scope

- Background to the Patient Protection and Affordable Care Act of 2010
- Wins and losses for the pharma industry – Medicare, Medicaid, coverage protection and expansion
- Next steps in terms of implementation
- Impact on protections, costs, taxes and coverage expansion

Reasons to buy

- Analyze the possible impact that the new healthcare reform legislation could have on your company’s future growth potential
- Assess the role pharmaceutical companies need to play to best ensure that all potential benefits are actually realized
- Learn the pitfalls for the pharmaceutical industry to avoid as the new legislation is rolled-out
- Identify the opportunities for growth in the new reform environment
- Understand the ways the new healthcare reform bill can help change how healthcare is delivered in the United States

Executive Summary

Introduction
Background to the Patient Protection and Affordable Care Act of 2010
Timeline for Reform

Wins and Losses for Pharma
Costs for the Pharmaceutical Industry

Taxation of “Cadillac” Plans

Medicare and Medicaid
Medicare Part D
Medicaid Rebates
Rewarding and Punishing Outcomes

Coverage Expansion
Marketplace Exchanges
Pre-existing Conditions
Early Retirement and Young Adults

Wins and Losses for Pharma (continued)
Coverage Protection
Ending Rescissions and Caps
Clinical Trial Participation

Preventative Care and Accessibility

Patent Protection for Biologics

Biomedical Research Tax Credits

Greater Transparency for Insurance Companies

What Isn’t in the Act
Comparative Effectiveness Research Requirements
Drug Importation
Pay for Delay Ban
Extended Hospital Drug Discount

What Pharma Needs to Do Now
Changing the Way the US Delivers Healthcare
Paying per Procedure to Paying per Outcome
Provider Shortfall
Shifting to Preventative Medicine
What Pharma Needs to Do Now (continued)
Implementation at the State Level
Marketplace Exchanges

Immediate vs. Longer-Term Impacts
Protections
Costs
Taxes and Coverage Expansion

Fall Elections and Public Perceptions

Appendix