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‘Essential Benefit’ Drug Coverage Protections Is Next Priority For Patient Group Behind Copay Accumulator Victory

 
• By Cathy Kelly

HIV+Hepatitis Policy Institute provides CMS with a long list of plan sponsors and vendors that appear to be engaged in the practice, which the group argues circumvents the cost sharing protections provided by the Affordable Care Act for hundreds of drugs.

Affordable Care Act Regs Offer Platform For Broader Change • Source: Shutterstock

The Centers for Medicare and Medicaid Services should crack down on all private health plans that engage in the practice of covering drugs but then avoiding some of the cost sharing protections established by the Affordable Care Act by designating the drugs as “non essential” benefits the HIV Plus Hepatitis Policy Institute urged the agency in 8 January comments.

Key Takeaways

  • Many commercial plans are circumventing patient Rx drug cost sharing protections provided by the Affordable Care Act by exploiting flexibility in "essential health benefits" protections, group says.

The comments, which call the practice “extremely widespread and growing,” respond to the CMS Notice of Benefit and Payment Parameters...

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EMA Explores Supporting Drug Development For High Unmet Need Disorder Scleroderma

 
• By Neena Brizmohun

While treatments for scleroderma are in development, none are approved for the condition that is associated with high morbidity and mortality. The European Medicines Agency says guidance on how to design development programs for the disorder is needed.

EMA Nod For First MASH Drug Rezdiffra, Cell Therapy Zemcelpro And 11 Others

 
• By Eliza Slawther

Madrigal Pharmaceuticals’ Rezdiffra is on track to become the first medicine approved in the EU for non-cirrhotic metabolic dysfunction-associated steatohepatitis after the European Medicines Agency recommended that it be granted conditional marketing authorization.

BIO Notebook: Policy Uncertainty Constraining Dealmaking

 
• By Mandy Jackson and Joseph Haas

Highlights from Day Four of the BIO International Convention include policy concerns helping constrain dealmaking, Novartis discussing its approach to partnering, and Generate looking for funding to move into Phase III.