Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

[EX Q]: Paragraph: Though modest, it was the first such price drop in 45 years, according to nonpartisan economic experts at the federal Department of Health and Human Services, who deliver an annual report on the nation’s health care spending. The price drop was for retail pharmacy prescriptions, not medications administered in hospitals or doctor’s offices. HHS experts said the last time retail prescription drug prices declined was in 1973, when they went down by 0.2%. The price drop comes amid questionable prospects for major legislation to curb prescription drug costs. Nonetheless, it was a nugget of decent news in a sobering, broader report on rising U.S. health care spending. The HHS report found that spending on prescription medicines at pharmacies accounted for 9% of the total $3.6 trillion national health care tab in 2018. Total U.S. health care spending grew by 4.6% last year, averaging $11,172 per person. In the real world, U.S. spending is concentrated on the sickest patients, with 5% of the population accounting for half of costs. Because of strong overall economic growth last year, health care spending as a share of the national economy declined slightly, from 17.9% in 2017 to 17.7%, the report found. Legislation pending in Congress to curb drug costs would mainly benefit older people on Medicare, who are the biggest consumers of medicines. House Speaker Nancy Pelosi is forging ahead with a floor vote next week on her bill authorizing Medicare to negotiate prices for the costliest drugs, including insulin. Under her bill, private insurance plans would be able to get Medicare’s prices as well. But President Donald Trump and Republicans in Congress are solidly opposed to Medicare negotiations. Instead Trump is backing a bipartisan Senate bill that would require drugmakers to pay rebates to Medicare if they hike prices above inflation. As a candidate Trump had called for allowing Medicare to negotiate directly. Both bills would cap what Medicare recipients must pay annually in out-of-pocket costs for their prescriptions. The HHS report made no forecast of future prescription drug prices. It’s unclear if the 1% price decline seen last year may be the beginning of a sustained trend or was merely a temporary pullback by drug companies getting pummeled by Trump and lawmakers of both parties. Thursday’s report found that nearly 9 out of 10 prescriptions dispensed are for generic drugs, which puts downward pressure on prices. Even though prices of brand-name drugs increased more moderately, they still accounted for most of the spending on prescriptions — nearly 79%. The government’s findings on prices for brand-name drugs dovetailed with  an analysis earlier this year by The Associated Press. In the first seven months of 2019, drugmakers raised list prices for brand-name prescription medicines by a median of 5%, the AP found. That was down from about 9% or 10% over those months the prior four years. The AP’s findings suggest that an easing in drug prices may continue this year. Reducing prescription drug costs remains one of the top priorities for consumers. The White House claims that Trump has already delivered historic price cuts, but a recent Gallup poll found that 66% of adults believe the president has made little or no progress. The government study was published online by the journal Health Affairs. Claim: US report: Prescription drug prices down slightly last year.
[EX A]: Prices for prescription drugs edged down by 1% last year, a rare result driven by declines for generics and slow, low growth in the cost of brand-name medications, the government said Thursday.

