Dr Keshav Sharma’s Post

Across cities in India, hospitals and doctors are exploiting patients by promoting unbranded generic medicines sold exclusively at in-campus pharmacies. These medicines are often prescribed under the guise of affordability, but the real motive lies in the kickbacks hospitals and doctors receive from the inflated profit margins. Patients are coerced into purchasing these medicines from the hospital pharmacy, with no transparency about the quality or pricing. This unethical practice undermines the intent of the National Pharmaceutical Pricing Authority (NPPA), whose mandate is to ensure affordable access to essential medicines, and raises questions about the effectiveness of the Ministry of Health and Family Welfare in regulating such scams. Furthermore, insurance companies often turn a blind eye to these practices, suggesting possible collusion, as they avoid questioning inflated billing linked to these medicines. The healthcare system, once a beacon of trust and healing got submerged practices of prescribing unnecessary medical tests for profit. Some doctors, driven by kickbacks from diagnostic labs, exploit patient vulnerability, turning routine consultations into profit-driven ventures. These unwarranted tests not only inflate medical bills but also expose patients to needless anxiety and risks, undermining the very purpose of care. This growing trend erodes trust in the medical profession and transforms healthcare into a monstrous system prioritizing greed over genuine patient welfare. Such practices demand stringent regulation and accountability to restore integrity and compassion in medicine. The result is a systemic failure that erodes public trust in healthcare, disproportionately affecting the financially vulnerable. The system is totally rotten & already stinging ! Modern healthcare is biggest scam which unfolding infront of our eyes & irony is we are gladly part of it being a victim & partner simultaneously !

Below are CBO estimates if Medicare covered GLP-1 for obesity.   In 2026:  2% or 300k eligible Medicare beneficiaries would take GLP-1 $5600/beneficiary annual cost in 2026 totalling $1.68 B If 300,000 people are charged $5600 per year in the first year and $4300 per year eight years later the total cost if reduced linearly per year is $11.88 B. The incremental healthcare cost savings from $50 per year in 2026 to $650 per year in 2034 would result in a total 8-year incremental savings of $840 million (linear over the 8 years) for these 300,000 Medicare beneficiaries if they stayed on for the entire eight years. Conclusion: $11.88 B spend for $840 M incremental healthcare cost savings

The Centers for Medicare & Medicaid Services (CMS) has released the FY 2025 Inpatient Prospective Payment System (IPPS) Final Rule, with a key update focusing on essential medicines for small, independent hospitals. This change is sparking widespread discussion in healthcare. #CMS #Healthcare #IPPS #Medicare #DZA Click to learn more:

📢 Important Update for Medicare Beneficiaries A new pilot program is being introduced that will make select generic drugs available for Medicare recipients at a cost of just $2 per prescription. This initiative is designed to help seniors better manage chronic conditions such as high blood pressure and high cholesterol, while reducing out-of-pocket expenses. The program aims to make healthcare more affordable for Medicare beneficiaries, with the goal of improving medication adherence and overall health outcomes. Stay informed as more details on this rollout become available. https://buff.ly/3Yhpb5p #Medicare #Healthcare #PrescriptionDrugs #AffordableHealthcare

What will be the impact of the #inflationreductionact #IRA on #healthequity and access to high-quality care? Interesting Health Affairs Forefront article today postulating that the answer may be more complicated and nuanced than it would initially seem. Particularly intriguing for me is the hypothesis that Centers for Medicare & Medicaid Services #CMS #performance measures around plan star ratings may inadvertently disadvantage stand-along Part D plans that serve a high fraction of individuals who qualify for the low-income subsidy (LIS). The idea is that medication adherence is a particularly highly weighted component of the star rating metrics, and stand-alone Part D plans that serve a high fraction of LIS beneficiaries may have fewer levers to improve adherence compared to #medicareadvantage plans (which have much stronger ties to the healthcare providers) or compared to plans that serve fewer LIS beneficiaries given their well-documented higher rates of inaccurate or outdated contact information. But then, of course, medication adherence is vital for patient safety and quality of care - and rightfully strongly prioritized in the star ratings. The article certainly raises a lot of food for thought, including: How much choice and competition do we need among stand-alone #Medicare Part D plans? How should we think about the trade-offs between #Medicareadvantage and traditional Medicare, both for individual beneficiaries and from a broader health policy perspective? and What more should #CMS do to stabilize the Part D market in the short, medium, and long term - and who else should be held accountable and/or play a key role?

Improving Hemophilia Care in Tanzania: Key Lessons from Recent Research Recent studies show significant cost disparities in managing hemophilia, with hemophilia B patients facing higher costs and longer hospital stays. In Tanzania, where the average annual income is around USD 1,080, these findings call for urgent action: 1. Cost Management: Hemophilia B treatment can cost up to USD 2,912.81, far exceeding the average income. Better price regulation and efficient procurement are essential. 2. Optimizing Treatment: Address suboptimal use of coagulation factors to ensure effective and affordable treatments. 3. Health Policy: Strengthen drug regulatory management and optimize insurance schemes to reduce the financial burden on patients. 4. Focus on Rare Diseases: Expand healthcare vision to include rare diseases like hemophilia. Without action now, the future healthcare landscape will be overwhelmed. Tanzania must enhance care for hemophilia patients to ensure sustainable public health for all.

I am extremely passionate about drug discovery, development and commercialization of innovation. That is what both the innovative pharmaceutical industry and Canada’s life sciences sector do! It is only by working together across the sector and with government that we can move the needle on industrial and access policies that turn Canada into a G7 leader where investments into innovation and access to these innovations go hand in hand. #HESA #collaboration #HealthyCanadians #healthyeconomy #healthyplanet Innovative Medicines Canada - Médicaments novateurs Canada

CMS Network Adequacy for Medicare, Medicaid, and ASA Plans; Critical Information for Physicians and Health Systems to Know and Report The Centers for Medicare and Medicaid Services finalized the regulation regarding network adequacy standards based on the time and distance patients have to travel for in-network care. Monitoring and reporting network adequacy will be beneficial for patients. So it goes n8 #valuebasedcare #healthinsurance #medicareadvantage #hospitals #physicians #healthsystems  Information for annual network adequacy for MA plans is available below: CY 2024 MMP Health Service Delivery (HSD) Network Adequacy Standards Criteria Reference Table (XLSX)

Outgoing US President Joe Biden has proposed a dramatic expansion of Medicare coverage of #obesity drugs; though it remains to be seen if it will survive under Donald Trump's new administration. #healthcare #healthcarecosts #medicare #medicaid #medicarecoverage #regulatoryaffairs #obesitymedicine #zepbound #wegovy #weightmanagement #diabetes #cardiovascularhealth

Detailed review of the MA and Part D rule - check it out