Pricing Debate
Obesity Gold Rush To Drive Significant Spending Growth Through Decade, IQVIA Says
IQVIA’s latest usage and spending trends report forecasts US obesity market will grow to $35bn by 2028, while the two leading GLP-1 agonists have already posted eye-popping sales growth.
Medicare Negotiation Timeline For Prices To Be Implemented In 2027
The schedule for the second round of negotiations is different from the first cycle, in part because the Inflation Reduction Act allowed for extra time initially as the program launched. The first- and second-year timelines also overlap: The second negotiation cycle will begin before the first cycle prices are implemented.
First Do No Harm: US MedPAC Wrestles With Complexity Of Low-Cost Drug Pricing
The US Medicare Payment Advisory Commission is analyzing two of the lower-cost segments of the US medicine marketplace: generic drugs and the 340B brand discount program. In both cases, there is a picture of complexity and unintended consequences to rival higher cost segments.
JNJ, BMS’s IRA Loss Is First Time Court Rejects Industry’s First Amendment, Takings Claims
The fourth court loss for pharma in industry's attempts to kill Medicare’s drug price negotiation program adds to the list of reasons courts have rejected legal challenges to the Inflation Reduction Act.
Quick Listen: Scrip's Five Must-Know Things
In this week's podcast edition of Five Must-Know Things: Teva’s immunology biosimilar launches; Intra-Cellular’s promising depression data; Phase III sleep apnea win for Lilly’s tirzepatide; an interview with Viking’s CEO; and China looks to define innovative drugs.
Medicare Reimbursement For Part B Drugs Is 48% Above 340B Prices To Hospitals, MedPAC Finds
New study updates past commission analyses and highlights the significant margin between Medicare payments for drugs and the prices paid by 340B-eligible providers.
Japan Regulatory Update: Revised Law Widens RWD Scope, Price Revisions/Listings
Japan now allows pseudonymized personal data for medical use under a licensing system for wider use of real-world data. Meanwhile, a national cost-effectiveness assessment scheme has slashed reimbursement prices for Lagevrio and Kerendia, and Alexion’s Voydeya has been added to the reimbursement tariff.
Medicare Reaffirms Faith In Formulary Review Process Ahead Of Part D Changes
Dramatic transformation in the US Medicare Part D benefit design does not require any changes to CMS’ overall approach to reviewing formulary submissions from private drug plan sponsors, the agency says in its final guidance implementing the design changes for 2025.
Califf Suggests Congress ‘Tighten Up Laws’ To Address Orange Book Abuses
US FDA Commissioner repeats longstanding FDA policy that the agency doesn’t have much power to address frivolous patent listings in the Orange Book, but seems to support Congress providing more authority.
Quotable: Top Experts On Policy Hot Topics
The Pink Sheet highlights recent comments and insights from pharma officials and executives on key issues we are covering.
Cost-Based Pricing: The Real Threat Hiding In Latest US Drug Price Headlines
Bernie Sanders is back at it, getting headlines for demanding immediate price cuts to Novo’s blockbuster GLP-1 brands. But behind the familiar rhetoric is a newer threat: academic research on cost-based pricing that could one day feed into the emerging Medicare ‘negotiation’ system.
Obesity Drugs Cost Concerns Not Yet Impacting HHS Risk Adjustment Models
Individual and small group plans in the commercial insurance market are not seeing ‘a large enough change in clinical indications or practice patterns to warrant a change to the current mapping of GLP-1 drugs,’ final rule states.
Biden vs Trump On Drug Pricing And Unfinished Business
While more significant reforms are less likely under a second Biden term unless Democrats control both chambers of Congress, former President Trump could look to put his stamp on drug pricing reform by resurrecting one of his former policies involving international reference pricing and Medicare Part B drugs.
Bernie Gets Mostly Pharma-Friendly Drug Pricing Results
Changes to inhaler pricing may be more ‘business as usual’ for the drug industry than the Vermont senator wants to let on. FTC, meanwhile, is keeping the patent pressure on Teva, the only inhaler manufacturer to not act following Sanders’ investigation.
Older Medicines Rebate Will Test UK’s New Pricing & Access Scheme
As the UK government implements a new rebate system for older medicines as part of the new pricing deal, industry trade bodies and experts suggest that exceptions will have to be made, such as higher prices or lower rebate levels for specific products.
Industry To Scrutinize Proposals On Updating UK Statutory Pricing Agreement
The UK government is consulting on updates to the UK’s statutory pricing scheme to bring it further into line with the voluntary pricing scheme.
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