As Part of a Comprehensive, Bipartisan Report on the High Cost of Hep C Drugs, Senior Finance Members Collected Data on Drug Costs, Prescription Volume, and Patients Treated in All 50 States, D.C.

 

State Medicaid Programs Imposed Access Restrictions Due to Budget Constraints, Yet Sovaldi Still Dominated Drug Spending

WASHINGTON - An investigation released earlier this month by Senate Finance Committee Ranking Member Ron Wyden, D-Ore., and Senator Chuck Grassley, R-Iowa, a senior member of the committee, demonstrated the significant financial impact that Gilead Sciences Inc.'s hepatitis C drug Sovaldi and its follow-on drug Harvoni had on state Medicaid programs during 2014, their first year on the market. As a part of the investigation, the senators assembled a comprehensive Medicaid data set based on state-reported data, which is highlighted in detail below. The senators also released today new data on the top 25 state-reported Medicaid drug expenditures, found in the table below.

The 18-month investigation found that because of Sovaldi's high price and Gilead's initial refusal to provide substantial discounts, Medicaid programs were only able treat 2.4% of some 700,000 enrollees infected with the disease, despite spending more than $1 billion on the drug during calendar year 2014, according to state-reported data.

Data provided by state Medicaid programs from all 50 states and the District of Columbia show that Sovaldi ranked among the top five pharmaceutical spending items for 33 different state Medicaid programs. Fourteen states reported that Sovaldi was the top pharmaceutical cost for their fee-for-service (FFS), managed care (MCO), or combined programs. Fifteen more reported Sovaldi was the second highest cost. Four more states reported that Sovaldi ranked third, fourth or fifth in their pharmaceutical spending in 2014. (page 84 of report)

The data provides a state-by-state breakdown of how much state Medicaid programs reported spending on Sovaldi and Harvoni, and where spending on the drugs ranked in comparison to spending on other medications. It also shows the reported prescription count and number of patients treated.

Appendix A of the report aggregated individual states' reported data on spending, prescription and patient recipients, as well as landmark state-reported estimates of Medicaid enrollees infected with Hepatitis C and whether states agreed to supplemental discounts with Gilead for Sovaldi. Appendix A is available in interactive spreadsheet form here. Details on how that data was collected and organized can be found here.

In addition, the senators highlighted letters from 10 states detailing how Sovaldi's high price affected their budgets, providing additional details in several instances, and explaining how their requests that Gilead offer more significant discounts were unsuccessful. Letters included in today's release are from Arizona, California, Florida, Iowa, Kentucky, Ohio, Oregon, Pennsylvania, Texas and Washington.

Gilead's own documents show that nine months after Sovaldi's release, the company analyzed the impact Sovaldi was having on Medicaid programs, concluding that half of state Medicaid programs were "limiting coverage to the sickest patients" and that budget concerns were leading to "strict management" of the drugs availability to enrolled patients. (page 99)

Staff also visualized Medicaid data in a nationwide map, found below. The map examines the percentage of state-reported Medicaid patients with hepatitis C receiving Sovaldi, as well as Sovaldi's rank for each state's Medicaid prescription drug spending.

DAVENPORT, Iowa - Dec. 14, 2015 - Genesis Medical Center, Davenport has again attained Magnet® recognition as part of the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program®.

This credential is the highest honor an organization can receive for professional nursing practice.  This voluntary credentialing program for hospitals recognizes excellence in nursing.

Genesis Medical Center Davenport previously attained Magnet® designation in 2005 and 2010.

"Magnet® recognition is a tremendous honor and reflects our commitment to delivering the highest quality of care to this community," said Jackie Anhalt, vice president of patient services and chief nursing executive, Genesis Health System.  "To earn Magnet® recognition twice previously was a great accomplishment and an incredible source of pride for our nurses. Our achievement of this credential for an additional four years underscores the foundation of excellence and values that drives our entire staff to strive harder each day to meet the healthcare needs of the people we serve."

