1. Pink Sheet

Medicare Will Pick Drugs For Negotiation Based On Gross Sales, Disadvantaging Highly-Rebated Products

 
• By Cathy Kelly

But on the bright side, knowing that eligibility will not be based on net sales to Medicare makes it easier to predict which drugs will be selected first.

Rebates Won't Protect Costly Drugs From 'Negotiated' Price Cuts • Source: Shutterstock

Medicare Part D drugs will be chosen for price negotiation beginning this fall based on gross sales to the program, without taking rebates into account, according to a recent proposal by the Centers for Medicare and Medicaid Services.

CMS discussed the policy in its Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program and Medicare Prescription Drug Benefit Program proposed rule. Released in December, the proposal also addressed allowing Part D plans to immediately substitute biosimilars once they become available

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