[EX Q]: Paragraph: The news release includes information about costs. We would have liked a little more context. The release states: “The costs associated with home infusion were also consistently lower than services provided in a health care facility, with savings ranging between $1,928 and $2,974 per course of treatment.” We need to know what percentage of savings that is per course of treatment. If the whole course costs $100,000, then saving $1,928 is a pretty small percentage. If the whole course is $10,000, than a savings of $1,928 looks more substantial. We found the news release skimmed over giving crucial numbers and metrics for benefits. Separate from the cost benefit to home infusion versus hospital or clinic infusion, the release should have given us some numbers for safety. Here is what the release stated (emphasis ours): “The research showed that patients receiving intravenous therapy at home had as good or better clinical outcomes as those patients who received the same therapy in a traditional health care setting. In addition, patients overwhelmingly preferred receiving their infusion therapies at home, reporting fewer disruptions in personal schedules and responsibilities. We need numbers to demonstrate how “as good” the clinical outcomes were. We need numbers to represent “overwhelmingly preferred.” By what percentage did what number of patients demonstrate preference? This is where the release could have taken some quantitative data from the study. The word “harms” does not appear in the news release. During intravenous infusions there are complications that may arise. The release does not mention harm, even to dismiss the probability as rare. The study being reported is a systematic literature review that only considered 13 prior studies. The release does not address the limitations of a literature review or give us the total number of patients represented by the 13 studies. Only 5 of the 13 studies used in the analysis addressed outcomes. One had no comparison group (“However, no adjustment for confounders was performed, and higher OPAT success rates were likely due to purposeful selection of younger, healthier patients for OPAT therapy,” according to the published study). In another study, “IPAT patients were selected from a time period during which OPAT was not available for any patients, minimizing selection bias by the matching fact.” In any case, less than half of the studies looked at outcome data and those that did involved different diseases from different time periods, some had control groups and some did not. We don’t think the evidence is strong enough to suggest outcomes were improved. The bias inherent in CVS employees culling the studies is also concerning. A better description of the review’s search and selection process may have helped allay any concerns about studies being cherry-picked. There is no disease mongering. The release is clear that the study was done by the CVS Health Research Institute. Since this is a news release from a profit-making company that operates directly to sell services under study, we hope the readers quickly understand there is an inherent conflict. This is the equivalent of a Coca Cola study about the benefits of drinking their product. The release explains the alternatives of clinic or hospital infusion compared to home infusion. Home infusion services are widely available. Their reimbursement is not widely available. The release says “clinical outcomes and quality of care have not previously been systematically evaluated.” The release doesn’t rely on any unreasonable or unjustified language. However, we do not think the news release proves the words used in the headline that say “Home Infusion Care Improves Patient Outcomes and Quality of Life While Reducing Overall Costs.” Based on a literature review, which does not randomize people into apples-to-apples comparison, you cannot claim to show better outcomes. The release does not offer any quantified benefits to support medical outcomes and doesn’t provide quantified information about quality of life improvement. The fact that patients prefer home infusion to travel to a clinic is not by itself a proof that their lives have been improved. As we wrote in the benefits section above — we are not given numbers to prove by what amount patients prefer home infusion. Claim: CVS Health Research Institute Study Shows that Home Infusion Care Improves Patient Outcomes and Quality of Life While Reducing Overall Costs
[EX A]: This news release describes the cost savings and safety of home infusion services from 13 previously published studies compared with infusion services at a clinic or hospital. Home infusion appears safe and clinically effective while saving money in the studies reviewed, but the release does not address limits in the review. We aren’t given any numbers to back up the claims that clinical outcomes were equal and that patients preferred the home setting. The release notes that CVS has a home infusion business–Coram–so at least they make this transparent. We applaud CVS for attempting to quantify the cost savings and other potential benefits of the service — and the claim that there are advantages are likely valid — but some context/background from other, independent studies would be helpful. Besides the lack of quantification, the release doesn’t delve into the potential risks from using the home infusion service. Treatments for chronic diseases, which often require drugs administered through infusion, are one of the fastest growing costs in the US health care system. If patients can be served at home, rather than in outpatient clinics or hospitals, it saves both money and time. But outcomes studies, which compare outcomes and safety between locations, are essential to judging whether home infusion is equal to clinic or hospital infusion. This release does not go far enough with numbers to quantify benefits and risks. We also see that CVS has a conflict of interest, because they have a business arm, Coram, that sells home infusion services. It appears this release (and study) are getting attention just as Congress is “discussing how to implement a comprehensive home infusion benefit for Medicare beneficiaries.”

