“Step Therapy” to Reduce Spending on Prescription Drugs: Legal and Ethical Implications

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Center for Policy Studies
Public Affairs Discussion Group
“Step Therapy” to Reduce Spending on Prescription Drugs: Legal and Ethical Implications

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Sharona Hoffman, J.D. – Edgar A. Hahn Professor of Law and Co-Director, Law-Medicine Center

Friday September 7, 2018
12:30-1:30 p.m.

***Alternate Location: Room LL06, Lower Level, Kelvin Smith Library***
Case Western Reserve University

Dear Colleagues:

It appears to be impossible to underestimate the creativity of American insurance companies as they seek ways to control health care costs – nor their ability to create hassles for patients while trying. The latest theory, and practice, is “step therapy.” The theory is that in many cases physicians prescribe more expensive drugs for patients when less expensive ones will do. So it makes sense to have physicians try the less expensive treatment first, moving on to the “next step” only if necessary. Doesn’t it?

Maybe not – for many reasons. As Professor Hoffman explains in a recent piece in the Food and Drug Law Journal, extra “steps” can have major consequences for some patients, causing worse outcomes and even higher costs. As she has explained, “some insurers are less than transparent with patients about their programs” and “adhere to a one-size-fits-all approach, ignoring nuanced clinical and economic evidence, and implement their policies in a discriminatory way.” Join us to learn about the latest “disruptive innovation” in U.S. health care.

All best regards,
Joe White
Luxenberg Family Professor of Public Policy and Director, Center for Policy Studies


About Our Guest

Sharona Hoffman joined the faculty in 1999. She is the Edgar A. Hahn Professor of Law, Professor of Bioethics, and Co-Director of the Law School’s Law-Medicine Center. She teaches Health Law courses, Employment Discrimination, and Civil Procedure and was voted First Year Teacher of the Year in 2011 and 2012. She also served as Associate Dean for Academic Affairs from 2006 until 2009 and won the 2014 Distinguished Teacher Award.

Professor Hoffman received her B.A. from Wellesley College, her J.D. from Harvard Law School, an LL.M. in health law from the University of Houston, and an S.J.D. in health law from Case Western Reserve University. Prior to becoming an academic, Ms. Hoffman was a Senior Trial Attorney at the Equal Employment Opportunity Commission in Houston, a litigation associate at O’Melveny & Myers in Los Angeles, and a judicial clerk for U.S. District Judge Douglas W. Hillman (Western District of Michigan).

In 2013, Professor Hoffman was selected by the Robert Wood Johnson Foundation for a scholar-in-residence fellowship in public health law. She has also twice spent a sabbatical semester as a Visiting Scholar at the Centers for Disease Control and Prevention (2007 and 2014) and was a Visiting Scholar at Emory University in 2014 as well. Professor Hoffman was elected to membership in the American Law Institute in 2017.

Professor Hoffman has published over sixty articles and book chapters on health law and civil rights issues. She has developed particular expertise and a national reputation in the area of health information technology. Her work has appeared in the Georgetown Law JournalWilliam & Mary Law Review, and Boston College Law Review, among many other journals. She is the author of two books: Aging with a Plan: How a Little Thought Today Can Vastly Improve Your Tomorrow (Praeger 2015) and Electronic Health Records and Medical Big Data: Law and Policy (Cambridge University Press 2016). Professor Hoffman has lectured throughout the United States and internationally and has been widely quoted in the press.

Where We Meet

The Friday Public Affairs Lunch convenes each Friday when classes are in session, from 12:30 p.m. to 1:30 p.m. Our programs are open to all and no registration is required. We usually meet in the Dampeer Room of Kelvin Smith Library.

* Kelvin Smith Library requires all entrants to show identification when entering the building, unless they have a university i.d. that they can magnetically scan. We are sorry if that seems like a hassle, but it has been Library policy for a while in response to security concerns. Please do not complain to the library staff at the entrance, who are just doing their jobs.

Parking Possibilities

The most convenient parking is the lot underneath Severance Hall. We regret that it is not free. From that lot there is an elevator up to street level (labeled as for the Thwing Center); it is less than 50 yards from that exit to the library entrance. You can get from the Severance garage to the library without going outside. Near the entry gates – just to the right if you were driving out – there is a door into a corridor. Walk down the corridor and there will be another door. Beyond that door you’ll find the entrance to an elevator which goes up to an entrance right inside the doors to Kelvin Smith Library.

Schedule of Friday Lunch Upcoming Topics and Speakers:

September 14: Aliens and Alienation: Social Implications If We Are Alone in the Universe.  With Michael W. Clune, Professor of English.

September 21: The Social Enterprise Zoo. With Dennis R. Young, Professor Emeritus, Georgia State University; Former Director, Mandel Center for Nonprofit Organizations.

