1. Pink Sheet
  2. >>Market Access

Part D Cost Sharing Based On Net Price, Boost For ‘High Discount’ Biosimilars Proposed In Draft Bill

 
• By Cathy Kelly

Senate Finance Committee’s PBM legislation would essentially pass through rebate value at the pharmacy counter for some drugs, block situations where beneficiaries pay more than plans and reward biosimilars that have list prices substantially below their reference products.

Lobbying To Reform PBM Rebate Practices Continues • Source: Shutterstock

Coinsurance obligations for Medicare Part D beneficiaries would be based on the net, post-rebate price of certain drugs for chronic conditions under a legislative discussion draft released by the Senate Finance Committee.

The committee plans to mark up the draft bill, which also includes policies related to pharmacy benefit manager contracts with...

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
Start Free Trial

Already a subscriber?

More from Market Access

China Unveils Multiple Policies To Support Innovative Drugs Throughout Life Cycle

 
• By Xu Hu

China has announced a raft of new measures to encourage innovative drug development across the product life cycle, including using insurance data to differentiate new therapies and applying commercial insurance to selected novel products.

Medicaid Changes Could Have Major Impact on Recent Coverage Improvements

 
• By Tim Casey

Insurance trade groups warned that the Big Beautiful Bill destabilize Medicaid and result in the largest ever roll-back in health care coverage in the US.

England’s NHS Plan Eyes Cancer Vaccine Boost, Single Formulary & ‘Pay For Impact’ Drug Deal

 
• By Eliza Slawther

The creation of a single national formulary for medicines prescribing that could impact industry is among the action points in the UK government’s new 10-year health plan for the National Health Service in England.

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

 
• By Neena Brizmohun

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.

More from Pink Sheet

US FDA Asking Questions About Commissioner’s Voucher Program With Details Scarce

 
• By Derrick Gingery

FDA staff are trying to plan for program implementation in the absence of critical eligibility and other details, although guidance may be coming soon.

Senate Appropriators Give US FDA More Non-User Fee Funds Than House

 
• By Sarah Karlin-Smith

US FDA would receive more funding for fiscal year 2026 in the Senate appropriations bill than its House counterpart, including $10m for unannounced foreign inspections.

EU Medical Countermeasures Strategy Promises More AMR Pull Incentives

 
• By Francesca Bruce

A new EU strategy to ensure access to essential medicines will boost the development of critical medical counter measures, including vaccines and therapies, according to one pharmaceutical industry group.