Senate Infrastructure Legislation ‘Pay Fors’ Not So Bad For Pharma But Real Threat is Ahead
Senate negotiators opt to delay but not withdraw the pharma-backed rebate rule and target a relatively small reform aimed at allowing Medicare Part B to recoup the cost of leftover physician-administered drugs
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Despite objections from pharmacy benefit managers and insurers, the Centers for Medicare and Medicaid Services moves ahead with rule to transfer concessions directly to beneficiaries.
Proposal reflects a concern that plans and pharmacy benefit managers are inappropriately benefitting from price concessions (in this case from pharmacies) while beneficiaries are not, a theme the pharma industry has been pushing for some time.
A policy eliminating rebates in the Medicare Part D program will be delayed until Jan. 1, 2026 – and is very likely to be repealed altogether. If that staves off more draconian reforms, the biopharma industry will celebrate.