Government Payers

French Health Care Professionals Warn Of Medicine Access Problems

 

A new survey of French healthcare professionals reveals concerns that France is increasingly being excluded from major international clinical studies.

Japan Prices New Products Including Milk Fortifier But Cuts Capivasertib Price 10.7%

 
• By 

Japan's regulatory authorities recommend approval of products including a cell therapy, while setting reimbursement prices of newly approved drugs and cutting some others following cost-effectiveness assessment.

US House Bill Would Codify GENEROUS Model, Exemption From MFN Pricing In Medicare

 
• By 

Although the legislation has little chance of passing, it offers some clues about the administration's goals for MFN agreements, which differ from the voluntary deals struck with large pharma companies.

Drug Price Negotiation And Part B: Not Much Impact In Year One

 

The expansion of the US Medicare drug price negotiation to include Part B products for the first time should be a very big deal, but the impact is not going to be significant in the first year and maybe future years.


Norwegian Industry Asks Government To Match Danish Response To US Pricing Pressures

 

Norway’s pharmaceutical industry association says it is waiting to hear from the ministry of health about how it will address the country’s low willingness to pay for innovation.

Off-BALANCE? Obesity Drug Model May Need Nearly Universal Part D Plan Participation

 
• By 

CMS also outlined eligibility criteria for patients with a body mass index of 27, 30 and 35 or more for the demonstration project planned in Medicare and Medicaid.

US Medicare Proposes Buy American Rx Incentives, But What Is A ‘Domestic’ Medicine?

 

CMS is proposing enhanced payments for hospitals that commit to purchasing essential medicines from domestic sources, but wants ideas for defining a “domestic” medicine.

Small, Mid-Size Firms Not Feeling GENEROUS? CMS Pursues MFN Model Participation

 
• By 

The agency may be prepared to discuss broader voluntary Most Favored Nation agreements with small and mid-size firms during April meetings about the GENEROUS model.


MFN Drug Pricing Policy Forces Companies To Rethink Selling Ex-US Rights

 
• By 

At BIO’s Investor and Growth Summit, panelists said Most Favored Nation pricing in the US is forcing biopharma companies to scrap plans to to out-license ex-US rights to their drugs, a previously common practice.

GLOBE, GUARD Demos’ Approach To Licensed Drugs Alarms Small, Mid-Size Firms

 
• By 

The CMS proposal to assign liability to manufacturers despite licensing arrangements reflects the agency’s concern that companies will try to game the models.

‘They May Do It’: Trump’s Call For Congress To Codify MFN Deals Suggests Challenges

 
• By 

Trump touted his "big achievement" on drug pricing during his State of the Union address and did not imply other reforms are coming.

Novo’s Wegovy, Ozempic List Price Cuts Reflect Competitive Pressures, Policy Environment

 
• By 

The move is aligned with a growing industry shift toward lowering list prices to current net pricing levels and eliminating rebates.


The Eliquis Paradox: US Price Caps Trigger Double-Digit Growth

 

The first round of price caps imposed via Medicare negotiation have taken effect, but if the leading target is any indication, industry appears able to handle the consequences.

England Finalizes Access For SGLT-2 & GLP-1s In Diabetes, Unlocks £560m Savings

 

SGLT-2 inhibitors should be used to treat patients with type 2 diabetes much earlier in their treatment, the English health technology assessment institute said, adding that using generic dapagliflozin would save the National Health Service £560m.

Medicare Negotiation Cycle Two: More Dynamic Offer Process, Better Public Input

 
• By 

CMS’ explanation of the process for arriving at the maximum fair prices for 15 Medicare Part D drugs scheduled to be implemented in 2027 still was general and opaque with significantly redacted documents.

TrumpRx Launch Highlights MFN Drug Discounts, With Caveats

 
• By 

The Trump administration has launched TrumpRx, a website the White House says could help save Americans billions in pharmaceutical spending, although it does not itself sell or dispense drugs.


Eli Lilly Predicts Medicare Coverage Of Zepbound Will Draw Current DTC Customers

 
• By 

The sales opportunity in Medicare Part D and Medicaid arrives as Lilly and Novo Nordisk face a new competitive threat from compounded semaglutide for obesity.

PBM Reform Bill Passes US Congress, But More Changes Likely Not Imminent

 
• By 

The US Labor Department also added a proposed rule requiring PBMs to disclose additional compensation information to certain employer-plan sponsors.

DTC Drug Safe Harbor Includes Sponsors Putting No Conditions On Future Sales

 
• By 

The HHS OIG advisory pertains to manufacturer sales to patients. OIG will seek stakeholder input regarding possible additional guidance on manufacturer arrangements with pharmacies, pharmacy benefit managers, telemedicine vendors and marketers.

New Medicare Negotiation List Spotlights Small Molecule Liability For Cancer Drugs

 
• By 

The process will pit breast cancer treatment competitors Kisqali and Verzenio against each other as CMS develops pricing offers.