Medicare Advantage
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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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When Less is More (in a not good way)
Read more: When Less is More (in a not good way)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…
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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 — 06/07/24
Read more: Caught my eye — 06/07/24A relatively quiet week around these parts. I think everyone is so ASCO’d and BIO’d that policy is taking a quick breather. A PDAB will do you. The National Pharmaceutical Council put out a nice round-up comparing four prescription drug affordability boards. The chart is my favorite part – Extra, extra. Elevance Health, a health…
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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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Affordable Care Act, Healthcare Costs, ICER, Inflation Reduction Act, Medicare Advantage, Medicare Negotiation, Medicare Part D, State-based ReformCaught my eye — 4/12/24
Read more: Caught my eye — 4/12/24PDAB-adieu. This week Governor Youngkin vetoed a bill that would have established a prescription drug affordability board (PDAB) in the state. The PDAB would have had authority over state-sponsored and state-regulated health plans. Younkin said that the PDAB would have determined drug availability solely on cost rather than unique patient needs and the opinions of…
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Part D Policy: Reading it so you don’t have to
Read more: Part D Policy: Reading it so you don’t have toLate Monday, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Rate Announcement for Medicare Advantage and the Medicare Prescription Drug Program (Part D) as well as the CY25 Part D Redesign Program Instructions. I was about to get on an airplane and instead of watching a movie, I figured what sounds like a…
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Caught my eye — 2/16/24
Read more: Caught my eye — 2/16/24Honestly? Not a lot caught my eye this week. Maybe we were all heads down getting stuff done before a long weekend? You say MPPP, I say smoothing. Late yesterday afternoon the Centers for Medicare & Medicaid Services released Draft 2 guidance for the Medicare Prescription Payment Plan. I’ve heard Michael Ward from Alliance for…
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Biosimilars, Caught my eye, Drug Prices, Healthcare Costs, Medicare Advantage, Medicare Part D, Pharmacy Benefit Managers, ValueCaught my eye — 2/9/24
Read more: Caught my eye — 2/9/24A whirlwind of a week. I regrouped on Wednesday and got a run in and some pottery wheel time and then it all fell apart again (in a good way) on Thursday where I forgot to leave my desk for hours and hours. One of those “I love working” and forget time exists. So much…
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340B, Alzheimer’s, Caught my eye, Drug Prices, Drug shortages, Medicare Advantage, State-based ReformCaught my eye — 1/26/24
Read more: Caught my eye — 1/26/24It has been fun to see the year really start to kick off this week with a bunch of policy releases. Shortages. Generic shortages are caused by a myriad of factors, but a big piece is the race to the bottom for prices. A fraction of a penny less and a contract shifts to another…
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