POLITICO’s Post

The rising costs of drugs are being mainly pushed onto patients who have to pay out of pocket. The different levels of premium, deductible, and co-payments pass on to the consumer due to cost-sharing levels. Cost-sharing involves a complex chain of drug supply which benefits Pharmaceutical and insurers. Through value-based patient cost sharing, the patients can pay for the levels of cost-effectiveness they can afford. This strategy would lead to better control of drug prices, leading to more accessible medications. #MedicationCosts #PriceTransparency #RisingDrugCosts

The 340B Drug Pricing Program’s rapid growth has created a complex web of financial and legislative challenges for pharma companies. My colleagues Nick Porter Neelabh Saxena Harshil Gagnani Shreya Bhatia dive into pharma’s and states’ responses to the program’s evolution and the effectiveness of these strategies. Since we drafted this whitepaper, several more manufacturers and states have evolved their policies, showing just how dynamic this space really is! Download the white paper to find out how pharma can adapt. #healthcare #pharma #340B #drugpricing #publicpolicy https://lnkd.in/eXczZneB

Medicare Part D, the prescription drug benefit program, has been run with a market-oriented approach and has been more successful than its critics will acknowledge. Now that #Medicare has been given the go-ahead to negotiate prices for some drugs, the big question is whether this change will impact innovation in the #pharmaceutical marketplace?   The attached The Wall Street Journal article “Expensive Drugs Targeted for First U.S. Price Negotiations,” could have been titled, “Expensive Drugs Targeted for Price Controls.”   As a seasoned #benefits executive, what I worry about is how this will impact the self-insured marketplace. What I have seen in the past is that, when government squeezes cost, self-insured plans pick up the tab. From my perspective, government intervention has forced costs to rise faster than only one other sector in the U.S. (education).   There are many other ways the government could control drug costs including revising the drug approval process, looking at patent protection reforms and increasing the contribution from other countries for the costs of drug development.   Managing your benefits programs like a business is only going to get more important because I believe pharma spend is getting ready to explode. Part of a well thought through benefit strategy will involve how you will manage your pharma spend in the upcoming years. DM if you would like help. Link to article in first comment below. Brown Vincent Drew Morgan Massie Meredith Ashok Subramanian Stacey Richter Brian Klepper 4C Digital Health jeff leston Ron Templeton Megan McErlane Gaupp Thomas Wudarski Will Ruch Colleen McHugh David W. Fields

🌟 Big Pharma to Hike Prices on 500+ Drugs in 2024 🌟 Reuters reports impending price increases on over 500 drugs in the US, impacting 140 brands. The Biden administration's plan to reshape drug price negotiations is set for 2026. Stay informed on the evolving healthcare landscape. #PharmaNews #DrugPrices #HealthcarePolicy #USHealthcare #BidenAdministration

There’s simply no evidence that 60 years spent building horizontally and vertically integrated, rationing, segregating monopolizing and inequitably subsidized mega-profitable health insurance conglomerates and their wholly owned PBM subsidiaries has improved most Americans preventive-medical-surgical or palliative care access, outcomes or costs. #tripleaim #valuebasedcare #valuebasedhealthcare #publicprivatepartnerships #publicprivatepartnership #patientcenterecare #capitation #MedicareAdvantage #HealthEquity #Healthcarecosts #HealthcareQuality #SDoH #Valuebasedcare #Valuebasedhealthcare #prevention #preventativecare #populationhealth #quadrupleaim #healthequity #healthcaretransformation #healthcarereform

A Recent Comprehensive Analysis of Commercial Drug Costs Shows That 23% of Prescriptions had Copays that Exceeded the Costs of the Drugs to the PBMs. And What Value Do Off Shore Rebate Aggregators Provide to Patients and Employers? Per a recently published report by the New Mexico Legislature, “...three PBMs, along with their national health insurer owners, control much of the drug supply chain, including retail, specialty, and mail order pharmacies, as well as recently created non-U.S. based “rebate aggregators.” These rebate aggregators negotiate and capture discounts from pharmaceutical manufacturers. This allows them to largely bypass local pharmacists should they choose to do so and also places at least some regulation of their activities outside the reach of U.S. regulators since many of them are based offshore." "The result of this vertical and horizontal growth and integration has been the creation of an opaque and closed system in which purchasers and patients have limited information or purchasing leverage. The results for consumers can also sometimes be baffling. As an example, research conducted by the USC Schaeffer Center showed that in a recent comprehensive analysis of commercial drug costs 23% of prescriptions had copays that exceeded the costs of the drugs to the PBMs..." The New Mexico State Legislature, Assessment of Pharmaceutical Purchasing Methods: Draft for Discussion and Approval, New Mexico Legislative Council Service, 1-28-24, PP 15-16 So it goes n8 #healthsystems #pbms #healthinsurance #valuebasedcare #hospitals #pharmacybenefits

Medicare is gaining the power to negotiate prices for certain drugs and punish pharmaceutical companies that don’t play by the rules. To read more, go to https://lnkd.in/gJEEJ9r9 #inflationreductionact #medicare #drugprices #pharmaceutical #hhs #medicarepartb #medicarepartd #healthcare 

🔍 Attention Pharma Manufacturers! This weekend, CMS issued preliminary notices regarding potential rebates/refunds that may be required for unused drug portions reimbursed by Medicare Part B. The preliminary notice is not a bill so final numbers may change in advance of the December 31, 2024 deadline for CMS to send their initial refund report to manufacturers. Read our June 2023 blog for key insights on the Drug Wastage Ruling or contact our experts today to ensure you’re prepared. #CMSUpdate #PharmaIndustry #healthcareinsights https://lnkd.in/g9ZxaBNk

This morning as the U.S. Department of Health and Human Services (HHS) announced that manufacturers of drugs selected for the IRA's Medicare Drug Price Negotiation Program (DPNP) had received initial offers, The Health 202 from The Washington Post and KFF Health News cited NPC research on the unintended consequences of the DPNP: "It’s also hard to predict the effect of litigation. Pharma companies have sued the Biden administration over the IRA and its negotiation program, and their associations have issued dire predictions about the unintended consequences. The program 'could result in fewer treatment options for patients, particularly those with rare diseases who may have to wait longer for access to innovative therapies,' the National Pharmaceutical Council warned in November." Read the Health 202: https://lnkd.in/eKeTgy5K Read NPC’s “How The IRA Could Delay Pharmaceutical Launches, Reduce Indications, And Chill Evidence Generation” in Health Affairs Forefront: https://lnkd.in/eWnp3JiW