The Boston Globe - 31.08.2019

(Joyce) #1

AUGUST 31, 2019


By Tim Logan
What do you do when someone has
bought a fancy condo in the sky, but
the elevators to get them to and from
that luxury home aren’t ready yet?
You put them up in the Four Sea-
sons, of course.
That’s what happened at the brand
new One Dalton tower for a few nights
in August. Elevator inspections had
been delayed to the point that buyers
were scheduled to close on condos
they couldn’t yet safely occupy. But
several had already sold their previous
homes, expecting they’d be able to
move in as scheduled.
“We felt bad about that,” said Dick
Friedman, whose Carpenter & Co. is
the developer behind Boston’s third-

tallest building. “So, as a courtesy, we
put them up in the hotel.”
“The hotel” is the Four Seasons One
Dalton, which occupies the lower 23
floors of the 61-story tower, and where
rooms next week start north of $600 a
night. It opened in May, and its full-
service amenities will be available to
residents of the condos above. A few
nights there could feel like a bit of a
preview to permanent residents of One
The delays, which Friedman as-
cribed to “very diligent” elevator in-
spections that have since been com-
pleted, are a hiccup in the complicated
process of opening a big building like
One Dalton is now a few months
behind its promised “spring” finish

this busy construction cycle where
buildings rarely seem to open on time.
And Friedman said construction giant
Suffolk has ramped up staffing to push
it over the finish line.
“Things are moving quickly now,”
he said.
Indeed, five more condo sales
closed on Thursday, according to
deeds filed in Suffolk County. That
brings the total of closed sales to 19,
mostly on lower floors, with an aver-
age price of $4.4 million.
Not bad, as long as the elevators are

Tim Logan can be reached at Follow him
on Twitter at @bytimlogan.

One Dalton tower back on track

Delays put residents in hotel; staffing increased to finish building

The new One Dalton hotel and residence is the third-tallest building in
Boston, and rises high above the Back Bay neighborhood.

By Ed Silverman
Over a 10-year period, rising prices
for multiple sclerosis drugs caused
Medicare spending for these medi-
cines to increase more than 10 times,
and Part D beneficiaries saw their out-
of-pocket costs increase more than
sevenfold, according to a new study.
Specifically, spending on multiple
sclerosis drugs per 1,000 beneficiaries
by the health program jumped from
nearly $7,800 in 2006 to more than
$79,400 in 2016. Meanwhile, out-of-
pocket patient spending per 1,
beneficiaries rose from $372 to nearly
$2,700 for patients with multiple scle-
rosis during that same period of time.
And the annual cost of treatment for
those patients climbed from about
$18,600 to almost $75,900, or 12.
percent a year, according to the analy-
sis in the journal JAMA Neurology.
Significantly, the researchers noted
the out-of-pocket spending rose sharp-
ly despite any rebates or other dis-

counts offered by drug makers. And
they maintained the findings chal-
lenge the argument that price breaks
may help dampen the effect that rising
list prices — or high list prices for new-
ly launched multiple sclerosis drugs —
may have on patients.
“Spending is increasing and it’s in-
creasing fast. Rebates may have had
some small effect, but price increases
do get passed down to patients, and
that can negatively affect access,” said
Inmaculada Hernandez, an assistant
professor of pharmacy at the Universi-
ty of Pittsburgh and one of the study
authors. She also noted that increased
spending could also be due to in-
creased use of the drugs, but the study
did not tally that.
The study only looked at so-called
disease-modifying therapies, which
patients can administer themselves, as
opposed to other medications that are
administered by physicians and cov-
ered by the Medicare Part B program.
An example of a DMT drug would be

Copaxone, which is sold by Teva Phar-
Another point: The estimates for
increases in total spending and annual
cost of treatment would be lower after
including rebates, but rebate data for
each medicine was not available. But
that would not have changed out-of-
pocket spending, since rebates are not
passed on to patients.
The findings arrive amid growing
national debate over ways to control
rising prices for medicines. Around
the country, several states have passed
laws seeking greater transparency
from drug makers or allowing impor-
tation, while federal lawmakers have
proposed various bills. The Trump ad-
ministration has suggested several
steps as well, but none have gained
Multiple sclerosis treatments,
meanwhile, have increasingly been cit-
ed as an example of the problem.
A 2015 study, for instance, found
that the costs for three older medi-

cines, which were launched between
1993 and 1996, rose by statistically
significant amounts after a new type of
treatment became available in 2002.
Earlier this year, another study
found that multiple sclerosis patients
paid $15 a month average out-of-pock-
et costs in 2004, but that jumped to an
average of $309 a month by 2016.
Meanwhile, patients with a high-de-
ductible plan paid an average of $
per month compared to $246 a month
for those not in a high-deductible plan
two years ago.
Recently, prices for new multiple
sclerosis drugs have drawn criticism
from patient advocates as well as a
cost-effectiveness watchdog. Two
months ago, the Institute for Clinical
and Economic Review determined the
$88,500 list price for a new Novartis
treatment called Mayzent was “far out
of line,” because it was approved for a
different patient population than one
studied in late-stage trials.
The latest study prompted a fresh

round of concern from the National
Multiple Sclerosis Society, which ac-
cepts industry funding.
“Medications can change lives only
if they are accessible — a seven-fold in-
crease in out-of-pocket costs is not ac-
cessible,” said Bari Talente, executive
vice president of advocacy for the or-
ganization. “People with MS, Medi-
care, and our health care system can-
not continue to face these types of in-
“The MS community is incredibly
grateful for the new [DMTs] that have
come to market over the past few
years. But this isn’t about innovation.
As the study authors point out, the
burden to people with MS and Medi-
care were ‘largely affected by strong
year-over-year increases observed in
drug prices,’ ” she continued.

