Healthcare & Health Economics

Dr. Louis Rossiter was recently elected chair of the Virginia Health Benefits Exchange Advisory Committee.

Our featured expert Prof. Ted Frech is a Professor of Economics and Technology Management at UC Santa Barbara, specializing in Industrial Organization, Health Economics, and Antitrust. His work spans academic research, policy consulting, and expert testimony, particularly in health care antitrust and regulation. 

This article explores the analytical tools that antitrust authorities and parties may employ several analytical tools to define the relevant market in hospital merger cases including: Hypothetical Monopolist Test (HMT), Critical Loss Analysis, Diversion Ratio, and the Elzinga-Hogarty Test.

CMS released data in April 2022 on hospital mergers and consolidations since 2016, revealing a slowdown in ownership changes, a rise in larger, for-profit acquisitions, and increased health system penetration.

Mr. Randy Farber, supported by the Vega Economics team, analyzed the variety of factors impacting revenue of a pediatric medical practices and how these factors that could contribute to the changes in revenue.

Congrats to Prof. David Bradford on being named the new Editor-in-Chief of Health Economics!

Vega Economics is a proud sponsor of the 2024 ASHEcon Conference in San Diego!

We look forward to seeing you at the Health Care Fraud 2024 conference at the Intercontinental Chicago Magnificent Mile on May 1-3, 2024!

We had the privilege of supporting numerous exceptional experts from diverse fields in 2023 and were delighted to welcome several new experts into our network. To delve into our achievements over the past year, you can find more details in our 2023 Year in Review brochure.

This compilation explores the offerings of prominent healthcare data providers.

This insight explores some common challenges the FTC might raise in a pharmaceutical merger and how our economists can analyze relevant issues in such actions.

This article discusses the origins of PBMs, their business models, some reasons why they are blamed for rising drug prices, and how the industry is changing.

Dr. Daniel Spulber was retained to analyze and opine on competition in the e-prescribing markets. Dr. Spulber examined how exclusionary contracts limited the choices of users on different sides of the network to utilize multiple service providers and the resulting adverse impact on market competition. Dr. Spulber also proposed a methodology to determine whether and to what extent class members were damaged due to the alleged anticompetitive conduct. 

Medicare will begin to negotiate directly with drug manufacturers to bring down the price of covered high-cost prescription drugs. CMS will announce the first 10 drugs selected for negotiation by September 1, 2023. 

Vega's expert Dr. Rossiter recently opined on the regulatory landscape surrounding physician referrals, the evolution of hospital remuneration and incentivization systems, as well as relevant co-management agreements.

Check out our growing Healthcare & Health Economics practice area for more information about our experts and example engagements!

Check out our article that discusses how the transition from volume to value in the provision of healthcare services has led to increases in quality of care.

Check out our article that discusses regulations that specifically apply to physician referrals, most notably the AKS and the Physician Self-Referral Law, commonly known as the “Stark Law.” 

Vega Economics is a proud sponsor of the annual ASHEcon Conference in St. Louis!

The term "U&C" refers to "usual and customary," which is a pricing benchmark used in the healthcare industry to determine the cost of drugs and medical services. This summary will provide an overview of the key details and timelines of some U&C litigation, including the major events and legal rulings that have occurred throughout the course of the proceedings.

We had the opportunity to support several outstanding experts in 2022 from a variety of disciplines and welcomed several new experts to our network. You’ll learn more about our work last year in this brochure, our 2022 Year in Review.

Governor Glenn Youngkin announced additional key administration and board appointments on December 6. 2022. Governor Youngkin appointed Dr. Louis Rossiter to the Virginia Health Benefits Exchange Advisory Committee, which will advise the State in setting up its own state-based exchange.

This brochure highlights some of our outstanding healthcare experts who focus on health economic policy, pharmaceutical markets, managed care, pharmacy, and more.

Our featured expert Robert Navarro is a managed care expert with more than 30 years of experience in drug pricing and contracting, drug formulary access and reimbursement, and drug benefit outcomes. He has practiced pharmacy in a variety of settings, including hospitals, long-term care facilities, and community pharmacies. Prof. Navarro is the editor of the textbook Managed Care Pharmacy Practice and is the lead author in the managed care pharmacy chapters of the last three editions of the textbook Essentials of Managed Health Care. 

Our featured expert, Jon Riddle, PhD, has worked as a professional economist for over 30 years. Dr. Riddle has provided expert opinions on a wide range of engagements including antitrust, health care, the pharmaceutical industry, and valuation and damages. In a recent case, Vega recently supported Dr. Riddle's profitability analysis of an infusion center. 

The FTC failed to obtain enough votes to go forward with a proposed study into the impact of PBMs on drug prices and pharmacies. The 2-2 vote effectively blocks the probe that would have examined the overall competition posture of PBMs, including their contracts and practices. Vega's team and experts have in depth knowledge of the economics issues surrounding PBMs and is well suited to assist our clients navigate and address these issues. 

Vega was retained by an infusion center to support Dr. Jon Riddle's profitability analysis, including a review of financial statements, claims data, as well as drug invoices. Dr. Jon Riddle also estimated profits the infusion center would have expected to earn under proper management.

As we look back on our practice throughout 2021, we are proud of the variety of issues our work has covered. We had the opportunity to support several outstanding experts from a variety of disciplines and welcomed several new experts to our network. You’ll learn more about our work last year in this brochure, our 2021 Year in Review.

Our featured expert, Dr. David Bradford, specializes in health economic policy. The Vega team recently supported Professor Bradford in a False Claims Act case where a long-term care pharmacy was alleged to give unfair discounts to nursing homes in exchange for drug referrals.

Analyzing drug pricing is a crucial part of antitrust cases and securities litigation involving pharmaceutical companies. This article discusses the various price metrics used in the industry, how they relate to one another, and some considerations to keep in mind when selecting the appropriate price metric for expert analysis.

Vega was retained by a group of major hedge funds as opt-out plaintiffs in several securities class actions to support Professor Lou Rossiter in analyzing issues related to pricing pressures and price fixing for certain drugs in the generic drug market.

Vega Principal Andrew Zuppann will present at this year’s 2021 Vizient Connections Summit in Las Vegas on November 15-18.

The regulatory framework for pharmaceuticals has evolved alongside this boom to facilitate the safe and affordable access to medicine as consumers increase their use of generics. This article reviews the historical development of the regulatory framework for generic pharmaceuticals in the U.S. and its economic impact, particularly in facilitating price competition.

Vega Principal Andrew Zuppann's paper on the role of relative childhood and adolescent obesity was recently published in The Journal of Human Resources.

Our featured expert, Lou Rossiter, is an expert in health economics. He has served as an expert on numerous cases and most recently he has been retained with the support of the Vega team to provide an analysis of pricing pressure and price fixing in the generic drug market for certain drugs.