Pricing Debate

Medicare Negotiations: Industry Makes Headway At Appeals Court With First Amendment Argument

Medicare Negotiations: Industry Makes Headway At Appeals Court With First Amendment Argument

 

Judges on the Third Circuit panel in the BMS and JNJ IRA cases seemed sympathetic to industry’s concerns about the government using the term “maximum fair price” in the IRA’s Medicare drug price negotiation program.

PBMs, FTC and IRA: Experts Tackle Pharma’s Tough Acronyms At BioFuture Conference

PBMs, FTC and IRA: Experts Tackle Pharma’s Tough Acronyms At BioFuture Conference

 

Some of the industry’s biggest challenges, and potential solutions, were hot topics at the BioFuture conference in New York.

Latuda, Other Generics Cleared In 2022 Helped Generate Nearly $19bn In Savings, US FDA Says

Latuda, Other Generics Cleared In 2022 Helped Generate Nearly $19bn In Savings, US FDA Says

 

Generics of the schizophrenia treatment Latuda generated more than $4bn in savings a year after their 2022 approval, according to an FDA study.

340B Sales Reach New Heights: Legislative Reform Prospects Depend On US Elections

340B Sales Reach New Heights: Legislative Reform Prospects Depend On US Elections

 
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Drug discount program reform would have the best chance of enactment if Republicans gain control of both the House and Senate and former president Trump is re-elected.


Updating The IRA Math: Not As Bad For Pharma As It Looked?

Updating The IRA Math: Not As Bad For Pharma As It Looked?

 

The landmark drug pricing reforms from the Inflation Reduction Act are starting to take full effect – and it turns out that the impact may not be as dramatic as originally projected based on updated analyses from the US Congressional Budget Office.

Medicare Part D Cost Sharing Relief Driving Surge In Specialty Drug Prescribing – UnitedHealth

Medicare Part D Cost Sharing Relief Driving Surge In Specialty Drug Prescribing – UnitedHealth

 
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A manufacturer information campaign is increasing awareness about the Inflation Reduction Act provisions easing cost sharing obligations for high-cost drugs in Part D, the insurer said.

India Rare Diseases: Court Shows Path For Policy Action, Funding, Price Issues

India Rare Diseases: Court Shows Path For Policy Action, Funding, Price Issues

 

A court order encompassing funding, drug pricing, clinical trials and overall policy implementation aspects is expected to cause a paradigm shift in the treatment of rare diseases in India. Sarepta, Roche and Sanofi are among the companies that have been part of pricing discussions.

Keytruda, Opdivo SubQ Conversions Cloud Near-Term Medicare Negotiation Savings Forecasts

Keytruda, Opdivo SubQ Conversions Cloud Near-Term Medicare Negotiation Savings Forecasts

 
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A growing number of future Part B candidates for Medicare price negotiation may avoid price controls in the program with injectable versions.


PBM Reform Legislation: PhRMA ‘Laser Focused’ On Passage This Year

PBM Reform Legislation: PhRMA ‘Laser Focused’ On Passage This Year

 
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But the prospects for attaching the legislation to a federal spending package in December will be dependent on the outcome of the upcoming elections.

Death of a PBM Reform Bill: Why Big Employers Helped Scuttle California’s SB 966

Death of a PBM Reform Bill: Why Big Employers Helped Scuttle California’s SB 966

 
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Big corporations fought to scuttle a California PBM reform bill, despite favoring federal efforts, in part from a desire to be held to one national standard.

Pink Sheet Podcast: Inside Medicare Price Negotiations, New US FDA Vaccine Pathway

Pink Sheet Podcast: Inside Medicare Price Negotiations, New US FDA Vaccine Pathway

 
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Pink Sheet reporter and editors discuss experts’ experience helping drug sponsors negotiate prices with CMS and the FDA’s proposal for a new pathway to update vaccines before a pandemic is declared.

For Generic Manufactures, New Medicare Drug Pricing Demo Is a Dud

For Generic Manufactures, New Medicare Drug Pricing Demo Is a Dud

 

The proposed CMS innovation center's $2 drug list model will not address the barriers to newer generics getting on Part D formularies and plans may have little incentive to participate in the demo, an industry group said. 


Perspectives From The Front Lines: Navigating The First Round Of Medicare Price Negotiation

Perspectives From The Front Lines: Navigating The First Round Of Medicare Price Negotiation

 
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Policy experts and consultants recount their experiences shepherding manufacturers through the first round of Medicare price negotiations during a recent webinar.

The ‘Unintended Consequences’ Of UK's New Pricing Scheme

The ‘Unintended Consequences’ Of UK's New Pricing Scheme

 
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Issues raised in the first six months of the new VPAG include potential adverse impacts on both older and newer innovative drugs, as well as uncertainties over the “exceptional circumstances” clause that allows requests for price increases or cuts in repayment rates.

340B Rebate Dispute: HRSA Threat To Bar J&J From Medicare Part B, Medicaid ‘Unprecedented’

340B Rebate Dispute: HRSA Threat To Bar J&J From Medicare Part B, Medicaid ‘Unprecedented’

 
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HRSA threatens nuclear option and Johnson & Johnson suspends its 340B rebate model. But the company also ‘reserves all of its legal rights with respect to this matter.’

Patient/CMS Roundtables For Medicare-Negotiated Drugs Will Be Interactive, But Not Public Next Time

Patient/CMS Roundtables For Medicare-Negotiated Drugs Will Be Interactive, But Not Public Next Time

 
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The final Medicare price negotiation guidance for the next cycle includes improvements from last year’s patient listening sessions.


A ‘Lame Duck’ Feast: December Could Be Busy For Pharma On Capitol Hill

A ‘Lame Duck’ Feast: December Could Be Busy For Pharma On Capitol Hill

 
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An agreement to extend government funding until 20 December means no shutdown for the US FDA or other agencies, but also that a busy December awaits for biopharma lobbyists.

England’s NICE Says Severity Modifier Working, But Industry Wants Cost Restrictions Lifted

England’s NICE Says Severity Modifier Working, But Industry Wants Cost Restrictions Lifted

 

The UK government should remove a cost-neutrality restriction on England’s health technology assessment institute, NICE, that limits the value it places on medicines for severe conditions, says industry body the ABPI.

Senate Hearing On Ozempic, Wegovy Again Highlights Concerns About PBMs

Senate Hearing On Ozempic, Wegovy Again Highlights Concerns About PBMs

 
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Senate HELP Committee chair Sanders is trying to broker a deal between Novo Nordisk and the major pharmacy benefit managers that will lead to lower list prices for Ozempic and Wegovy. Prominent Republican raises international reference pricing.

‘Alternative' PBMs Say Vertical Integration Unfairly Carving Them Out Of The Game

‘Alternative' PBMs Say Vertical Integration Unfairly Carving Them Out Of The Game

 

Alternatives to the top pharmacy benefits managers argue health plan-PBM integration is leading to anti-competitive tactics that make it impossible for some employers to switch PBMs.