HHS Price Negotiations Could Be Delayed When Biologics Have Biosimilars Pending Under Bill
Latest iteration of drug pricing legislation from Senate Democrats would also firm up the number of drugs HHS must choose for price negotiation each year and no longer treats insulin as a separate class for purposes of negotiation.
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CMS will need to continue to be ‘savvy’ to strategies brand manufacturers already employ to shape the landscape for generic and biosimilar competition, policy expert says.
CMS’s new price negotiation authority has an exemption for ‘small biotech’ companies. The agency’s implementation plan suggests that will be a tricky concept to define.
ASP metric used in Medicare, and often in commercial insurance, for reimbursement of physician-administered drugs is an important factor in the sales arc for biosimilars. Price negotiations under IRA could bring their own margin-squeezing pain to pharmacy-benefit biosimilars.