Last week's Medicare & Drug Pricing program in partnership with The Hill saw robust discussion about unintended consequences of the IRA. Thank you to all who attended! Read our full recap: https://lnkd.in/ePagyT_E
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Please read this brilliant analysis. In short, the IRA is not reducing prices, helping Americans’ health, or even targeting the costliest drugs. It IS attacking the very reason drug prices currently have the lowest inflation (<2%) in the CPI. It IS penalizing drugs that HELP the most people. It IS ending our medical innovation ecosystem and our access to cures and hope. Thanks Tomas J. Philipson, for the painful truth.
Founder, Board Member, Former Acting Chairman of the White House Council of Economic Advisers, Chaired Professor Emeritus - University of Chicago
My op-ed in The National Review on the launch of the Medicare drug price control program which targets top spending drugs. But 70% of the top spending drugs initially selected were blockbusters due to high volume rather than a high price, indeed the high volume partially induced by the low prices. And 60% percent of the drugs selected have patent expiration around the corner that will dramatically cut prices. The selected drugs by CMS could not send a worse signal to medical R&D investors: If you invent a drug that helps many patients at an affordable co-pay, the government will come after you.
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Please read this brilliant analysis. In short, the IRA is not reducing prices, helping Americans’ health, or even targeting the costliest drugs. It IS attacking the very reason drug prices currently have the lowest inflation (<2%) in the CPI. It IS penalizing drugs that HELP the most people. It IS ending our medical innovation ecosystem and our access to cures and hope. Thanks Tomas J. Philipson, for the painful truth.
Founder, Board Member, Former Acting Chairman of the White House Council of Economic Advisers, Chaired Professor Emeritus - University of Chicago
My op-ed in The National Review on the launch of the Medicare drug price control program which targets top spending drugs. But 70% of the top spending drugs initially selected were blockbusters due to high volume rather than a high price, indeed the high volume partially induced by the low prices. And 60% percent of the drugs selected have patent expiration around the corner that will dramatically cut prices. The selected drugs by CMS could not send a worse signal to medical R&D investors: If you invent a drug that helps many patients at an affordable co-pay, the government will come after you.
The Problems with Drug Price Controls
https://www.nationalreview.com
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Founder, Board Member, Former Acting Chairman of the White House Council of Economic Advisers, Chaired Professor Emeritus - University of Chicago
My op-ed in The National Review on the launch of the Medicare drug price control program which targets top spending drugs. But 70% of the top spending drugs initially selected were blockbusters due to high volume rather than a high price, indeed the high volume partially induced by the low prices. And 60% percent of the drugs selected have patent expiration around the corner that will dramatically cut prices. The selected drugs by CMS could not send a worse signal to medical R&D investors: If you invent a drug that helps many patients at an affordable co-pay, the government will come after you.
The Problems with Drug Price Controls
https://www.nationalreview.com
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The Biden Administration is preparing to unveil the first 10 drugs up for price negotiation by Medicare. Big Pharma is loudly opposed to the historic measure, but a new poll by West Health and Gallup shows Medicare drug price negotiations have wide bipartisan support among Americans: 95% of Democrats, 76% of Independents and 75% of Republicans are in favor of Medicare negotiating drug prices directly with pharma. Read more: https://lnkd.in/dvpcfFNz
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Prescription Benefit Manager (PBM) bills advanced yesterday in the House and Senate... This important legislation aims to control the way PBMs are able to profit by increasing drug prices. The primary focus of PBMs is to manage prescription drug benefits for insurers and payers. In the United States, there are three PBMs that control 75-80% of all U.S. prescriptions! Rebating is a common practice in which drug makers return part of the purchase price back to the PBMs, who should then pass the savings on to consumers. However, research shows that PBMs more often then not are the ones profiting from this system. Some argue that the practice of making drug manufacturers provide rebates to payors encourages insurers to use more expensive brand name medications vs. generics which results in higher out of pocket costs for patients and higher cost for the Medicare administration. The PBM bills aim to correct oversights and flaws within the system by: 1) Prohibiting PBMs in the Medicare Part D program from receiving compensation based on a manufactuer's list price 2) Reforming Medicare Part D's pharmacy reimbursement policy to prevent "spread pricing"- a practice that occurs when a PBM charges health plans for prescription medications more than they pay the pharmacy. 3) Requiring transparency from insurers and PBMs to allow employers and patients to have the information needed to stimulate competition. The bill would require a report be completed by the Health and Human Services Inspector General about the price impacts of vertical integration of Part D plans, PBMs and pharmacies. Learn more about the current role PBMs paly and the process in this quick video:
Understanding Your Drug Costs: Follow the Pill
https://www.youtube.com/
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Ozempic could be the next target of Medicare drug price negotiations – here's why by Wall Street analysts expect Ozempic to be selected for price negotiations in 2025 due to the amount of money Medicare Part D already spends on the drug.
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Ozempic could be the next target of Medicare drug price negotiations – here's why by Wall Street analysts expect Ozempic to be selected for price negotiations in 2025 due to the amount of money Medicare Part D already spends on the drug.
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Healthcare policy expert and technology leader. Healthcare and technology investor. Co-Founder/Chief Solutions Officer, Lilac Software. Healthcare blogger/podcast host. Author, The Healthcare Labyrinth. Ukraine blogger.
Six lawsuits now on Medicare drug price negotiations. While anything is possible in our court system today, I have my doubts about the merits of the brand drugmakers' and allies' arguments, including the free speech and takings claims. Setting aside the lawsuit for a moment, my view is that brand drug prices are far too high and this needs to change. Companies must have an incentive to make margin/profit and innovate. But various statistics bear out that we have the highest drug prices in the developed world, our health indicators are among the lowest, and the rest of the world successfully regulates price (not only drugs) and has better cost-savings and quality. It is important to note, too, that the drug world is anything but a free market -- it lacks transparency, behaviors are monopolistic, etc. There are many ways to ensure appropriate innovation and progress -- if in fact there is impact when driving lower drug prices. #drugpricing #drugprices
Industry Lawsuits Against Medicare Rx Negotiation Rise To Six
insidehealthpolicy.com
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A “big” news for healthcare today… Let's not forget the bigger picture: the need for consistent innovation and research. If we focus only on present gains, we risk undermining efforts like the cancer moonshot, and efforts for conditions less talked about, like rare diseases. Above all, priority should be to tackle unmet needs, address bottlenecks like insurance practices, and foster an environment of continuous innovation.
Patients are losing out in the political games being played by the administration on drug pricing. This op-ed in The Wall Street Journal from Giovanni Caforio, Chairman and CEO at Bristol Myers Squibb, shows how: The government selected a medicine for price setting that is 540th on the list of Medicare Part D drugs in terms of spending per patient. What’s more, seniors on Medicare pay, on average, $55 a month for the drug. As Giovanni shares, “it makes no sense to take a medicine that is already priced based on the value it delivers and demand even greater concessions, especially given that there is no requirement that the insurance companies that administer Medicare benefits will pass any new savings to patients.” You can read the piece here:
Opinion | The High Cost of Price Controls on Eliquis and Other Drugs
wsj.com
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https://lnkd.in/eCx43gn2 Court challenges to the IRA's drug pricing negotiation programs could cause problems for the IRA's aim to lower drug prices for Part D enrollees. My analysis explores how that impact could play out.
ANALYSIS: Drug Pricing Lawsuits Jeopardize Medicare Pay Scheme
news.bloomberglaw.com
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