Could Government Negotiated Prices Curtail Access? PBMs And Potential Perverse Incentives Dominate First Medicare Listening Session

Patients and advocacy groups tell Medicare they want lower cost drugs but are concerned that if government negotiations lower list prices, rebate-focused PBMs may preference higher list-price competitors. 

CMS patient listening meena
CMS deputy administrator Meena Seshamani opened the listening session. • Source: Screenshot

Patients and patient advocates raised a potentially concerning paradox at the first Medicare public listening session on the drugs that will be subject to US government price negotiations under the new Inflation Reduction Act – that the government’s ability to get lower list prices for selected drugs might lead pharmacy benefits managers to make the medications more inaccessible to patients.

The Centers for Medicare and Medicaid kicked off the first of 10 days of listening sessions 30 October with public...

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required

More from Pricing Debate

Here At Last: Canada’s Long-Contested Guidelines For Curbing Excessive Drug Prices

 

Final guidelines explaining how staff at Canada’s Patented Medicine Prices Review Board should go about identifying drugs that could be considered for an excessive price hearing will come into force soon.

US Budget Bill Eases IRA Price Controls But Coverage Losses Will Impact Pharma

 
• By 

The legislation expected to be signed by President Trump is a mixed bag for pharmaceutical manufacturers depending on their product mix and manufacturing situation.

Kennedy Appears Ill-Informed On Major Pharma Priorities, Creating Unique Lobbying Dynamics

 

The Health and Human Services Secretary made incorrect statements about the status of key industry priorities at a recent House hearing, which actually may be a good thing for drug sponsors.

How Could MFN Pricing Impact Commercial Market?

 
• By 

Industry experts forecast the impact of President Trump's Most-Favored Nation drug pricing policy on the commercial insurance industry.

More from Market Access

US Budget Bill Eases IRA Price Controls But Coverage Losses Will Impact Pharma

 
• By 

The legislation expected to be signed by President Trump is a mixed bag for pharmaceutical manufacturers depending on their product mix and manufacturing situation.

Kennedy Appears Ill-Informed On Major Pharma Priorities, Creating Unique Lobbying Dynamics

 

The Health and Human Services Secretary made incorrect statements about the status of key industry priorities at a recent House hearing, which actually may be a good thing for drug sponsors.

How Could MFN Pricing Impact Commercial Market?

 
• By 

Industry experts forecast the impact of President Trump's Most-Favored Nation drug pricing policy on the commercial insurance industry.