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Event Description

The FTC held a public workshop on the implications of competition law and policy for health care financing and delivery. The workshop considered the impact of competition law and policy on the cost, quality, and availability of health care, and the incentives for innovation in the field. The goal was to promote dialogue, learning, and consensus building among all interested parties.

  • Final Agenda

    Monday, September 9, 2002: 9:30 a.m. 5:30 p.m.
    Tuesday, September 10, 2002: 9:15 a.m. 5:15 p.m.

    Speakers and Times subject to change

    September 9, 2002

    Morning Session
    (9:30 a.m. - 12:35 p.m.)

    Introductory Remarks

    9:30 a.m. - 9:45 a.m.

    • Chairman Timothy J. Muris, Federal Trade Commission

    Speaker 1: Overview of the Health Care Marketplace: Structural, Legal, and Policy Issues
    9:45 a.m. - 10:25 a.m.

    • William Brewbaker, University of Alabama

    Speaker 2: Competition and Antitrust in Health Care
    10:25 a.m. - 11:05 a.m.

    • William Vogt, Carnegie Mellon University

    Speaker 3: Recent Developments in the Health Care Market
    11:05 a.m. - 11:45 a.m.

    • Cara Lesser, Center for Studying Health System Change

    Speakers 4-6: FTC's Health Care Initiatives
    11:45 a.m. - 12:15 p.m.

    • Joe Simons, Bureau of Competition, Federal Trade Commission
    • J. Howard Beales III, Bureau of Consumer Protection, Federal Trade Commission
    • David Scheffman, Bureau of Economics, Federal Trade Commission

    Speaker 7: DOJ's Health Care Initiatives
    12:15 p.m. - 12:25 p.m.

    • Deborah P. Majoras, United States Department of Justice

    Speaker 8: State Attorneys' General Health Care Initiatives
    12:25 p.m. - 12:35 p.m.

    • Ellen Cooper, Office of the Attorney General, State of Maryland

    Lunch Break
    (12:35 p.m. - 2:00 p.m.)

    Afternoon Session
    (2:00 p.m. - 5:30 p.m.)

    Introductory Remarks


    2:00 p.m. - 2:10 p.m.

    • Commissioner Sheila F. Anthony, Federal Trade Commission

    1st Panel: Health Care Services: Provider Integration
    2:15 p.m. - 3:45 p.m.

    What are the current trends in the marketplace? What types of financial risksharing arrangements, clinical integration, and other forms of economic integration have developed or are developing? Where and for what types of services? What are the barriers (transactioncost and otherwise) to the development of stable, integrated arrangements? What are the attributes of clinical integration? What are the attributes of economic integration? What effects do clinical and economic integration have on quality, choice, and the functioning of the market? Do the Statements of Antitrust Enforcement Policy in Health Care, jointly issued by the Commission and the Department of Justice, delineate a sound approach to enforcement? Is the approach of the Statements of Antitrust Enforcement Policy too restrictive in some circumstances? Are antitrust enforcement efforts appropriately targeted? Do enforcement decisions appropriately take account of nonprice competition, including quality, service, and innovation?

    Panelists:

    • Dr. Ellen Burkett, MedSouth
    • Henry R. Desmarais, Health Insurance Association of America
    • Stuart Fine, Grand View Hospital, representing the American Hospital Association
    • Warren Greenberg, George Washington University
    • Catherine I. Hanson, California Medical Association
    • Stephanie Kanwit, American Association of Health Plans

    Moderator:

    • John Wiegand, Federal Trade Commission

    2nd Panel: Health Insurance: Payor/Provider Issues
    3:50 p.m. - 5:30 p.m.

    What are the current trends in the marketplace? What kinds of conduct are providers engaging in that payors consider to be anti-competitive? What kinds of conduct are payors engaging in that providers consider to be anti-competitive? Do payors have monopsony power in certain geographic and product markets? Do providers have monopoly power in certain geographic and product markets? Do consumers benefit when providers combine to create "countervailing power" to payors with market power? Do the Statements of Antitrust Enforcement Policy in Health Care, jointly issued by the Commission and the Department of Justice, delineate a sound approach to enforcement? Is the approach of the Statements of Antitrust Enforcement Policy too restrictive in some circumstances? Do other regulatory/enforcement frameworks (e.g., state insurance laws/regulations, licensure and accreditation, fraud and abuse laws) complement or frustrate the goals of competition policy? Are antitrust enforcement efforts appropriately targeted? Do enforcement decisions appropriately take account of non-price competition, including quality, service, and innovation?

    Panelists:

    • Helen Darling, Washington Business Group on Health
    • Henry R. Desmarais, Health Insurance Association of America
    • Stuart Fine, Grand View Hospital
    • Stephen Foreman, [Document 2] Pennsylvania Medical Society
    • Stephanie Kanwit, American Association of Health Plans
    • Donald J. Palmisiano, American Medical Association
    • Lawrence Wu, NERA

    Moderator:

    • Mark Botti, Department of Justice

    September 10, 2002

    Morning Session
    (9:15 a.m. - 12:00 p.m.)

    Introductory Remarks


    9:15 a.m. - 9:25 a.m.

    • William Kovacic, Federal Trade Commission

    Speaker 9: An Empirical Perspective on Health Care Competition Policy
    9:25 a.m. - 10:05 a.m.

