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The Rebate Rule: US Pricing Proposal Becomes Congressional Piggy Bank

 
• By Michael McCaughan

A policy eliminating rebates in the Medicare Part D program will be delayed until Jan. 1, 2026 – and is very likely to be repealed altogether. If that staves off more draconian reforms, the biopharma industry will celebrate.

Piggy coin bank and stock candlestick chart going down for investments and savings loss

When the bipartisan infrastructure bill becomes law later this year, the US pharmaceutical industry will have contributed over $50 billion in “savings” to fund the new investments – but most companies won’t in fact feel the loss of a single penny.

Welcome to the world of Congressional Budget Office “scoring,” the official process by which Congress keeps track of how much

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More from Government Payers

EU Pharma Reform: Exclusivity Vouchers Alone Are Insufficient Incentive For Antimicrobials, Industry Says

 
• By Eliza Slawther

European pharma trade associations EFPIA and EUCOPE outline their respective views on how the EU’s pharma legislation overhaul should tackle antimicrobial resistance, and why transferable exclusivity vouchers alone will not suffice as incentives.

Raising Drug Prices In The EU Could Take Years, Even If Pharma Effort Succeeds

 
• By Cathy Kelly

Manufacturers are engaging the European Commission and individual countries to allocate more health care spending to innovative medicines and align prices more closely to those in the US.

Why Successful Companies Are ‘Tough On Themselves’ When It Comes To HTA

 
• By Eliza Slawther

Pharmaceutical companies need to “pressure test” their clinical development strategies early for health technology assessment purposes, particularly in light of the new EU HTA Regulation, a life sciences consultant says.

If CMS Takes Over 340B, Will Government Allow Rebate Model Changes?

 
• By Cathy Kelly

Manufacturers have supported the proposed shift in oversight authority, which could create a more pharma-friendly environment in the drug discount program, but uncertainty remains.

More from Market Access

Raising Drug Prices In The EU Could Take Years, Even If Pharma Effort Succeeds

 
• By Cathy Kelly

Manufacturers are engaging the European Commission and individual countries to allocate more health care spending to innovative medicines and align prices more closely to those in the US.

Non-Submissions To England’s NICE Surge Across All Disease Areas

 
• By Leela Barham

Blood cancer therapies were most proportionately impacted by the failure of pharmaceutical companies to submit evidence on their cancer therapies to England’s health technology appraisal body, shows analysis by the Pink Sheet.

PBMs No Longer Profit From Rebates But Plans Benefit; Should Sponsors Push More For Reform?

 
• By Cathy Kelly

Employers and other health plan sponsors may need to push for better targeted reforms that lower cost sharing for patients.