Initial take at 3:30 today … which could change as I learn more… The foundational premise of the President’s new Executive Order (EO) is that the United States should pay less for drug and other countries should pay more; there should be an equalization. The Administration will take steps to work with foreign countries and…
I had visions of touring college campuses during the day and working on this post in the evenings. It turns out touring two colleges a day is really tiring in a way that working at my desk is not. I hit 22k steps in NYC yesterday (good prep for Asembia.) So what would I have…
Mom and Pop Going Broke. The economics of pharmacies are fascinating. Like did you know they usually lose money on brand-name drugs? A pharmacy benefit manager (PBM) law in Montana would help those pharmacies get closer to at least breaking even and make sure they get dispensing fees. I thought this KFF piece was a…
It’s time to set 2025 priorities and action plans – an exercise I love to do — and this week’s caught my eye is a hodgepodge of things to consider. Planning Woes. I’ve been wanting to write about the presidential candidates and what they might do in terms of health policy and pharmaceuticals if elected.…
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.…
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…
Recently RAND put out a study about prices paid to hospitals by private payers. Right in the summary is a statistic that made me pause – commercial insurance prices for administered drugs received in a hospital setting averaged 278 percent of average sales price (ASP) compared with 106% of ASP paid by Medicare for administered…