Who Needs The BBB? Aduhelm Shows Medicare Price ‘Negotiation’ Is Already Here

Biogen is making clear that its decision to cut the price of the Alzheimer’s therapy Aduhelm is in no way tied to the upcoming US Medicare coverage decision for the treatment. But it still shows how Medicare can already ‘negotiate’ prices even without explicit statutory authority.

CMS flexes its muscles (Nielsen Hobbs; the Pink Sheet | Alamy image)
CMS is flexing its muscle on drug pricing. • Source: Nielsen Hobbs; the Pink Sheet | Alamy image

The Democrat’s latest carefully crafted plan to create a drug price “negotiation” program for the US Medicare program is suddenly on life support after West Virginia Democratic Senator Joe Manchin stunned his colleagues by declaring his opposition to the $1.75 trillion “Build Back Better Act” that includes the provision.

More from Pricing Debate

UK Health Secretary Admits VPAG ‘More Expensive’ Than Expected & Needs To Be ‘Resolved’

 

The UK government has listened to industry concerns about high clawback rates under the voluntary scheme and will review it in June in a bid to resolve the issue and “move on to bigger and more important things,” health secretary Wes Streeting says.

Think Tank Suggests CMS, USTR Could Enforce Most Favored Nation, Other Drug Pricing Policies

 
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A Republican think tank suggested variations of the Most Favored Nation and international reference policies in Medicare and Medicaid, as well as tariffs and other trade levers to rebalance drug pricing disparities between US countries and abroad.

CMS Nominee Oz Nears Confirmation Despite Concerns About Medicaid Cuts

 
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Democrats opposed the nomination because they believe Mehmet Oz will not defend Medicaid from spending cuts. His pledge to continue lowering drug costs in Medicare and Medicaid did not offset the concerns.

Branded Pharma And Generics Industries At Odds Over UK VPAG Framework

 

The UK branded drug industry is calling for adjustments to be made to the UK voluntary scheme framework for branded medicines, after the payment rate increased to 22.9% for 2025. Meanwhile, the generics industry says the scheme is functioning “as intended” and opposes any changes.

More from Market Access

AI Could Be Used ‘In The Deliberation’ Of HTA Reviews In England, Says NICE

 

England’s health technology assessment institute, NICE, is looking to “reimagine” its evaluation process with the help of AI, rather than just using this technology to speed up its existing processes.

Dramatic HHS Layoffs A Response To ‘Existential Crisis,’ Kennedy Advisor Argues

 
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Calley Means defended reductions in force at the Health and Human Services Department that shocked and outraged federal workers and stakeholders.

Brazilian Drug Price Increase Rates Hit Eight-Year Low

 

CMED, which sets medicine prices in Brazil, has published the maximum price adjustment index for 2025.