potential Fifa 20 best young players: 100 wonder kids in career mode, future stars, cheap signings with best potential By www.standard.co.uk Published On :: 2020-05-08T09:37:00Z Has there been a better time to start a FIFA 20 career mode and lead a generation of young footballers along the road to glory? Full Article
potential Fifa 20 best young players: 100 wonderkids in career mode, future stars, cheap signings with best potential By www.standard.co.uk Published On :: 2020-05-06T05:07:00Z What better time to start a FIFA 20 career mode and lead a generation of young footballers along the road to glory? Full Article
potential Fifa 20 best young players: 100 wonderkids in career mode, future stars, cheap signings with highest potential By www.standard.co.uk Published On :: 2020-05-04T10:38:00Z Football across the globe is on hold, so it seems the perfect moment to load up a new FIFA 20 career mode save. Full Article
potential Police chief refuses to tell Parliament about secret spyware with potential to target Aussie smartphones By www.abc.net.au Published On :: Thu, 24 Oct 2019 09:49:00 +1100 NSW Police has refused to reveal if defence lawyers are being spied on with electronic surveillance as part of criminal investigations. Full Article ABC Radio Sydney canberra southeastnsw sydney Government and Politics:All:All Law Crime and Justice:Police:All Science and Technology:Computers and Technology:Internet Science and Technology:Information Technology:All Australia:ACT:Parliament House 2600 Australia:NSW:Bega 2550 Australia:NSW:Sydney 2000 Egypt:All:All Ethiopia:All:All
potential 'Meanwhile use' properties offer potential as a short-term solution to social housing needs By www.abc.net.au Published On :: Fri, 01 Nov 2019 08:54:00 +1100 A vacant Sydney nursing home awaiting redevelopment has been lent to a women's shelter as transitional housing, with the concept of 'meanwhile use' housing acclaimed by experts. Full Article ABC Radio Sydney sydney Community and Society:Domestic Violence:All Community and Society:Homelessness:All Government and Politics:All:All Government and Politics:Housing:All Government and Politics:Social Policy:All Australia:NSW:Beecroft 2119
potential CFL, CFLPA resume talks on potential contingency plans for 2020 season By www.thestar.com Published On :: Fri, 8 May 2020 18:55:33 EDT CFL commissioner Randy Ambrosie said the CFL lost collectively about $20 million last year and its future is “very much in jeopardy.” Full Article
potential Rams' potential replacements for Greg Zuerlein have made big kicks, just not in NFL By www.latimes.com Published On :: Wed, 6 May 2020 22:56:20 -0400 Kickers Lirim Hajrullahu and Austin MacGinnis welcome the challenge of a three-man competition with Rams draft pick Sam Sloman to replace Greg Zuerlein. Full Article
potential Potentially fatal combinations of humidity and heat are emerging across the globe By www.eurekalert.org Published On :: Fri, 08 May 2020 00:00:00 EDT A new study has identified thousands of incidents of previously rare or unprecedented extreme heat/humidity combinations in parts of Asia, Africa, Australia, South America and North America, including in the US Gulf Coast region. Full Article
potential Plasma medicine research highlights antibacterial effects and potential uses By www.eurekalert.org Published On :: Fri, 08 May 2020 00:00:00 EDT As interest in the application of plasma medicine -- the use of low-temperature plasma (LTP) created by an electrical discharge to address medical problems -- continues to grow, so does the need for research advancements proving its capabilities and potential impacts on the health care industry. Across the world, many research groups are investigating plasma medicine for applications including cancer treatment and the accelerated healing of chronic wounds, among others. Full Article
potential VE Day celebrations and potential lockdown easing lead the papers By www.itv.com Published On :: Sat, 09 May 2020 02:13:24 +0100 Saturday’s papers are dominated by the 75th anniversary of VE Day. Full Article
potential Johnson's hospitalisation exposes potential flaw in the British system By www.brisbanetimes.com.au Published On :: Fri, 10 Apr 2020 12:55:02 GMT There is now a leadership vacuum in Britain at a time when some of the most important decisions in the nation’s history will need to be made. Full Article
potential Potential of Ayurveda should not be ignored in the fight against COVID─19: Dr Saravadekar By pharmabiz.com Published On :: 20200505080002 Full Article
potential Pune's Ayush CoE, CRD & Dr DY Patil Univ to propel possible potential of Ayurveda─Yoga as preventive medicine for COVID─19 By pharmabiz.com Published On :: 20200506080002 Full Article