Ed Silverman can be reached at Follow
him on Twitter @Pharmalot. Follow
Stat on Twitter: @statnews.

MS drug prices are driving up Medicare costs, study says

Here’s the last word
that casino execu-
tives in Southern
New England want
to hear right now:
They had better
get used to it.
As of Thursday,
all the public numbers for July are in
for the region’s casinos. The prevail-
ing trend? Minus signs. July, of
course, was the first full month of
operations for the $2.6 billion En-
core Boston Harbor that Wynn Re-
sorts built on the Mystic River in Ev-
erett. Experts say Encore grew the
market a bit, but also took gamblers
from existing casinos.
Clyde Barrow, a political science
professor at the University of Texas-
Rio Grande Valley, says Fitch Rat-
ings considers a market to be satu-
rated when slot machine revenue
falls below $200 per machine a day.
While several casinos remain well
above that mark, take a moment to
review everyone’s numbers for July.
The “S word” quickly comes to
EncoreBostonHarbor:Nearly 60
percent of Encore’s $48.6 million in
gross gaming revenue for July came
from table games, compared with
slot machines — an unusually high
percentage. That’s the good news for
Wynn. Table-game play is seen as a
proxy for big spenders. The bad
news? Wynn is falling short of the
first-year outlook that the company
gave Massachusetts regulators in
2014 when it vied for the Boston-ar-

ea casino license. A Wynn consultant
had projected more than $800 mil-
lion in gross gaming revenue in the
casino’s first year. At this rate, Wynn
will be lucky to clear $600 million.
And that $200-per-slot machine
threshold? Lasell University profes-
sor Paul DeBole estimates Encore
was precariously close, reaping only
$216 per machine a day in July.
Richard McGowan, a gaming ex-
pert at Boston College, offers this ca-
veat: July is a tough month. Wait un-
til the September numbers are in, af-
ter everyone returns from vacation,
he says, before making a full assess-
CEO Matt Maddox just told inves-
tors that battling for slot-machine
players in this region is like guerrilla
warfare. He wasn’t kidding.

MGMSpringfield:It’s been open a
year now, and MGM chief executive
Jim Murren readily admits MGM
Springfield is falling behind projec-
tions. Hard to argue with the num-
bers: MGM once estimated more
than $400 million in gaming revenue
in year one. But it only received $
million from its opening in late Au-
gust of 2018 through the end of July.
One bright spot: Monthly gaming
revenue actually rose in July from
June, indicating that Encore’s arrival
didn’t take much business away. By
DeBole’s calculations, MGM Spring-
field’s slots take has been below that
$200 threshold for the past two
oldest casino – it opened at the har-
ness track in Plainville in 2015 – has

shown signs of suffering lately. Its
slot machine revenue fell 17 percent
in July from the same time a year
ago. (Plainridge doesn’t offer table
games, though state lawmakers in
that area would like to change that.)
TwinRiver:The Providence-based
company’s year-old Tiverton, R.I., ca-
sino took a modest hit in July, when
compared with June: a roughly 4
percent decline in gambling revenue,
mostly at the tables. But Wynn’s ar-
rival took a serious bite out of Twin
River’s flagship casino in Lincoln,
R.I. Executives there said the new
competition had a greater-than-ex-
pected impact: Table game revenue
fell 34 percent in July, year over year,
while slots revenue dropped 17 per-
cent from the same time in 2018.
The company unveiled plans this

month to lay off nearly 100 employ-
ees as it prepares for a harsh new re-
woods and Mohegan Sun only report
slot machine revenue, not table
games. But it was an unlucky month
for the two tribal casinos at the slot
machines. Slots revenue fell 11 per-
cent, year over year, at Foxwoods,
and 15 percent at Mohegan. MGM
could be a bigger factor than Encore:
Slots revenues at both casinos have
declined every month since MGM
opened in Springfield a year ago.
Nextup:Foxwoods and Mohegan
Sun plan a joint $300 million casino
in East Windsor, Conn., to recapture
some of the gamblers they’re losing
to MGM. When they start building is
anyone’s guess. MGM sued to block
their project, arguing the tribes were
granted an unfair monopoly for off-
reservation gambling. (MGM has its
own plans for a casino in Bridge-
Then there’s Southeastern Massa-
chusetts. Chicago casino mogul Neil
Bluhm hasn’t given up his dream for
a casino in Brockton, and Quincy de-
veloper Tom O’Connell just unveiled
his vision for a slots parlor/race-
track/hotel in Wareham.
Public officials in all three states
have a big incentive to allow more
construction: to pull the tax revenue
over the state line and into their cof-
fers. It’s an expensive tug-of-war.
McGowan, the BC casino expert,
doesn’t see room for another casino.
But developers are still lining up to
place their bets.

Jon Chesto can be reached at Follow him on
Twitter @jonchesto.

Have casinos already saturated the market?


Jon Chesto





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