Drug Pricing 'Deeper Dive' Planned By Senate Cmte. As Industry Avoids First Blood

Manhattan Institute Director and Senior Fellow, Health Policy Paul Howard:

• Refocus the scope of the 340B program to hospitals that largely serve indigent and uninsured patients.
• Remove regulatory barriers to outcomes-based or indication-based contracts.
• Pursue reforms that would allow payers to take a longer perspective on the value and costs of new drugs, including encouraging value-based insurance design, new financing tools for Medicaid programs to purchase curative drugs rapidly but spread the costs over longer periods of time, and multi-year private insurance contracts that may align payers' incentives with long-term health.

Pew Charitable Trusts Senior Director, Health Program Alan Coukell:

• Ensure brand manufacturers can't block generic developers' access to sample products needed for bioequivalence testing.
• Limit "pay for delay" agreements.
• Limit 340B carve out for drugs with orphan designation.
• Consider capping the value of public subsidies for orphan drugs.
• Increase competition in Medicare Parts B and D.
• Shift reimbursement of some drugs from the medical to the pharmacy benefit.
• Remove regulatory barriers to outcomes-based contracts.
• Require transparency of contracts between payers and pharmacy benefit managers and mandate payers can audit these deals.

Avalere President Dan Mendelson:

• Assess value of drugs in the context of total medical costs.
• Increase competition in pharmaceutical markets by speeding approval of second and third branded drugs in a class, ensuring a continued "robust" generics market and growing biosimilar competition.
• Promote value-based drug purchasing based on outcomes.

Johns Hopkins School of Public Health professor Gerard Anderson:

• Curb use of limited distribution networks that restrict ability of generic companies to pursue ANDAs.
• Include drugs in bundled payments and accountable care organizations