potential FTSE 100 boosted amid optimism over potential coronavirus drug By www.theguardian.com Published On :: 2020-04-17T12:20:43Z Stock index up more than 3% in early trading on the back of hopes for remdesivir treatmentOptimism about a potential treatment for Covid-19 gave a shot in the arm to stock markets around the world, amid claims that a drug called remdesivir has spurred rapid recovery in 113 patients.A University of Chicago hospital participating in a study of the antiviral medication, made by US firm Gilead Sciences, found that nearly all patients suffering severe fever and respiratory symptoms were discharged within a week. A report of the study, issued by specialist healthcare publication Stat News shortly after Wall Street closed on Thursday night, spurred hopes among investors that lockdowns around the world could soon be eased. Continue reading... Full Article Coronavirus outbreak FTSE Stock markets Business Chicago Medical research World news US news Pharmaceuticals industry Infectious diseases Microbiology Biology Science
potential Researchers studying heartburn drug as potential coronavirus treatment By www.pharmafile.com Published On :: Mon, 27 Apr 2020 10:42:23 +0000 Researchers in America have been studying famotidine, the active ingredient in Pepcid, as a potential treatment for COVID-19. Full Article coronavirus COVID-19 pandemic Pepcid Sales and Marketing
potential AstraZeneca joins forces with University of Oxford to develop and manufacture potential coronavirus vaccine By www.pharmafile.com Published On :: Thu, 30 Apr 2020 11:05:49 +0000 A “landmark” partnership has been struck between AstraZeneca and the University of Oxford in the ongoing battle against COVID-19, with the former agreeing to aid in the development and large-scale manufacture of the latter’s potential recombinant adenovirus vaccine for the prevention of novel coronavirus infection. Full Article Research and Development Manufacturing and Production
potential Supercomputer simulations present potential active substances against coronavirus By www.pharmanews.eu Published On :: Tue, 05 May 2020 10:00:00 +0200 Several drugs approved for treating hepatitis C viral infection were identified as potential candidates against COVID-19, a new disease caused by the SARS-CoV-2 coronavirus. This is the result of research based on extensive calculations using the MOGON II supercomputer at Johannes Gutenberg University Mainz (JGU). One of the most powerful computers in the world, Full Article Featured Research Research & Development
potential Biogen gears up Swiss manufacturing facility for potential aducanumab rollout By www.fiercepharma.com Published On :: Thu, 07 May 2020 14:51:06 +0000 Biogen has had a rocky road with its controversial Alzheimer's disease candidate aducanumab, resurrected late last year. But despite postponing the drug's FDA filing half a year, Biogen is still moving forward with plans to scale up production if aducanumab eventually passes muster. Full Article
potential Departments of Justice and Education Reach Settlement with Arizona Department of Education to Ensure That Potential ELL Students Are Properly Identified By www.justice.gov Published On :: Fri, 25 Mar 2011 16:44:31 EDT The Department of Justice’s Civil Rights Division and the Department of Education’s Office for Civil Rights today entered into a settlement agreement with the Arizona Department of Education (ADE) to ensure that Arizona’s English Language Learner (ELL) students receive the educational services that they need. Full Article OPA Press Releases
potential Remarks as Prepared for Delivery by Assistant Attorney General Lanny A. Breuer at Public Hearing on Potential Regulation to Strengthen Anti-Money Laundering Safeguards By www.justice.gov Published On :: Tue, 31 Jul 2012 13:29:49 EDT "This rulemaking presents an important opportunity to close a gap in our financial regulations that makes it easier for criminals to move illicit proceeds through the United States financial system," said Assistant Attorney General Breuer. Full Article Speech
potential Obama Administration Announces a Coordinated Effort to Protect Consumers by Preventing and Detecting Potential Fraud in the Health Insurance Marketplace By www.justice.gov Published On :: Wed, 18 Sep 2013 12:10:18 EDT Attorney General Eric Holder, Health and Human Services (HHS) Secretary Kathleen Sebelius, and Federal Trade Commission (FTC) Chairwoman Edith Ramirez met at the White House to kick off a comprehensive interagency initiative to prevent, protect against, and where necessary prosecute consumer fraud and privacy violations in the Health Insurance Marketplace. Full Article OPA Press Releases
