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New postings and analysis from Health Affairs, the leading journal of health policy. Health Affairs publishes new research each week online at For more information, contact Chris Fleming at 301-347-3944.

September/October Health Affairs Focuses On Biopharmaceuticals

An analysis in the new issue of Health Affairs, by Jennifer Bowman and colleagues at Avalere Health, reveals that virtually all of the 3,000 Medicare Part D plans cover most cancer drugs, generally with low copayments. But some cancer drugs -- particularly brand names -- require prior authorization from a physician before the pharmacist can fill the prescription, potentially limiting access.

Bowman's study is one of the many peer-reviewed papers in the September/October 2006 Health Affairs, released Sept. 12 and titled "Biotech Drugs Come Of Age," that deal with matters relating to the use and coverage of biopharmaceuticals.

Print editions of Health Affairs may be ordered for $35 each from Health Affairs' Customer Service at 301-347-3900 or online at

Mass. Health Reform: Great Potential, But Significant Challenges Remain

Massachusetts' plan to move toward universal coverage represents an impressive political achievement, and the plan's policy innovations offer important lessons to other states. However, the true significance of the Massachusetts experiment will become clear only after the state addresses daunting implementation challenges over the next several years. That's the verdict delivered by the two lead papers of a six-paper package on the Massachusetts experience published September 14 on the Health Affairs Web site. John McDonough, executive director of the Boston-based Health Care For All, teams with three colleagues from that organization to provide a comprehensive look at the important events and key players involved in the plan's package. John Holahan and Linda Blumberg (Urban Institute) survey the issues Massachusetts will have to address as it seeks to turn its path-breaking plan into reality. The six papers on Masschusetts' reform are available free on Health Affairs' Web site until September 28.

Public Assistance Workforce Might Not Meet Expected Demand

As the use of biopharmaceuticals spreads beyond rare diseases and academic subspecialists to more common conditions and community practices, health plans are attempting to manage these drugs through strategies such as medical management (formulary placement and prior authorization), network design (physician contracting arrangements and distribution of biopharmaceuticals through specialty pharmaceutical firms), and benefit design (coinsurance and annual payment limits). University of California, Berkeley, economist James Robinson says in the Sept./Oct. Health Affairs that these strategies have the potential to improve the manner in which biopharmaceuticals are prescribed, purchased, and used, but he cautions that health plans "cannot serve as society's fulcrum for comparing and balancing the cost and quality of novel therapeutics."


Health Affairs, published by Project HOPE, is the leading journal of health policy. The nonpartisan, peer-reviewed journal appears bimonthly in print, with additional online-only papers published weekly as Health Affairs Web Exclusives at The full text of each Health Affairs Web Exclusive is available free of charge to all Web site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. The abstracts of all articles are free. The Sept./Oct. 2006 issue was supported principally by the Blue Shield of California Foundation with additional support from Amgen and Genentech. Web Exclusives are supported in part by a grant from the Commonwealth Fund.


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Health Affairs gratefully acknowledges the support of Health Care Update News Service in the dissemination of this e-alert.