Aaron Mitchell

Complaints About Gaps in Medicare Advantage Networks Are Common. Federal Enforcement Is Rare. - KFF Health News Health systems drop out of Medicare Advantage plans all the time. Yet government documents obtained by KFF Health News show that federal regulators rarely warn plans that their networks of health prov...

Government documents obtained by @kffhealthnews.org show the agency overseeing Medicare Advantage does little to enforce long-standing rules intended to ensure about 35 million plan members can see doctors in the first place.

socialism never works. norway is socialist and theyre doing great. theyre not socialist,, theyre capitalist countries with strong welfare policies. then lets do those policies. no thats socialism.

FDA Aims to Streamline Biosimilar Drug Development FDA proposals include ‘major updates’ to simplify biosimilarity studies, reduce unnecessary clinical testing, and ease the process for making biosimilars interchangeable with brand-name biologics.

@medscape.com piece on biosimilars policy, including our recent @jamanetworkopen.com study on biosimilar prices:

www.medscape.com/viewarticle/...

MSK Research Highlights, November 20, 2025 New MSK research finds a potential therapeutic opportunity in regulatory T cells’ resilience to the loss of Foxp3; shows how cancer develops resistance to antibody-drug conjugates; develops a new syst...

In good company alongside some cutting-edge basic science, our recent @bmj.com study examining the association between cancer drug profitability and utilization made the @mskcancercenter.bsky.social research highlights!
www.mskcc.org/news/msk-res...
@dusetzinas.bsky.social

It had been far too long since my last GREETINGS OF THE DAY email! This one may be my new all time favorite.

How much better could you signal "this is spam"? LOL right now 🤣

@ankurfactorial.bsky.social

When someone leaves the “-ized” out of “generalized estimating equations”

Kristi Noem sits on a horse wearing a cowboy hat. In the background is Mount Rushmore.

NEW: We’ve uncovered the first known example of taxpayer money flowing from DHS to businesses controlled by Kristi Noem’s allies and friends.

It’s part of a money trail that’s been shrouded in secrecy—and involves $220 million, a mysterious Delaware LLC & a horse named Gill.

KIDS.
Every morning, how does it always take 20 minutes between “ready to leave” and “ready to leave”????

“Housing shortage – Jews to blame," letter sticker, German Reich, 1938

zwangsraeume.berlin/en/context

NIH program officer @jenna-m-norton.bsky.social has been placed on admin leave, sources say.

Norton has been outspoken about the Trump administration's dismantling of science, and she signed the Bethesda Declaration.

Bhattacharya has said that "science is dead without free speech".

Honored to have been a co-author on you first thread in this role! But the credit is really all to Dr. Paul, who led this study.

I was honored to have been asked to collaborate by the @portalresearch.org team

Excited to see this study out in the world! Looks at the counterfactual of a world in which biosimilars didn't launch. Always fun working with @thewonkologist.bsky.social

Huge kudos to @abduaziz.bsky.social for leading this study, and huge thanks to @dusetzinas.bsky.social as always for her ideas!

And another huge thank-you to our funders, @commonwealthfund.org @arnoldventures.bsky.social @johnarnoldfndtn.bsky.social

Policy implications?

Price declines from biosimilars are great, but could be even better.

CMS should consider additional mechanisms to accelerate price competition. MedPAC has proposed such mechanisms:

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www.medpac.gov/wp-content/u...

In this study, we compared biosimilar prices not to the pre-launch price of their originator, but to the counterfactual of where that price likely would have been absent competition. Drug prices rise over time, after all.
We believe this more accurately captures true price changes.

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Our understanding is that the "single HCPCS" reimbursement model used by CMS for generic drugs achieves accelerated price competition. However, each biosimilar receives a unique HCPCS, so price competition plays out over a longer time frame.

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The conventional wisdom, for a while, was that savings from biosimilars were quite modest.

However, we found that biosimilar prices were about 2/3rds below where biologic prices would have been otherwise. So, savings are substantial. The rub: it took 5yrs post-market to get there.

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Biologic Drug Prices in Medicare Part B After Entry of Biosimilars to the Market This cohort study evaluates the associations of biosimilar entry to the market with the prices of originator biologics under Medicare Part B reimbursement.

Our new study is out today in @jamanetworkopen.com!
We looked at trends in biologic drug prices after biosimilar competition.

Key takeaways: savings from biosimilars are substantial, but take longer to accrue than commonly seen with generic small molecules.

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jamanetwork.com/journals/jam...

As the ~discourse~ seems to bend interminably towards Republicans trying to figure out how they can (further) HDHP-ify ACA coverage, it's worth revisiting what is probably our best (most rigorous) study on the effect of deductibles in health insurance.

academic.oup.com/qje/article-...

Postdoc opportunity at @mskcancercenter.bsky.social ! Read about and apply to OPTICS below:

“I’m in the ‘Hitler sucks’ wing of the Republican Party,” Senator Lindsey Graham, Republican of South Carolina, said over the weekend at the R.J.C. event. “Here’s what I do know: You can sit in a basement with weird people and say weird things. It’s a free country.”

Cool. What would you call the other wing then? www.nytimes.com/2025/11/03/u...

Trends in and Predictors of Physician Attrition From Clinical Practice Across Specialties: A Nationwide, Longitudinal Analysis: Annals of Internal Medicine: Vol 0, No 0 Background: The United States faces a predicted shortage of 36 500 physicians by 2036, with an increasing proportion of physicians leaving clinical practice or expressing an intent to do so. Evidence ...

This study could be titled "what makes doctors quit"

The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients

www.acpjournals.org/doi/10.7326/...

Our new study, out yesterday in @bmj.com !
👇🏼👇🏼👇🏼

I'm hesitant to call it an apples to apples comparison, though. Prior study looked at only one cancer type. And included a time frame (prior to 2005 MMA) when profit margins on cancer drugs were far higher, so very different environment)

Physician response to financial incentives when choosing drugs to treat breast cancer - PubMed This paper considers physician agency in choosing drugs to treat metastatic breast cancer, a clinical setting in which patients have few protections from physicians' rent seeking. Physicians have explicit financial incentives attached to each potential drug treatment, with profit margins ranging mor …

I'm aware of only one prior study that had a similar question and design as this one. It supported the opposite conclusion - profit margin seemed to matter.

pubmed.ncbi.nlm.nih.gov/23124970/

Huge thanks to the large, multidisciplinary team that helped get this study to the finish line!

I joke that I've been planning this study since I started oncology fellowship - now 10 years ago - but this is very true. @ethanbasch.bsky.social

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This is a reassuring result.
Both in terms of physician professionalism, and also in the current policy context.
It suggests clinicians will continue to use clinically necessary drugs, even if they become less profitable - for example after generic competition, or IRA price negotiation.

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However, the result for profit margin was very null.
All cancer types clustered around that red line of OR=1 (no difference)

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For clinical benefit, the result was clearly positive. More beneficial (per NCCN) treatments were used more often.
OR = 1.62 in our random effects meta-analysis.

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Using a conditional logit ("McFadden") model, we can ask whether a given treatment's clinical recommendation and/or its profit margin increases its likelihood of use.

We modeled each cancer type separately, and then meta-analyzed to achieve an aggregate result.

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