potential Statement of Mythili Raman Acting Assistant Attorney General U.s. Justice Department Criminal Division Before the Committee on Homeland Security and Governmental Affairs United States Senate for a Hearing Entitled “Beyond the Silk Road: Potential Risks, T By www.justice.gov Published On :: Mon, 18 Nov 2013 16:48:58 EST Chairman Carper, Ranking Member Coburn, and distinguished Members of the Committee: Thank you for the opportunity to appear before the Committee today to discuss the Department of Justice’s work regarding virtual currencies. Full Article OPA Press Releases
potential Gathering in Putrajaya Opens Year of Optimizing Human Potential By www.apec.org Published On :: Thu, 20 Feb 2020 10:35:00 +0800 The first Senior Officials Meeting for APEC Malaysia 2020 begins Full Article
potential Tapping the Economic Potential of Women By www.apec.org Published On :: Mon, 09 Mar 2020 06:00:00 +0800 La Serena Roadmap for Women and Inclusive Growth to bolster progress Full Article
potential Ajinomoto to produce potential COVID-19 treatment for CytoDyn By www.biopharma-reporter.com Published On :: Tue, 05 May 2020 15:16:00 +0100 Ajinomoto agrees partnership to manufacture leronlimab, which is currently undergoing clinical trials for the treatment of COVID-19. Full Article Bio Developments
potential COVID-19: T cells offer clues to the potential power of Roche's Actemra By www.fiercebiotech.com Published On :: Fri, 01 May 2020 11:56:40 +0000 The successful activation of T cells is critical to the immune system's ability to clear infections. A retrospective study in China found that COVID-19 patients had remarkably low T-cell counts in their blood, while some pro-inflammatory cytokines such as IL-6—which Roche’s Actemra targets—were elevated. Full Article
potential Harnessing the potential of multimodal radiotherapy in prostate cancer By feeds.nature.com Published On :: 2020-05-01 Full Article
potential The transient receptor potential vanilloid 4 (TRPV4) ion channel mediates protease activated receptor 1 (PAR1)-induced vascular hyperpermeability By feeds.nature.com Published On :: 2020-04-27 Full Article
potential Considering mutational meltdown as a potential SARS-CoV-2 treatment strategy By feeds.nature.com Published On :: 2020-04-06 Full Article
potential The untapped potential of ascites in ovarian cancer research and treatment By feeds.nature.com Published On :: 2020-05-08 Full Article
potential Potential through simplicity: thymidine kinase-1 as a biomarker for CDK4/6 inhibitors By feeds.nature.com Published On :: 2020-05-08 Full Article
potential TMB: a promising immune-response biomarker, and potential spearhead in advancing targeted therapy trials By feeds.nature.com Published On :: 2020-04-28 Full Article
potential Biallelic mutations in <i>SORD</i> cause a common and potentially treatable hereditary neuropathy with implications for diabetes By feeds.nature.com Published On :: 2020-05-04 Full Article
potential Bioinformatic prediction of potential T cell epitopes for SARS-Cov-2 By feeds.nature.com Published On :: 2020-05-06 Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential Using physiologically-based pharmacokinetic modeling to assess the efficacy of glove materials in reducing internal doses and potential hazards of N-methylpyrrolidone during paint stripping By feeds.nature.com Published On :: 2020-03-09 Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential Harvard Project on Climate Agreements Hosts COP25 Panel on Realizing the Potential of Article 6 By www.belfercenter.org Published On :: Dec 12, 2019 Dec 12, 2019A highly engaged and well-informed audience filled the Pavilion of the International Emissions Trading Association at the 25th United Nations Climate Change Conference (COP25) on December 11 in Madrid to hear from an expert panel about the current state of negotiations on linkage, international cooperation, and the Paris Agreement. The discussion, “Realizing the Potential of Article 6,” was hosted by the Harvard Project on Climate Agreements (HPCA) and moderated by HPCA Director Professor Robert Stavins. Full Article
potential The Potential Promises and Pitfalls of Solar Geoengineering: An Interview with David Keith By www.belfercenter.org Published On :: Feb 7, 2020 Feb 7, 2020Professor Robert Stavins interviews David Keith, Gordon McKay Professor of Applied Physics at the Harvard John A. Paulson School of Engineering and Applied Sciences, and Professor of Public Policy at Harvard Kennedy School, considered one of the world's leading scholars on solar geoengineering. Full Article
