Broken Crystal Ball. Does the knowledge that RFK Jr might be heading up the Department of Health and Human Services get me any closer to guessing what might happen in the next 2 – 3 years for pharmaceutical health policy? Nope. But it wouldn’t seem like it would be good for innovation. NIH grants? Developing…
Some days you eat the bear and some days the bear eats you. Looking at Canada? No, not like that. JAMA featured a supply chain shortage look at the U.S. versus Canada. While not all of the lessons from Canada carry over (more flat bureaucracy because of connections between regulators and facilities) – they do…
As I write this, the elementary school across the street has Thriller playing at the 5th grade Halloween party happening in the parking lot. Things change and they stay the same. Not the worst reminder this week. Waiting. Payment rules expected from the Centers for Medicare & Medicaid Services plus maybe eventually the Medicare Transaction…
Caught my eye .. This week I am struck by connections between 340B and pharmacy benefit managers (PBMs) in terms of being issue areas that need complete makeovers. A glow up won’t do; we’re beyond that. But the trajectory toward change is very different. PBMs and payers (maybe) benefit from the way PBMs currently work.…
Order (Not) Ready. The National Community Pharmacists Association surveyed just under 500 independent pharmacy owners and the results are really interesting. Almost ¾ had not signed 2025 Part D pharmacy contracts as of about a month ago. Of those that dispense GLP-1 agonists, 96% lose money on them; it makes sense why 59% are thinking…
For most drugs, it is not IF but WHEN they will be negotiated by Medicare so if you thought you could ignore guidance coming out this week, you were wrong. Everyone on the pharma side needs to be thinking of how the Inflation Reduction Act impacts them, even if you’re early on in the pipeline…
If you haven’t trained your teams on Medicare Part D changes for 2025, hop to it. Or reach out to me. These are January 1 issues and we’re about to hit October…. Let me clear my throat. The STAT news breaking news headline read “Sanders says pharmacy benefit managers (PBMs) won’t penalize Novo for cutting…
Adding 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…
On the pile. 46Brooklyn put out a piece demonstrating the difficulty of understanding drug prices. It is a doozy of a read. A set-aside-time-to-concentrate read. But if you are skeptical about drug pricing and want to lump it all on manufacturers, you should take the time to read it. Big picture, there is no single…
The slight panic of 4 months left in the year is starting to hit but the amazing weather in the D.C. area made it seem just a bit less urgent. If you need any help with policy work these next few months or filling a speaking gig, I’m here for it. MedPAC was back this…