    • Peter Hammer, University of Michigan School of Law

    Speaker 10: Hospital Group Purchasing Overview
    10:05 a.m. - 10:15 a.m.

    • JoAnne Bailey, General Accounting Office

    3rd Panel: Hospital Group Purchasing Organizations
    10:15 a.m. - 12:00 p.m.

    What are the current trends in the marketplace? Do most hospitals participate in GPOs? What percentage of total hospital purchasing is made through GPOs? What are the efficiencies associated with using GPOs to handle hospital purchasing? Is there evidence that GPOs are exercising market power? Are there particular examples of products that are being foreclosed from the market? How are GPOs weighing cost against quality in their decisions? To what extent do rebates by manufacturers influence GPO decisions? To what extent do rebates by manufacturers foreclose competition? In assessing the competitive effects of such rebates, are there analogies to the slotting allowances that are paid by food manufacturers? What is the role for competition policy in dealing with the complaints that have been made about GPOs? How transparent are GPOs to those who use them? Do the Statements of Antitrust Enforcement Policy in Health Care, jointly issued by the Commission and the Department of Justice, delineate a sound approach to enforcement? Is the approach of the Statements of Antitrust Enforcement Policy too restrictive in some circumstances? Does the proposed GPO Code of Conduct effectively address the concerns that have been raised about GPOs? Does the proposed GPO Code of Conduct raise concerns about concerted anti-competitive conduct?

    Panelists:

    • Robert Betz, [Document 2] Health Industry Group Purchasing Association
    • Lawton Robert Burns, Wharton School
    • Bruce Clark, Intermountain Health Care
    • Cliff Goodman, Lewin Group
    • Larry Holden, Medical Device Manufacturers of American
    • Stephen Latham, Quinnipiac University School of Law
    • Carl Manley, Sentara Health Care

    Moderator:

    • Susan DeSanti, Federal Trade Commission

    Lunch Break
    (12:00 p.m. - 1:15 p.m.)

    Afternoon Session
    (1:15 p.m. - 5:15 p.m.)

    Introductory Remarks


    1:15 p.m. - 1:25 p.m.

    • Commissioner Thomas B. Leary

    Speaker 11: FTC Generic Drug Study
    1:25 p.m. - 1:40 p.m.

    • Michael Wroblewski, Federal Trade Commission

    Speaker 12: FDA Perspective on Generics and Branded Pharmaceuticals
    1:40 p.m. - 1:50 p.m.

    • Jarilyn Dupont, Food & Drug Administration

    4th Panel: Generics and Branded Pharmaceuticals
    1:50 p.m. - 3:20 p.m.

    What are the drivers of competition for brandname pharmaceutical products? Have there been any significant changes in the drivers of pharmaceutical competition in recent years? What effect will proposed legislative changes to Hatch-Waxman have on generic drug competition? Are there issues appropriate for further study, beyond those already addressed in the FTC's generic drug study? The FTC's generic drug study collected data through 2000; are the results of that study (particularly with regard to the 30-month stay and 180-day marketing exclusivity provisions) representative of conduct during 2001-2002? Are strategies other than those identified in the FTC generic drug study emerging that impact on generic entry into the market? Are antitrust enforcement efforts appropriately targeted? Are there anti-competitive practices that current enforcement efforts have not addressed?

    Panelists:

    • Ashoke Bhattacharjya, Ph.D., Jensen Pharmaceuticals (Johnson & Johnson)
    • Greg Glover, Ropes & Gray
    • Sarah Lock, AARP
    • Amanda McCloskey, Families USA
    • David Reiffen, [Document2] Treasury Department (Speaking on his own behalf)
    • Bill Schultz, Generic Pharmaceutical Association

    Moderator:

    • Michael Kades, Federal Trade Commission

    Speaker 13: FDA Perspective on DTC Advertising and Promotion
    3:20 p.m. - 3:30 p.m.

    • Lesley R. Frank, Food & Drug Administration

    5th Panel: Advertising and Pharmaceuticals: DTC Advertising and Promotion
    3:30 p.m. - 5:00 p.m.

    To what extent does direct-to-consumer (DTC) advertising influence the cost and utilization of pharmaceuticals? How does the role of physicians and pharmacists affect the likely costs and benefits of advertising for prescription drugs versus advertising for other products, such as dietary supplements, over-the-counter drugs, and foods? How does insurance coverage interact with the effects of DTC advertising? What are the characteristics of pharmaceuticals that are promoted through DTC advertising versus pharmaceuticals that are not promoted through DTC advertising? Is there evidence that DTC advertising is harmful or beneficial to consumers? What consumer protection issues are raised by DTC advertising? What is the appropriate enforcement role for the FTC in dealing with DTC advertising?

    Panelists:

    • Rebecca Burkholder, National Consumer League
    • Jack Calfee, [Document 2] AEI
    • Steve Findlay, National Institute Health Care Management
    • Peter Lurie, Public Citizen
    • Sandra Raymond, Lupus Foundation
    • Richard Samp, Washington Legal Foundation

    Moderator:

    • Thomas B. Pahl, Federal Trade Commission

    Speaker 14: What Does the Future Hold for Health Care Competition Policy?
    5:00 p.m. - 5:15 p.m.

    • Thomas Greaney, St. Louis University School of Law

     

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