potential Harvard Professor David Keith Discusses Potential Promises and Pitfalls of Solar Geoengineering in New Episode of "Environmental Insights" By www.belfercenter.org Published On :: Feb 7, 2020 Feb 7, 2020David Keith, Gordon McKay Professor of Applied Physics at the Harvard John A. Paulson School of Engineering and Applied Sciences, and Professor of Public Policy at Harvard Kennedy School, discussed his groundbreaking research and policy work in the field of solar geoengineering in the newest episode of “Environmental Insights: Discussions on Policy and Practice from the Harvard Environmental Economics Program.” Listen to the interview here. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By www.belfercenter.org Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential The Past and Potential Role of Civil Society in Nuclear Security By feedproxy.google.com Published On :: Feb 10, 2020 Feb 10, 2020Civil society has played a very important role in nuclear security over the years, and its role could be strengthened in the future. Some nuclear organizations react against the very idea of civil society involvement, thinking of only one societal role—protesting. In fact, however, civil society has played quite a number of critical roles in nuclear security over the years, including highlighting the dangers of nuclear terrorism; providing research and ideas; nudging governments to act; tracking progress and holding governments and operators accountable; educating the public and other stakeholders; promoting dialogue and partnerships; helping with nuclear security implementation; funding initial steps; and more. Funding organizations (both government and non-government) should consider ways to support civil society work and expertise focused on nuclear security in additional countries. Rather than simply protesting and opposing, civil society organizations can help build more effective nuclear security practices around the world. Full Article
potential A controversial new demonstration in Medicare: Potential implications for physician-administered drugs By webfeeds.brookings.edu Published On :: Tue, 03 May 2016 12:56:00 -0400 According to an August 2015 survey, 72 percent of Americans find drug costs unreasonable, with 83 percent believing that the federal government should be able to negotiate prices for Medicare. Recently, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) Andy Slavitt commented that spending on medicines increased 13 percent in 2014 while health care spending growth overall was only 5 percent, the highest rate of drug spending growth since 2001. Some of the most expensive drugs are covered under Medicare’s medical benefit, Part B, because they are administered by a physician. They are often administered in hospital outpatient departments and physician offices, and most commonly used to treat conditions like cancer, rheumatoid arthritis, and macular degeneration. Between 2005 and 2014, spending on Part B drugs has increased annually by 7.7 percent, with the top 20 drugs by total amount of Medicare payments accounting for 57 percent of total Part B drug costs. While overall Part B drug spending is a small portion of Medicare drug spending, the high growth rate is a concern, especially as new expensive breakthrough cancer drugs enter the market and have a negative effect on consumers’ pockets. Unlike Part D, the prescription drug benefit, there are fewer incentives built in to Part B for providers to consider lower cost treatments for patients even if the lower cost drug may be clinically equivalent to the more expensive drug, because prior to budget sequestration, providers received 6 percent on top of the Average Sales Price (ASP) of the drug. Larger providers and hospitals often receive discounts on these drugs as well, increasing the amount they receive directly on top of the out-of-pocket cost of the drug. This leads to more out-of-pocket costs for the consumer, as patients usually pay 20 percent of Part B services. The Government Accountability Office (GAO) estimated that in 2013, among new drugs covered under Part B, nearly two-thirds had per beneficiary costs of over $9,000 per year, leading to out-of-pocket costs for consumers of amounts between $1,900 and $107,000 over the year. On top of these high costs, this can lead to problems with medication adherence, even for serious conditions such as cancer. A New Payment Model To help change these incentives and control costs, CMS has proposed a new demonstration program, which offers a few different reimbursement methods for Part B drugs. The program includes a geographically stratified design methodology to test and evaluate the different methods. One of the methods garnering a lot of attention is a proposal to lower the administration add-on payment to providers, from current 6 percent of ASP, to 2.5 percent plus a flat fee of $16.80 per administration