Manatt Professional Interviewed on Future of Biologics in Healthcare Reform

“How Will Biologics Fit Into Healthcare Reform?”
Biotechnology Healthcare

December 1, 2011 – Manatt’s Ian Spatz, a senior advisor in the firm’s Healthcare Division, was interviewed by Biotechnology Healthcare for insight into how biologics and other specialty drugs will be affected by healthcare reform.

Biotechnology Healthcare, a publication covering the impact of biologics on health, business and benefits, reports that industry observers are concerned about whether health insurers will be able to maintain current levels of coverage for biologics after the healthcare reform mandates take effect. Several provisions of the Patient Protection and Affordable Care Act are intended to keep insurance premiums down, which raises the question of whether costly specialty drugs will be considered an essential health benefit.

“The law says that pharmaceuticals have to be covered. Well, what does that mean? Which pharmaceuticals? When do they have to be covered? What’s the cost-sharing related to their coverage?” asks Spatz.

“If you’re producing a cholesterol-lowering medicine, there’s a good chance it’s going to be covered,” added Spatz. “But what if it is a new, expensive treatment — let’s say for cancer where there hasn’t been a lot of proof of its life-extending or curative powers?”

Spatz also told the publication he thinks a lot of discretion regarding the scope of affordable coverage will be left to the state health benefit exchanges. He thinks that healthcare reform will not impose “a complete, top-down, command-and-control effort that specifies the same content for every plan in the United States.”

Read the article here.