Merith Basey’s Post

"On Sept. 1, Medicare will target its first 10 drugs for historic price negotiations. The medications are sure to be among the country's costliest and will likely include common treatments for cancer and diabetes. The negotiations could save the federal government nearly $100 billion by 2031 and slash some prices Medicare pays by half. They are also the subject of multiple lawsuits by major drugmakers including Merck and Johnson & Johnson. The power to negotiate prices directly with drug companies is one Medicare has never before had in its 58-year history. Exercising that power requires the government to grapple with a difficult question: What makes a drug price fair?" [If healthcare systems in other countries can negotiate with Big Pharma, what would make price negotiations by Medicare unfair?] #medicare #prescriptiondrugs #negotiations #costs #fairness #bigpharma #innovation #incentives #affordability #treatmentoptions https://lnkd.in/gwanzMTe

NEW: The Medicare agency may continue implementing its drug price negotiation program even as litigation over the plans play out in federal court, a judge ordered Friday. This is the first ruling in a lawsuit challenging the price talks. The US Chamber of Commerce and several affiliates haven’t demonstrated a “strong likelihood” of succeeding on their claim that the Inflation Reduction Act’s drug price negotiation provisions violate the due process clause of the Fifth Amendment, wrote Judge Michael J. Newman for the US District Court for the Southern District of Ohio. The Chamber, whose members include drugmaker AbbVie Inc., had used the due process argument as a basis for requesting a pause on the program. The order is a win for the Biden administration, which also faces seven additional federal lawsuits seeking to topple the drug price negotiation program. Lawsuits from companies like Merck & Co. and Bristol-Myers Squibb Co., as well as industry trade group the Pharmaceutical Research and Manufacturers of America, allege the IRA unconstitutionally forces drugmakers to lower prices for their products, which they claim would harm future pharmaceutical development. More on the judge's order in my latest Bloomberg Law story: https://lnkd.in/eUvnhKT5 #medicare #drugprices #lawsuit

Congress has moved closer to regulating prescription drug prices and enhancing affordability for Medicare Beneficiaries with a significant development. Senators Wyden, Crapo, Menendez, Blackburn, Tester, and Marshall introduced bipartisan legislation aimed at untethering the compensation of Pharmacy Benefit Managers (PBMs) from the expenses associated with prescription drugs and their utilization in Medicare Part D.   In a recent article, Frier Levitt attorneys Dae Y. Lee, Pharm.D, JD, CPBS, Adam Farkas, and Geordan Ferguson delve into the Patients Before Middlemen Act and discuss the potential advantages it offers to different pharmacy benefit stakeholders.   Read article here: https://bit.ly/453Xptg   #FrierLevitt #PBMs #PatientsBeforeMiddlemenAct #PharmacyLaw

Despite filing lawsuits questioning Medicare's ability to negotiate on behalf of the 65 million American's who receive medical benefits through the medicare program, Merck elects for its products to participate in the Medicare program. It's a simple choice for Merck, participate in the program, or miss out on having the largest drug purchasing group in the world, The US Medicare population, purchase your products. Going forward, #Medicare will operate as a Costco for drug purchasing because it has the greatest RX purchasing clout in the world and it's the smart, right way to operate the program. "it is not tenable for any manufacturer to abandon nearly half of the U.S. prescription drug market." https://lnkd.in/ezHc_fjm #PublicHealth #DrugPricing #RXPricing #HealthPolicy #HealthCareCosts #PublicPolicy #UniversalHealthcare

This is a great (and non-biased) article, giving a lot of details regarding the upcoming Medicare Drug Price 'Negotiation' that is upcoming. If you have customers, patients or other constituents who are asking about the process, the timing, the outcomes, and the potential benefits to the Medicare members, then you should share this article. A couple of the most interesting notes: 1. It remains to be seen how "maximum fair price" will be defined. This will be a real pivot-point and potential driver of litigation. 2. If a drug price negotiation is successful, then every Part D plan will be REQUIRED to make that drug available on the formulary - in a preferred position. 3. The actual benefits to a MEMBER remain to be seen. Depending on the benefit design of the member's Part D plan, there could be no benefit at all. Whatever the future holds for 'drug price negotiation' this is groundbreaking work, it's IMPERATIVE that you understand what's about to happen - and have a plan to address it. If you are a provider, payer or member, it's in your best interests to know what's going on.

Another Week, Another Blow to Big Pharma's Efforts to Block Medicare Negotiation 💥 This week brought major developments in the ongoing legal battle between patients and pharmaceutical corporations over the historic Medicare drug price negotiation program established by the Inflation Reduction Act. The biggest win came on Monday (4/29) when a federal court in New Jersey resoundingly rejected constitutional challenges from Bristol Myers Squibb and Janssen, who claimed the negotiation program violates the Takings Clause and First Amendment. 🗽 The judge dismantled Big Pharma's core arguments, stating clearly "Selling to Medicare is a choice...This is true for any negotiation between a purchaser and a seller." Both BMS and Janssen have since indicated that they will appeal this ruling. Just hours after this decisive ruling in New Jersey, AstraZeneca filed a notice to appeal a previous court ruling against its lawsuit challenging Medicare negotiation of its blockbuster drug Farxiga - underscoring how far the industry will go to regain complete pricing power at the expense of patients. And on Wednesday, PhRMA, the drug industry’s top trade association, had oral arguments heard in their appeal. Amid these legal maneuvers, our message is clear: Patients will NOT back down in defending these hard-won reforms that 80% of Americans overwhelmingly support. Every case and appeal is an assault on the millions struggling to afford life-saving medications. Stay tuned as we continue battling Big Pharma's relentless resistance.

The #IRA has radically changed the #Medicare prescription drug benefit, and dubbing it a negotiation only obscures the reality of a process in which the government is calling all the shots. Read more in this op-ed: https://lnkd.in/ePN8Ende

In their new Forefront article, Sheela Ranganathan and Zachary Baron of the O'Neill Institute for National and Global Health Law discuss an April 29 New Jersey decision regarding cases brought by Bristol Myers Squibb and Janssen Pharmaceuticals, oral argument at the Fifth Circuit for an appeal by PhRMA and allied associations, and next steps in the ongoing litigation over the Medicare drug price negotiation program. "On April 29, 2024, Judge Quraishi issued an opinion granting the summary judgment motions filed by the Department of Justice (DOJ) in the cases brought by BMS and Janssen Pharmaceuticals. Those lawsuits alleged that 1) the Medicare drug price negotiation program effects an unconstitutional taking of private property under the Fifth Amendment; 2) the program’s requirement that drug manufacturers sign certain agreements in connection with the negotiation process compels speech in violation of the First Amendment; and 3) the program violates the doctrine of unconstitutional conditions in Medicare and Medicaid by forcing the companies to give up their constitutional rights in order to participate in these federal programs." Read the full article here: https://bit.ly/3JRzjKj

The Inflation Reduction Act of 2022 (the Act), signed into law in August 2022, includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. #medicare #drugdevelopment

Biden administration as major drug manufacturers come on board for Medicare’s price negotiation program! This is a big step towards making healthcare affordable for many Americans. Being a Finance in the healthcare, I see every day how drug prices impact our lives. This new journey of negotiating fair prices is a shining example of what can be achieved when different parts of the healthcare system come together for a common goal - better healthcare for all. Yes, there are challenges ahead, and yes, the road may be long. But, this is a step forward. It shows that change is possible when we all – from policymakers to pharmaceutical companies to healthcare professionals – work together. #Medicare #DrugPricing #HealthcareForAll #PBM