340B
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340B, Caught my eye, Drug Prices, Healthcare Costs, Inflation Reduction Act, Medicare Advantage, Medicare Negotiation, Medicare Part DCaught my eye — 9/20/24
Read more: Caught my eye — 9/20/24Adding On. So glad to see this research from Avalere conducted on behalf of the Community Oncology Alliance (COA) on the impact of the Inflation Reduction Act (IRA) negotiation on Medicare Part B provider reimbursement. While in Medicare Part D, negotiated prices do not factor into Average Manufacturer Price, the legislation is silent on whether…
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340B, Caught my eye, Drug Prices, Generics, Inflation Reduction Act, Medicare Negotiation, Medicare Part D, Medicare Transaction FacilitatorCaught my eye — 8/23/24
Read more: Caught my eye — 8/23/24It’s an Inflation Reduction Act (IRA) hangover kind of week. Last week the first Medicare negotiated prices for 2026 were announced and this week is the “what does this mean?” week with everyone catching up and chiming in. What I wrote last week stands but if you want another review, Health Affairs/KFF has you covered.…
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340B, Biosimilars, Drug Prices, Generics, Healthcare Costs, Medicare Advantage, Medicare Part D, ValueCaught my eye — 6/21/24
Read more: Caught my eye — 6/21/24You know it is hot when I say, “Let’s go for a walk” and my dog looks at me from the stop of the stairs and refuses to move. At 6:30 in the morning. I hope you’re feeling more motivated than he is. Same same, not different. Late last year, the Medicare prescription drug benefit…
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Caught my eye — 05/31/24
Read more: Caught my eye — 05/31/24Trying to change my view. I don’t know if it is summer malaise setting in or an existential crisis about the state of society, sometimes it is hard to tell. Earlier this week, Jessica Yellin of News Not Noise pointed out that a lot of articles are really negatively titled and it is driving a…
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340B, Caught my eye, Drug Prices, Inflation Reduction Act, Medicare Negotiation, Pharmacy Benefit Managers, State-based ReformCaught my eye — 05/24/24
Read more: Caught my eye — 05/24/24Coulda, woulda, shoulda. On Tuesday, the Senate Judiciary committee had a hearing on prescription drug prices. It became clear that comparisons to international prices remain a focus but so is patent abuse. I am not sure that’s a fair characterization. What companies are doing is legal and I’m not sure they’d be doing their fiduciary…
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Part B, ASP and 340B
Read more: Part B, ASP and 340BRecently RAND put out a study about prices paid to hospitals by private payers. Right in the summary is a statistic that made me pause – commercial insurance prices for administered drugs received in a hospital setting averaged 278 percent of average sales price (ASP) compared with 106% of ASP paid by Medicare for administered…
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It just keeps on growing
Read more: It just keeps on growingWhen I first got into this pharmaceutical health policy and reimbursement world in 2005, I mostly ignored 340B. It was a big discount that was required, and you couldn’t do anything about it, so it just was. Then maybe 2012 or so I remember Andy Swire from Amgen was super amped up about 340B…
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340B, Caught my eye, Drug Prices, Employers, Healthcare Costs, ICER, Inflation Reduction Act, Medicare Negotiation, Medicare Part D, Medicare Transaction Facilitator, Reference Pricing, ValueCaught my eye — 5/10/24
Read more: Caught my eye — 5/10/24Back to back. Arnold Ventures put out the latest anti-pharma talking points (h/t Brian Reid) and here were two back to back – Here’s the problem, it really isn’t about the cost of drugs. I mean you could take that drug price and reduce it 98% and the 25% cost share would still be too…
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Caught my eye — 4/26/24
Read more: Caught my eye — 4/26/24What the math. Yesterday afternoon CMS released a technical memo on the changes to True Out-of-Pocket (TrOOP) Costs and the maximum monthly cap for the Medicare prescription payment plan (MP3.) Simply put, they put out a memo that shows the math for the smoothing program. I need to work through some of the examples because,…
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Caught my eye — 3/29/24
Read more: Caught my eye — 3/29/24It has been a week of odds and ends so if you’re catching up after ignoring your emails, you didn’t miss a ton. Honestly, it seems like a good time to be a DC law firm working on pharmaceutical issues. You have the usual Inflation Reduction Act submissions, comment letters (which, for what it is…
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