Magnet® recognition has become the gold standard for nursing excellence and is taken into consideration when the public judges healthcare organizations. In fact, U.S. News & World Report's annual showcase of "America's Best Hospitals" includes Magnet® recognition in its ranking criteria for quality of inpatient care.

To achieve initial Magnet® recognition, organizations must pass a rigorous and lengthy process that demands widespread participation from leadership and staff. The process begins with the submission of an electronic application, followed by written documentation demonstrating qualitative and quantitative evidence regarding patient care and outcomes.  If scores from the written documentation fall within a range of excellence, an on-site visit will occur to thoroughly assess the applicant.  After this rigorous onsite review process, the Commission on Magnet® will review the completed appraisal report and vote to determine whether Magnet recognition will be granted.

An organization seeking to reapply for Magnet® recognition must provide documented evidence of how Magnet concepts, performance, and quality were sustained and improved over the four-year period since the hospital received its most recent recognition.

In particular, the Magnet® model is designed to provide a framework for nursing practice, research, and measurement of outcomes.  Through this framework, ANCC can assess applicants across a number of components and dimensions to gauge an organization's nursing excellence.  The foundation of this model is composed of various elements deemed essential to delivering superior patient care.  These include the quality of nursing leadership and coordination and collaboration across specialties, as well as processes for measuring and improving the quality and delivery of care.

Magnet® recognition has been shown to provide specific benefits to hospitals and their communities, such as:

• Higher patient satisfaction with nurse communication, availability of help, and receipt of discharge information;

• Lower risk of 30-day mortality and lower failure to rescue;

• Higher job satisfaction among nurses;

• And, lower nurse reports of intentions to leave position.

"We're a better institution today because of the Magnet® recognition we achieved four years ago," Anhalt added. "Magnet® has raised the bar for patient care and inspired every member of our team to achieve excellence every day. It is this commitment to providing our community with high quality care that helped us become a Magnet® facility, and it's why we continue to serve as a Magnet hospital today."

Genesis Medical Center, Davenport is in a select group of 378 healthcare organizations out of nearly 6,000 U.S. healthcare organizations to earn Magnet® designation.

Genesis Medical Center, Davenport was initially designated a Magnet® hospital in 2005. Hospitals must reapply for Magnet® recognition every four years based on adherence to Magnet® concepts and demonstrated improvements in patient care and quality.

About Genesis Medical Center, Davenport

For nearly 150 years Genesis Medical Center, Davenport and its predecessors have provided compassionate, quality care to all those in need in the Quad Cities and surrounding areas. Genesis Medical Center, Davenport provides comprehensive acute care and outpatient services. Genesis Medical Center, Davenport has been recognized at the top-ranked community hospital in Iowa twice - 2014 and 2015 -- by U.S. News and World Report Best Hospitals.

About the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program®

The Magnet Recognition Program® administered by the American Nurses Credentialing Center (ANCC), the largest and most prominent nurses credentialing organization in the world, recognizes healthcare organizations that provide the very best in nursing care and professionalism in nursing practice. The Magnet Recognition Program® serves as the gold standard for nursing excellence and provides consumers with the ultimate benchmark for measuring quality of care. For more information about the Magnet Recognition Program® and current statistics, visit www.nursecredentialing.org/magnet.

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Davenport, Iowa (December 09, 2015) - The Scott County Sheriff's Office has taken a pledge to keep tobacco, alternative nicotine and vapor products out of the hands of Scott County youth.

Known as I-PLEDGE, the program is a partnership with the Iowa Alcoholic Beverages Division (ABD) to educate local retailers and to enforce Iowa's tobacco, alternative nicotine and vapor product laws. Due to a change in Iowa law, alternative nicotine and vapor products are now considered age-restricted products and will be part of the I-PLEDGE program's compliance initiatives this year. Since the program's inception in 2000, the statewide tobacco compliance rate has grown to 93%. By participating in the program, the Sheriff's Office has committed to do its part to increase the compliance rate even more this year.

