CAR-T Label Update Could Address Medicare Coverage Challenges, FDA’s Gottlieb Suggests

The US Medicare Payment Advisory Commission worries that Medicare prescription drug market trends may cause the stand-alone plan portion of the program to “wither away,” which could take the traditional fee-for-service side of Medicare with it.

For the Trump Administration, the blockbuster GLP-1 drugs for obesity have become a poster child for the disparity between US and foreign prices.

Enrollment in the new Medicare Prescription Payment Plan was lower than expected in the first year and well below CMS expectations, and invoicing data indicates members are slow to pay.

A former CMS official suggested the most likely way it could happen is through a Center for Medicare and Medicaid Innovation demonstration.