day. Policymakers, physician organizations, and patient advocacy organizations have voiced major concerns raising the alarm that this initiative will negatively affect patient access to vital drugs and therefore produce poorer patient outcomes. The sequester will also have a significant impact on the percentage add on, reducing it to closer to an estimated .86 percent plus the flat fee. But we believe the goals of the program and its potential to reduce costs represent an important step in the right direction. We hope the details can be further shaped by the important communities of providers and patients who will deliver and receive medical care. Geographic Variation Last year, we wrote a Health Affairs Blog that highlighted some of the uses and limitations of publicly available Part B physician payment data. One major use was to show the geographic variation in practice patterns and drug administration, and we particularly looked at the difference across states in Lucentis v. Avastin usage. As seen in Exhibit 1, variation in administration is wide among states, even though both are drugs used to treat the same condition, age-related macular degeneration, and were proven to have clinically similar outcomes, but the cost of Lucentis was $2,000 per dose, while Avastin was only $50 per dose. Using the same price estimates from our previous research, which are from 2012, we found that physician reimbursement under the proposed demonstration would potentially change from $120 to $66.80 for Lucentis, and increase from $3 to $18.05 for Avastin. Under the first payment model, providers were receiving 40 times as much to administer Lucentis instead of Avastin, while under the new proposed payment model, they would only receive 3.7 times as much. While still a formidable gap, this new policy would have decreased financial reimbursement for providers to administer Lucentis, a costly, clinically similar drug to the much cheaper Avastin. As seen in Exhibit 1, a majority of physicians prescribe Avastin, thus this policy will allow for increased reimbursement in those cases, but in states where Lucentis is prescribed in higher proportions, prescribing patterns might start to change as a result of the proposed demonstration. Source: Author’s estimates using 2012 CMS Cost Data and Sequestration Estimates from DrugAbacus.org The proposed demonstration program includes much more than the ASP modifications in its second phase, including: discounting or eliminating beneficiary copays, indication-based pricing that would vary payments based on the clinical effectiveness, reference pricing for similar drugs, risk-sharing agreements with drug manufacturers based on clinical outcomes of the drug, and creating clinical decision tools for providers to help develop best practices. This is all at the same time that a new model in oncology care (OCM) is being launched, which could help to draw attention to total cost of care. It is important that CMS try to address rising drug costs, but also be sure to consider all relevant considerations during the comment period to fine-tune the proposal to avoid negative effects on beneficiaries’ care. We believe CMS should consider offering a waiver for organizations already participating in Center for Medicare & Medicaid Innovation (CMMI) models like the OCM, because financial benchmarks are based on past performance and any savings recognized in the future could be artificial, attributable to this demonstration rather than to better care coordination and some of the other practice requirements that are part of the proposed OCM. Furthermore, because this demonstration sets a new research precedent and because it is mandatory in the selected study areas rather than voluntary, CMS must try to anticipate and avoid unintended consequences related to geographic stratification. For example, it is possible to imagine organizations with multiple locations directing patients to optimal sites for their business. Also, without a control group, some findings may be unreliable. The proposed rule currently lacks much detail, and there does not seem to be enough time for organizations to evaluate the impact of the proposed rule on their operations. Having said that, it will be important for stakeholders of all types to submit comments to the proposed rule in an effort to improve the final rule prior to implementation. The critical question for the policymakers and stakeholders is whether this model can align with the multitude of other payment model reforms — unintended consequences could mitigate all the positive outcomes that a CMMI model offers to beneficiaries. Helping beneficiaries is and should be CMS’ ultimate obligation. Authors Kavita PatelCaitlin Brandt Full Article