September 28: Panama and Paradise: What Have We Learned From the “Papers,” and Will It Make Any Difference? With Richard Gordon, Professor of Law and Director, Financial Integrity Institute.

October 5: TBA ***Alternate Location: Mather House 100, 11201 Euclid Ave.***

October 12: Caesarism: Populism and Leadership in Ancient Rome and Greece. With Timothy Wutrich, Senior Instructor in Classics, and Rachel Sternberg, Associate Professor of Classics. ***Alternate Location: Mather House Room 100, 11201 Euclid Ave.***

October 19: The Context of Coverage: Ohio’s Medicaid Expansion. With Loren C. Anthes, Public Policy Fellow and Director, Medicaid Policy Center, Center for Community Solutions.

October 26: TBA

November 2: Biennial Pre-Election Forecast Discussion. With Joseph White, Luxenberg Professor of Public Policy, and Andrew M. Lucker, Adjunct Professor of Political Science Alternate Location: Mather House Room 100, 11201 Euclid Ave.

November 9: TBA

November 16: TBA

November 23: Thanksgiving break.

November 30: Just How Powerful is Putin? With Stephen Crowley, Professor and Chair, Department of Political Science, Oberlin College.

December 7: Union Decline in a Populist Era: The Experience of Western Democracies. With Chris Howell, James Monroe Professor of Politics, Oberlin College.

September 4, 2018

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Upcoming Events

ENCRYPTION: PRIVACY v. PUBLIC SAFETY

Join a student panel for the 2018 CWRU Constitution Day program featuring Raymond Ku, J.D., Professor of Law and Director, Center for Cyberspace Law & Policy, Case Western Reserve University School of Law and William C. Snyder, J.D., Teaching Professor, Syracuse University College of Law, Monday September 17, 2018, 4:00 p.m., CWRU School of Law, Moot Courtroom (A59), 11075 East Blvd., Cleveland, Ohio 44106. Free and open to the public. Sponsored by the Office of the President, Office of Government and Community Relations, Department of Political Science, Center for Policy Studies, and School of Law.

The social contract upon which the United States government is based obliges the government to protect its citizens,and this may restrict certain of their liberties. Thus, a balance must be struck between the government’s duty to provide protection and a person’s right to privacy.

Pressure to eliminate the digital privacy of individuals is increasing. From the FBI’s efforts to decrypt the iPhone of the December 2015 San Bernardino mass shooter to Carpenter v. US (2017), the debate on privacy versus public safety needs to be addressed. How can the federal government strike a balance between privacy and public safety? What, if any, restrictions should be placed on the government when accessing private data during the course of a criminal investigation?

The Constitution Day Student Committee is pleased to welcome Raymond Ku, J.D. and William C. Snyder, J.D. to discuss these critical questions related to the Fourth and Fifth Amendments.


STATE COURTS IN A FEDERAL SYSTEM

A discussion with The Honorable Joan L. Larsen, judge of the United States Court of Appeals for the Sixth Circuit, Tuesday September 25, 2018, 4:30 p.m., CWRU School of Law, Moot Courtroom (A59), 11075 East Blvd., Cleveland, Ohio 44106. Free and open to the public.

State courts are the courts most likely to affect an ordinary person’s life. Development of the common law of property, tort and contract, as well as the law governing our most personal relationships, family law, are the province of state courts. Most criminal law is state law; and most criminal prosecutions happen in state court. In these, and in other areas, state courts have been innovators. For example, state courts have taken the lead in developing new ways to work with non-violent criminal offenders, through the creation of problem-solving courts such as veterans’ treatment courts, drug courts, and mental health courts. And while most people think only of the U.S. Constitution when they think of their rights, each of our fifty states has its own constitution too, whose interpretation, by state judges, is not formally constrained by the parallel work of the federal courts. In other words, state courts matter. In fact, there was no guarantee that federal courts, besides the Supreme Court, would even exist. Our Constitution did not require it—Congress had the discretion, but not duty, to create lower federal courts. But as the federal court system has grown, it has developed an ever-evolving, complicated relationship with the state courts. There are many doctrines, such as abstention and procedural requirements in habeas corpus that are designed to respect the work of the state courts and recognize the states’ primacy. But how robustly should federal courts apply these doctrines? And how much deference should state courts give to federal court resolution of the parallel problems that confront them? These, and many other questions, are inherent in our federal system.

The Honorable Joan L. Larsen was nominated by the President on May 8, 2017 and confirmed by the Senate on November 1, 2017. Before her appointment to the federal bench, Judge Larsen served two terms as a Justice of the Michigan Supreme Court, where she was the court’s liaison to Michigan’s drug, sobriety, mental health and veteran’s courts.

September 2018

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