Erin Seidler, MPA’s Post

Negotiated Drug Prices Under Medicare Resulted In Price Reductions Compared With 2023 Net Prices, Analysts Say Bloomberg Law (9/3, Phengsitthy, Subscription Publication) reports, “Negotiated drug prices under Medicare resulted in a variety of price reductions compared with their 2023 net prices, which included five drugs facing cuts in the 30% to 40% range and two drugs subject to no price cuts, health policy analysts say.” A new “report in Health Affairs Forefront compared the Biden administration’s 10 lowered drug costs from the first cycle of the Medicare Drug Price Negotiation Program with their Part D net prices in 2023.” https://lnkd.in/g6qxVYGV

The 2/12 Healthcare Labyrinth Blog is now live. Click below to read! Blog Topic: A review and assessment of the 2/8 Senate HELP Committee hearing on drug pricing. It shows how deeply divided Congress is on the issue. #healthcare #healthinsurance #healthcarereform #healthcarelabyrinth

5 Things to Watch During State Prescription Drug Affordability Board Meetings (Beyond the Oregon Ozempic and Trulicity discussions) Sometimes, the implications of PDABs are not readily apparent in Board votes, meeting minutes, or summaries. Here's what we're noticing. 1️⃣ Affordability is ill-defined. 2️⃣ Leadership sets the tone of the debate. 3️⃣ Patient input matters (even if limited). 4️⃣ Acceptance of patient expertise is inconsistent. 5️⃣ 90-second reel-like public comment periods offer little. Let's break it down: 1️⃣ Affordability is ill-defined. 🧠 Affordability for whom? If for consumers, how should food, housing, or employment factors be considered? How do health plan premiums and formulary tiers affect #affordability? The boards have struggled. Patient qualitative data collected in states varies. Definitions matter. Definitions that are not defined are hard to assess. 2️⃣ Leadership sets the tone of the debate. Today's Oregon PDAB meeting is the first public meeting after the 20-minute Executive Director "State of the Union" on April 17. Missed it? Check out Brian Reid's Cost Curve April 25 newsletter. Discussions in Colorado feel different. Refer someone or apply for the open Executive Director role ( 🔗 in comments). 3️⃣ Patient input matters (even if limited). ❗ Early lessons from Trikafta, Genvoya, and the insulin discussions have shown that #patientengagement and #patientinsights matter. Even if they are limited in numbers. More work is needed to make it "easy" for patients to engage. 4️⃣ Acceptance of the value of patient input is growing but inconsistent. ⁉ Heard on a recent discussion: What is the value of having patient or consumer representatives? Are they qualified? Can they engage? But when other board members spoke up on the importance of patient representatives on IRBs and other forums, it was 😍. Sometimes, progress takes time. 5️⃣ 90-second reel-like public comment periods offer little. Comments and Q&A can go on. But 90 seconds ⌚ for stakeholder comments is really, really short. Even TikTok videos allow 3 minutes. 90-second clocks are a little more for an advertisement to read written comments. It does not allow discussion or dialogue. Until then...we're watching Oregon today and the selection of drugs for cost review in Maryland on Monday. What are you noticing?

The Inflation Reduction Act is significantly altering the U.S. #healthcare landscape, impacting Medicare drug pricing and creating ripple effects across the ecosystem. This legislation introduces direct drug price negotiations, redesigns Medicare Part D, and imposes inflation rebates, affecting #payers, #providers, and #biopharma companies. Understanding these changes is crucial for stakeholders to navigate the evolving health care environment effectively. For an in-depth analysis of the IRA's implications and strategic recommendations, read the full article

Excerpt: "In fact, the Inflation Reduction Act’s poorly conceived government price-setting will disrupt access to medicines for millions of Medicare patients with diabetes, cancer, atrial fibrillation, rheumatoid arthritis and other diseases. The law’s price controls are likely to raise annual out-of-pocket costs for 3.5 million Medicare beneficiaries who take price-controlled medicines, according to an analysis commissioned by the Pharmaceutical Research and Manufacturers of America. These cost increases stem from the interaction of price controls with mandated changes to how Medicare drug plans design their benefits. "The Inflation Reduction Act’s harmful effects extend beyond higher out-of-pocket costs to higher premiums. Its mandated changes to benefit designs clash with how the plans would otherwise work to serve customers" #medicare #inflationreductionact #incompetence #hubris #mediabias #weakleaders #economics #healthcare #prescriptiondrugs

What's on Congress' health care agenda this year? Download Axios Pro's latest report for analysis on key drug pricing and #healthcare legislation to watch in 2024.

We are in an endless pursuit to make healthcare more simple, transparent, affordable, and equitable. The role of PBMs in healthcare has historically been less transparent, creating a ripple effect of grayness across our members, pharmacists, and providers. This , when intersects with our aging population (in 2050, over 50% of us will be above the age of 65), the need for reduced prices and transparency takes the front-row seat. The White House shares the results of the first Medicare drug price negotiations, which will lead to $6 billion in savings across 10 drugs when new prices take effect in 2026 and beneficiaries could save roughly $1.5 billion in out-of-pocket costs. Meanwhile, Mark Cuban and Alex Oshmyansky, MD, PhD are accelerating the journey to less costs and affordable healthcare by reducing the middlemen Mark Cuban Cost Plus Drug Company, PBC. #healthcare #PBM #publichealth #generic #drugs #equity #health #aging #medicare

Actions that help foster a more sustainable #generic #medicines industry in the U.S. are essential to keeping #prescription #drug costs down, for patients. Unfortunately, lack of transparency around negotiated prices -- specifically under the Inflation Reduction Act (IRA) -- threatens the generic drug industry. In a recent Inside Health Policy article, written by Maaisha Osman, Mark McClellan, former FDA commissioner and director of the Robert J. Margolis Center for Health at Duke University, told the publication "...that generic manufacturers may be discouraged from investing and as a result the brand drug manufacturers could maintain market dominance for a longer period under the IRA. 'There is some concern that the generic manufacturers won't bother investing for some drugs, and that the brand name manufacturer could keep a longer-term monopoly, even though they won't be making as much,' McClellan said." Read the full article, here: https://lnkd.in/eKAYsFi8 Centers for Medicare & Medicaid Services

Have you heard about the Inflation Reduction Act (IRA)? While it’s a significant step forward in reducing drug prices for those on Medicare, it doesn’t go far enough. Millions of Americans under 65—those with private insurance or no insurance at all—still face high medication costs. In her latest blog post, Emily Moll explores how the government can leverage march-in rights to help make life-saving drugs more accessible. March-in rights allow the federal government to step in and use patented inventions when prices are too high, potentially lowering costs for countless Americans. Emily also discusses the challenges and roadblocks the government faces in utilizing these rights effectively, including the need to define what constitutes an "unreasonable" drug price and the importance of increasing federal funding for drug research. 📖 Dive into the details and discover how these proposed changes could pave the way for a more equitable healthcare landscape! 🔗 Read the full post here: https://lnkd.in/gBKJV3-e #Healthcare #DrugPricing #InflationReductionAct #MarchInRights #AffordableMedications #HealthPolicy #Innovation

The Inflation Reduction Act is significantly altering the U.S. #healthcare landscape, impacting Medicare drug pricing and creating ripple effects across the ecosystem. This legislation introduces direct drug price negotiations, redesigns Medicare Part D, and imposes inflation rebates, affecting #payers, #providers, and #biopharma companies. Understanding these changes is crucial for stakeholders to navigate the evolving health care environment effectively. For an in-depth analysis of the IRA's implications and strategic recommendations, read the full article https://lnkd.in/gjQCZQcC