I-PLEDGE places emphasis on retailer training. Clerks who successfully complete an online training course and then pass an exam will become I-PLEDGE certified. This allows a retail establishment to use an affirmative defense against a civil penalty if the certified clerk makes an illegal sale. Although not required to retake the training if currently certified, ABD encourages clerks to repeat the training after October 3rd, in order to familiarize themselves with the newly age-restricted products.

"I-PLEDGE's retailer training is a great way for clerks to prepare themselves to refuse illegal tobacco, alternative nicotine and vapor product sales," Sheriff Dennis Conard said. "The training also assists retailers to ensure they maintain a compliant and responsible establishment."

Deputies will also be conducting compliance checks on local establishments as part of the I-PLEDGE program. Underage customers, under the supervision of law enforcement officials, will enter establishments and attempt to buy tobacco, alternative nicotine and vapor products. Clerks who make the illegal sale will be cited on the spot.

Criminal penalties for selling tobacco, alternative nicotine and vapor products to a minor include a $100 fine for a first offense, a $250 fine for a second offense and a $500 fine for third and subsequent offenses. However, handing out citations is not the intent of the I-PLEDGE program.

"By partnering with the Iowa Alcoholic Beverages Division, we hope to educate clerks and maintain a compliant retail environment in our community," Sheriff Conard said. "Moreover, we pledge to help keep tobacco, alternative nicotine and vapor products out of the hands of Iowa's youth."

To take the I-PLEDGE training or search certification records go to www.iowaabd.com.

The Be Healthy QC Worksite Wellness Workgroup of the Quad City Health Initiative (QCHI) is pleased to celebrate the first anniversary of its Be Healthy QC Workplace Recognition Program and identify the new organizations that have been recognized. This program was designed to highlight the work of local businesses and organizations and bring awareness to workplace wellness. By highlighting organizations that create a healthier workplace, the Be Healthy QC Worksite Wellness Workgroup strives to create an overall culture of health within the community. The latest organizations to receive recognition are Augustana College, the City of Bettendorf, the City of Davenport, Family Resources Inc., Pleasant Valley School District, QCR Holdings/Quad City Bank and Trust, Rock Valley Physical Therapy, U.P.S., U.S. Army Sustainment Command and the Waste Commission of Scott County. Since the program's inception in November of 2014, a total of 17 organizations have been recognized.

All organizations interested in applying for recognition are invited to complete the "Be Healthy QC: Creating a Healthy Workplace Assessment". The brief assessment identifies worksites in Rock Island and Scott Counties that are choosing to implement evidence based best practices promoting physical activity, nutrition, tobacco cessation and/or overall employee health and well-being. The assessment is intended to be completed by human resource or administrative staff at worksites in the Quad Cities. Instructions and the assessment can be found at www.qchealthinitiative.org under "Our Projects - Be Healthy QC Coalition".

The Be Healthy QC Coalition seeks to align all sectors of our bi-state community and work together on program, policy, systems and environmental changes in order to create a "culture of wellness" that supports healthy eating and active living.

This work is supported by the Quad City Health Initiative, a cross-sector partnership working to create a healthy community since 1999. The Quad City Health Initiative creates collaborative action on health and abides by the core values of commitment, collaboration and creativity. The Initiative seeks to be our community's recognized leader for creating collaborative action on health and abides by the core values of commitment, collaboration and creativity. Major financial support of the Quad City Health Initiative is currently provided by the generous direct and in-kind investments of Genesis Health System and UnityPoint Health-Trinity. Additional financial support is provided by Deere & Company, Mississippi Valley Health, KJWW Engineering Consultants, Davenport Eye Group, Modern Woodmen of America, Community Health Care, ILLOWA Construction and Labor Management Council, United Way of the Quad Cities Area, Hy-Vee, Inc., QCR Holdings, Inc., Quad Cities Chamber of Commerce, Scott County Family Y, Scott County Health Department, and Rock Island County Health Department.

For more information, please call 563-421-2815 or visit our website at www.qchealthinitiative.org or www.behealthyqc.org.