Medicare Part D
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Return of the MAC (Well I tried to tell you so)
Read more: Return of the MAC (Well I tried to tell you so)Last week MedPAC, the Medicare advisory committee to Congress, had a really interesting session on generic drug pricing in the Medicare prescription drug program (Part D.) There is always so much focus on branded drugs that an opportunity to flip the script and learn about the 90% of prescription drug utilization in Part D (and…
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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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Biosimilars, Caught my eye, CMMI, Drug Prices, Drug shortages, Health Equity, Inflation Reduction Act, Medicare Part D, ObesityCaught my eye — 4/5/24
Read more: Caught my eye — 4/5/24Ruling It. Yesterday afternoon, the Centers for Medicare & Medicaid Services released the MA/Part D final rule. Personally, most of it was not up my alley but I did read over the changes to the changes to an approved formulary sections. In December 2022, CMS proposed allowing immediate substitution of interchangeable biosimilars or branded biologics…
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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 — 3/8/24
Read more: Caught my eye — 3/8/24Happy International Women’s Day. Best display of International Women’s day I’ve ever seen was in Russia when I was studying abroad. They took it SERIOUSLY. Not just a LinkedIn Holiday. Cat-astrophe? No, just a political speech – not reality. President Biden talked about increasing the number of negotiated drugs up to 50 a year. Not…
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Caught my eye, Copay Accumulators, Inflation Reduction Act, Medicare Part D, Pharmacy Benefit ManagersCaught my eye — 3/1/24
Read more: Caught my eye — 3/1/24It took my until 5 pm on Thursday to figure out why there was a frog on the Microsoft tool bar. Leap year. Frog. Leap. Sigh. I prefer not. Congress seems to have hit the pause button (at least temporarily) on pharmacy benefit manager (PBM) reform. And that sort of felt okay because, realistically, things…
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Caught my eye — 2/23/24
Read more: Caught my eye — 2/23/24Gross to Net, a Saga. As soon as I saw Adam Fein’s Drug Channels article on Gross to Net in Part D redesign, I knew it would throw off my day. It was just catchy enough to cause a buzz and get the attention of Heads of Market Access at pharmaceutical companies and start the…
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Yays and Nays
Read more: Yays and NaysThis 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…
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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, Biosimilars, Copay Accumulators, ICER, Inflation Reduction Act, Medicare Negotiation, Medicare Part D, Pharmacy Benefit ManagersNot on my 2023 Bingo Card
Read more: Not on my 2023 Bingo CardWe’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…
Latest news
- Caught my eye — 1/24/25
- Caught my eye — 1/16/25
- Caught my eye — 1/10/25
- Caught my eye — 12/20/24
- Nurturing the Potential of Biosimilars
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