Bill Overview
Title: MVP Act
Description: This bill provides statutory authority for regulations that allow for the use of varying best price points under value-based purchasing arrangements for purposes of the Medicaid Drug Rebate Program. ( Value-based purchasing arrangements refer to arrangements in which the price of a drug is linked to clinical outcomes; such arrangements are particularly used for new high-cost treatments, such as gene therapies.) The Government Accountability Office must study the impact of value-based purchasing arrangements on federal health care programs, including with respect to the bill's changes.
Sponsors: Rep. Schrader, Kurt [D-OR-5]
Target Audience
Population: Medicaid beneficiaries
Estimated Size: 83000000
- The bill specifically targets alterations in the best price points under Medicaid regulations, directly impacting Medicaid beneficiaries.
- There are over 83 million individuals enrolled in Medicaid across the United States as of 2023.
- The MVP Act impacts value-based purchasing arrangements used for high-cost treatments, making these treatments potentially more accessible under Medicaid, directly affecting those who need such treatments.
- The bill might specifically impact patients who require newer high-cost drugs, such as gene therapies.
- Globally, Medicaid itself does not apply, but similar programs in other countries could be influenced by the outcomes and findings of the GAO study.
Reasoning
- The MVP Act is designed to make expensive, outcome-dependent medications more accessible for Medicaid patients, mostly those who need treatments such as gene therapies.
- Given the size of the Medicaid population in the US (over 83 million), the policy will target specific high-cost treatments under Medicaid, which are currently less accessible or not accessible at all.
- The impact will vary greatly, with some individuals experiencing significant benefits due to decreased costs or increased accessibility to expensive medications.
- Others who do not require high-cost therapies might not see direct changes, although system-wide savings could have indirect effects.
- We aim to cover a spectrum of individuals, including those who are highly likely to benefit directly, those who benefit indirectly, and those not affected at all.
Simulated Interviews
nurse (Texas)
Age: 40 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 18/20
Statement of Opinion:
- The MVP Act sounds promising because it might help families like mine access better and more effective treatments without the constant fear of debt.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 5 |
unemployed (Ohio)
Age: 58 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- I believe this change could give me a second chance at life if I can access new treatments that are effective.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 9 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 5 |
software developer (California)
Age: 29 | Gender: other
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- I don't think this policy affects me directly, but it's good to see the government supporting those in need.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
retired (New York)
Age: 65 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- If this reduces the costs of new high-impact drugs, it should help Medicaid save money, possibly improving services elsewhere.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
construction worker (Florida)
Age: 50 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 10/20
Statement of Opinion:
- The idea of value-linked drug prices is good, but I worry that it might mainly benefit those with the newest conditions or diseases – not someone like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
retired teacher (Georgia)
Age: 71 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- This could be transformative if the therapy I'm considering comes within reach financially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
social worker (Michigan)
Age: 34 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 14/20
Statement of Opinion:
- It's essential to integrate such policies to improve accessibility, though its full implementation may take years.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
college student (Illinois)
Age: 22 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 20/20
Statement of Opinion:
- I'm glad policies like these exist, even if they don't directly touch my life yet – could influence my future.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
truck driver (North Carolina)
Age: 48 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 9/20
Statement of Opinion:
- I'm interested to see if this creates more access to cutting-edge treatment for my condition.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
artist (Washington)
Age: 37 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 5/20
Statement of Opinion:
- This could be a lifeline if it makes experimental therapies more affordable or approved.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 5 |
Cost Estimates
Year 1: $50000000 (Low: $25000000, High: $75000000)
Year 2: $55000000 (Low: $27000000, High: $80000000)
Year 3: $57500000 (Low: $29000000, High: $83000000)
Year 5: $62500000 (Low: $31000000, High: $88000000)
Year 10: $70000000 (Low: $33000000, High: $95000000)
Year 100: $100000000 (Low: $50000000, High: $150000000)
Key Considerations
- Implementation cost vs potential long-term savings from better drug pricing.
- Impact on Medicaid drug spending and implications for state budgets.
- Uncertainty surrounding how strategies for value-based purchases will evolve with drug market dynamics.
- The necessary infrastructure for monitoring and evaluating outcomes of value purchases.