[EX Q]: Paragraph: The plan would take now-hidden rebates among industry players like drug companies and insurers and channel them directly to consumers when they go to pay for their medications. Patients with high drug copays stand to benefit from the proposal, while people who take no prescription drugs, or who rely on generics mainly, would probably pay somewhat more, since premiums are expected to rise. A day after unveiling the plan as a proposed regulation, Health and Human Services Secretary Alex Azar raised the stakes by calling on Congress to make it law and broaden it to include people covered by employer health insurance, not just Medicare and Medicaid beneficiaries. “Congress has an opportunity to follow through on their calls for transparency ... by passing our proposal into law immediately and extending it into the commercial drug market,” Azar said in a speech at the Bipartisan Policy Center think tank. Ahead of next week’s State of the Union speech, President Donald Trump is under political pressure to show results for his promise to slash prescription drug costs. Data show that prices for brand-name drugs have continued to rise, though at a somewhat slower pace. Polls show consumers across the political spectrum want government action. Democrats say the administration’s plan doesn’t go far enough because it still leaves drug companies free to set high list prices. They say drug pricing is like a black box, and it’s impossible to tell if prices reflect actual costs or if companies are charging what they think the market will bear. House Speaker Nancy Pelosi, D-Calif., says she’s also worried that the plan would raise premiums. HHS acknowledges Medicare prescription premiums would go up $3 to $5 a month. Nonetheless, the administration’s proposal appears to be in the mix as Congress gears up to craft legislation addressing prescription drug costs. Friday evening, the Republican chairman of the Senate Health, Education, Labor and Pensions Committee, expressed his support. Rebates “ought to lower costs to patients, and this is a good first step towards that goal,” Sen. Lamar Alexander, R-Tenn., said in a statement. The complex plan would work by doing away with an exemption from federal anti-kickback rules that currently allows drugmakers, insurers and middlemen called pharmacy benefit managers to negotiate rebates among themselves. Drug companies pay rebates to make sure their medications are covered by insurance plans that are the intermediaries between them and patients. HHS says hidden rebates can amount to up to 30 percent of a drug’s list price. Insurers say they use the money from rebates to hold down premiums for all consumers. Under the plan, the current anti-kickback exemption for industry rebates would be replaced with a new one for discounts offered directly to consumers. Azar said the idea would reshape the drug pricing system, shifting it away from hidden rebates to upfront discounts, creating pressure on drugmakers to keep prices down. The proposal was co-authored with the HHS inspector general’s office. Experts say it will take time to sort out all the potential consequences. Peter Bach, director of the Center for Health Policy and Outcomes at New York’s Memorial Sloan Kettering Cancer Center, said the current system of rebates harms patients who take costly drugs with high copays. Think people with cancer, patients with intractable illnesses such as multiple sclerosis or rheumatoid arthritis, and those who take brand-name medicines with no generic competition. Patients’ cost sharing is often based on list prices, not the cost of the drug after rebates. “Simply put, those on no medications at all will just see their premiums go up and see no savings because they don’t take any medicine,” said Bach. “Those on generics only may be essentially in this category (as well). “But those on expensive medications ... they will see savings in total,” he added. More than half a million people filled at least $50,000 in prescriptions in 2014, according to an Express Scripts report. Insurers and pharmacy benefit managers like Express Scripts and CVS oppose the administration plan, saying it will undercut their ability to bargain with drugmakers for lower prices. Drugmakers have applauded the administration’s action. Consumers are worried about prices for brand-name drugs, particularly new medications that promise breakthrough results. Generics account for nearly 90 percent of prescriptions filled, but brand-name drugs account for more than 70 percent of the spending. Azar contends that under the current system everybody but the patient benefits from high prices. A high list price makes room for bigger negotiated rebates for insurers and middlemen. And drugmakers then merely build that expectation into their prices. Before joining the Trump administration, Azar was a top executive for drugmaker Eli Lilly. That led to criticism that he would be an industry pawn. But the drugmakers vehemently disagree with some of his other ideas, including an experiment using lower international drug prices to cut some Medicare costs. Claim: Trump health chief asks Congress to pass drug discount plan.
[EX A]:
The Trump administration’s top health official asked Congress on Friday to pass its new prescription drug discount plan and provide it to all patients, not just those covered by government programs like Medicare.