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Part D Overhaul: The Silver Lining Amid Very Dark Cloud Of US Drug Pricing Bill

 
• By Michael McCaughan

Senate version of a potential drug pricing overhaul in the US includes one silver lining for manufacturers: a re-design and update of the Part D drug benefit. Is there any chance of extracting that item for the very dark clouds around it?

dark congressional cloud silver lining
• Source: Nielsen Hobbs; the Pink Sheet | Shutterstock images

The Senate Democrats’ efforts to revive US Medicare drug price “negotiation” in 2022 also means reviving an idea that the pharmaceutical industry could get behind: re-designing the Part D benefit in Medicare to establish a firm cap on beneficiary out-of-pocket spending.

Indeed, the Senate version of that proposal is (from industry’s perspective) an improvement on the version that passed the House in 2022, since it would require manufacturers to provide a smaller mandatory discount (20% instead of 30%) for drugs purchased by beneficiaries who have spent enough to reach the

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Decision in AstraZeneca’s lawsuit against the Health and Human Services Department is a precedent-setting victory for the government and a blow to manufacturer efforts to block the price negotiation program.

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The preliminary budget document supports legislation clawing back funds appropriated for the program.

More from Government Payers

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

 
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