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HHS Drug Pricing Proposals: Some Things Are Off The Table

 
• By Michael McCaughan

The US Centers for Medicare and Medicaid Services is proposing an interesting package of innovative pricing policy changes, but some of the topics not included might be as important as the ideas that are.

Medicare puzzle
CMS has decided that because Congress did not include changes to the protected classes policy in the IRA, that issue is settled. • Source: Shutterstock

The US Centers for Medicare and Medicaid Services will be pursuing an interesting and important package of drug pricing policy changes as it follows through on a White House executive order to expand the reforms incorporated in the 2022 Inflation Reduction Act.

On 14 February, the Health and Human Services Department unveiled three immediate priorities in response to President Biden’s directive, including...

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Saving Part D: US Medicare Advisors Sound The Alarm

 
• By Michael McCaughan

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.

GLP-1 Pricing ‘Paradigm Shift’ Possible, But Would It Meet Trump’s MFN Goals?

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

Rocky Rollout Spells Trouble for Medicare Prescription Payment Plan

 
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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.

Will International Prices Influence Medicare Price Negotiation?

 
• By Cathy Kelly

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

More from Government Payers

Rocky Rollout Spells Trouble for Medicare Prescription Payment Plan

 
• By Lauren Flynn Kelly

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.

Japan Reimburses 11 New Drugs But Slashes Price Of Others By Up To 20%

 
• By Lisa Takagi

Japan's NHI program continues to give and take as 11 new drugs are granted reimbursement, while the prices of others - including three ophthalmic therapies - are cut by up to 20% under a Market Expansion Repricing scheme.

HHS Negotiating With Manufacturers On Most Favored Nation Drug Pricing

 
• By Cathy Kelly

MFN policy would would apply to all single source drugs in all insurance markets, according to HHS release. Secretary Robert F. Kennedy Jr. said the department is discussing the plan with drug sponsors.