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…
It’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.…
Just a quiet health policy week. Well actually, depending on your level of wonkiness, it kind of was? But let’s get into what you need to know. They’re Here! On Thursday, the Centers for Medicare & Medicaid Services released the “negotiated” prices for the initial ten Medicare prescription drug benefit drugs (Part D); these prices…
In my 20s, today would have been like the Super Bowl for nerdiness. I would have been really excited about the first look at the negotiated rates for the first 10 drugs, effective January 2026. But I’m not. Why is my wonkiness holding back? So my hunch is that plans will put the competitor drugs…
A pretty quiet week for pharma health policy but there are a few things I think you should know … The Auchincloss Venn Diagram. Brian Reid improved upon Congressman Auchincloss’s diagram and I think it provides a great way to think about pharmacy benefit manager (PBM) reform. No chicken, no egg – straight to the…
Up, up and away. Earlier this week, the Centers for Medicare & Medicaid Services (CMS) announced initial premium information for the 2025 Medicare prescription drug benefit. The base beneficiary premium went up 6% or $2.08 to $36.78. Which sounds okay until you realize that 6% is a capped amount due to the Inflation Reduction Act.…
Let’s be honest, health policy has sort of taken a backseat when it comes to what we’re all tracking these days. And that’s okay. If you’ve taken a deserved timeout, let me catch you up on what caught my eye. Ice Ice Baby. The House of Representatives Committee on Oversight and Accountability released a report…
According to the June 2024 analysis by Milliman for the Pharmaceutical Research and Manufacturers of America (PhRMA), the Inflation Reduction Act’s (IRA) drug pricing provisions could increase out-of-pocket (OOP) costs for 3.5 million Medicare Part D patients in 2026. The analysis estimates that beneficiaries who take medicines subject to the Medicare Drug Price Negotiation Program (MDPNP) could…
Trying 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…
Today I’m doing a presentation for patient advocates on the Initial Price Applicability Year (IPAY) Guidance 2027 that the Centers for Medicare & Medicaid Services put out a few weeks ago. I thought you might enjoy the overview as well. Long story short – the guidance is focused on the Medicare negotiation process for 2027.…