This afternoon I’m giving a talk to a group of patient advocates on the Medicare prescription drug benefit (Part D). As I prepared, I was struck by the fact that this is one of the few times that I feel that I’m (mostly) giving out good policy news. Are there downsides to the Medicare Part…
It is a dumb bucket list thing but one day I will go experience the Groundhog Day festivities. Dream big, I know. Cell and Gene Update. This week the Centers for Medicare and Medicaid Innovation (CMMI) released the Cell and Gene Therapy (CGT) Access model which will initially focus on sickle cell disease. It is…
A thoughtful piece on price hikes. Price hikes are the routine story of January. Look price hikes! But because net price hides behind discounts and rebates, the full story is seldom in media. Here is a story that is (finally) a little more balanced on price hikes (and decreases). It even talks about the new…
Aye-n’t going to happen. Last week I covered how Florida had their importation plan approved by the Food and Drug Administration. It all seems so unlikely to happen or, if it does, it has a lot to go through before it happens. And already the Canadians are saying no thank you. International Math. The Commonwealth…
Give me time off and I’m likely to find myself in over my head with a project of my own making. #cantstopwontstop. Like deciding to bake 120 giant cookies and then deciding that I didn’t like the look of half of them and starting over. Health policy took a backseat to cookies and scones for…
We’re in that last work week before everyone dashes off. My own clients have headed for the hills (Short Hills?) and I’ve been baking and wrapping this week. It makes me appreciate the usual day to day of policy and reimbursement more than I would have thought. Next week I’ll pull out the vision boards…
Driving home (the message.) Yesterday President Biden drove up to the National Institutes of Health and gave a speech about drug prices. My main issue with it is the traffic caused by shutting down the beltway and all the roads around my neighborhood. Okay and I think that a lot of the inflation penalties for…
Yesterday, the Kaiser Family Foundation released survey results that showed that only 25% of adults over 65 knew about the Medicare prescription drug benefit (Part D) out-of-pocket cap starting in January 2024. Coincidentally, I also spent a chunk of yesterday explaining the $0 patient cost-sharing in catastrophic to two different groups yesterday. Both of whom…
This morning I attended the Innovation and Value Initiative’s (IVI’s) event on “Ensuring Equity in Implementation of IRA Drug Price Negotiations.” As the discussions went on, I began to believe that ensuring equity in the Inflation Reduction Act (IRA) negotiation process was too herculean. To ensure equity would require… So maybe the title of the…
Back on November 17, the Centers for Medicare & Medicaid Services (CMS) released a slew of policy on the Medicare prescription drug benefit transition to the Medicare manufacturer discount program. This is the program that will be replacing the Coverage Gap discount program as of January 2025. The big document was the Part D Manufacturer…