Medicare Negotiation
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Orphan drug: Expand the label and you lose
Read more: Orphan drug: Expand the label and you loseFrom a patient perspective, the Inflation Reduction Act (IRA) definitely has some upside. Starting in 2024, the out-of-pocket cap in the Medicare prescription drug benefit starting is fantastic for beneficiaries taking more expensive products. Although this is a minority of patients, it still gives piece of mind to many knowing that if they find themselves…
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Caught my eye — 11/10/23
Read more: Caught my eye — 11/10/23Guess which one costs more. This Wall Street Journal article has been making the rounds this week. It highlights how if there are two prices for a drug, plans tend to prefer the higher cost one with higher rebates. I hesitate to call it news because it seems so obvious to those of us who…
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Caught my eye — 11/3/23
Read more: Caught my eye — 11/3/23InNOvation. Seagen said they aren’t looking at a drug that would treat early-stage bladder cancer because it would be subject to negotiation too soon after approval and wouldn’t have a financial return on the investment. Today the National Pharmaceutical Council published a great piece in Health Affairs that goes deeper into the subject of innovation…
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Caught my eye — 10/6/23
Read more: Caught my eye — 10/6/23Patients driving change. I love this story because it involves Carl Schmid, patient groups and copay accumulators. Copay accumulators are when insurance does not allow pharmaceutical manufacturer contributions to count towards patient out-of-pocket spending calculations. Thanks to the HIV+Hepatitis Policy Institute, the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition and their suit against…
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Caught my eye — 9/29/23
Read more: Caught my eye — 9/29/23It’s not a vacation. Let’s start with federal employees; you deserve better. You often could get paid more elsewhere but you want to serve. And instead of saying thank you, Congress asks you to take a seat on the bench and (hopefully) get backpay. It feels awful and I am so sorry you have to…
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Caught my eye — 9/22/23
Read more: Caught my eye — 9/22/23Leave the gun, take the cannoli. House Energy and Commerce hearing on Medicare price negotiation gets feisty. Not often that the mafia comes up on the House floor but an interesting comparison of price negotiation and an offer they can’t refuse. I doubt Congressman Griffith (R-VA) and I agree on much politically but on this,…
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Caught my eye — 9/15/23
Read more: Caught my eye — 9/15/23Suited up: The Department of Justice responded to Merck’s Medicare negotiation suit. It leaned into the argument that this is a negotiation. “Manufacturers that do not wish to make their drugs available at negotiated prices can avoid doing so by forgoing sales of the relevant drugs to Medicare beneficiaries— including by withdrawing from the Medicare…
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Caught my eye — 9/8/23
Read more: Caught my eye — 9/8/23Weight list: The rush for access to weight loss drugs is not just in the United States. 20,000 people were interested in Wegovy in Britain and the wait list (weight-list?) is long. Ozempic is in shortage there. Another story highlighted shortages for weight loss drugs in United Arab Emirates. Interestingly, each area in the UAE…
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Costs and Consequences
Read more: Costs and ConsequencesThe Inflation Reduction Act (IRA) is a sneaky piece of legislation. It sounds so promising with a cap on out-of-pocket (OOP) spending in Part D and really sticking it to Big Pharma. But does the legislation get us to the stated goal of lower drug prices and have outcomes (or consequences) that are worth the…
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Huh, Insulin?
Read more: Huh, Insulin?Yesterday the Centers for Medicare & Medicaid Services (CMS) released the list of drugs that they have selected as part of the initial year of Medicare drug price negotiation under the Inflation Reduction Act (IRA). These drugs will be negotiated over the next year with implementation of the prices to begin in 2026. And there…
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