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Thoughts on this? >> Lilly exec points to Medicare as more pay full list price for Zepbound than Mounjaro >> Comment below! >>> lqventures.com #strategy #competitiveintelligence #marketing #productmarketing #biotech #pharma #pharmaceutical #healthcare
Thoughts on this? >> Lilly exec points to Medicare as more pay full list price for Zepbound than Mounjaro >> Comment below! >>> lqventures.com #strategy #competitiveintelligence #marketing #productmarketing #pharma #biotech #pharmaceutical #healthcare
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:
What is the Annual Notice of Change Medicare Letter? The Annual Notice of Change (ANOC) Medicare letter is a document sent by your Medicare Advantage or Medicare Part D prescription drug plan provider. The ANOC letter provides detailed information about changes to your plan. These changes can have big effects on your out-of-pocket costs, your plan network, the plan’s formulary of covered drugs, and changes to other covered benefits and programs. Find out more here »» https://bit.ly/3ZhTrMH
📢 ADVI Health recently welcomed Zachary Friend to the team as senior associate, federal and state policy. At ADVI, Zack works with clients to help them better understand how the implementations of the #InflationReductionAct (IRA), state-level Prescription Drug Affordability Boards (PDABs), and other #Medicare Part D policies will impact their businesses and products. Read more on Zack and his experience: https://lnkd.in/eqn_5inv
As a highly utilized component of health coverage, prescription drug benefits are a significant cost driver for employers. ↘ Download our Prescription Drug Benefits Toolkit and explore common benefits plan designs and strategies for employers to control prescription drug costs. #prescriptiondrugs #employeebenefits
“All of the drug industry’s criticisms and so-called 340B ‘reform proposals’ culminate in one goal, which is to limit the number of prescriptions available at 340B prices. This would inevitably prioritize drugmaker balance sheets over the clinical outcomes of vulnerable Americans.” That’s from an editorial published by The Hill — one of three articles, from the last week alone, examining drug manufacturer restrictions and their impact on both 340B hospitals and the patients they serve. To learn more, read our blog summary of those articles. https://bit.ly/3sdP1dg To learn how ProxsysRx has generated over $435M in 340B savings for the health systems we serve, despite manufacturer restrictions, contact Howard Hall. howard.hall@proxsysrx.com | 205.588.0946 #DrugsPharmaceuticals #340B #Savings #Revenue
“All of the drug industry’s criticisms and so-called 340B ‘reform proposals’ culminate in one goal, which is to limit the number of prescriptions available at 340B prices. This would inevitably prioritize drugmaker balance sheets over the clinical outcomes of vulnerable Americans.” That’s from an editorial published by The Hill — one of three articles, from the last week alone, examining drug manufacturer restrictions and their impact on both 340B hospitals and the patients they serve. To learn more, read our blog summary of those articles. https://bit.ly/3sdP1dg To learn how ProxsysRx has generated over $435M in 340B savings for the health systems we serve, despite manufacturer restrictions, contact Howard Hall. howard.hall@proxsysrx.com | 205.588.0946 #DrugsPharmaceuticals #340B #Savings #Revenue
Empowering patients with transparent drug pricing information is essential to enhance decision-making, improve member satisfaction, and meet regulatory requirements. As drug cost transparency becomes increasingly vital, payers and healthcare stakeholders should strive to go beyond compliance, delivering comprehensive data and lower-cost alternatives to drive cost-effective care and substantial savings. Don't live in the dark, let us help shed light on your policy details. #HealthcareTransparency #DrugPricing #PatientEmpowerment
Read part 1 of our new 5-part blog series on the recent disclosure of the first 10 drugs that Medicare will target for price cuts. All industry leaders need to understand and prepare for the impact this will have on the market and each individual brand. #IQVIA #MarketAccess https://bit.ly/46OuRFs
In this week's Union Healthcare Insight blog post, Christopher Kerns cuts through the (ample) noise surrounding the Inflation Reduction Act's drug price provisions. Link below for our thoughts on what the IRA will mean for drug pricing and innovation.
CEO and co-founder of Union Healthcare Insight | executive, researcher, strategist, speaker
There has been so much breathless commentary on the release of the first 10 drugs targeted for Medicare negotiation as part of the Inflation Reduction Act, much of it bordering on unhinged--with some painting it as the first step toward tamping down drug costs for good, and others lamenting the death knell for innovation. And look, I know I tend to be the guy who throws cold water on things, but in this case, I really do think the IRA is a big deal. Still, so much of the coverage on this legislation/regulation has focused on what it does *to* pharma companies and *for* patients, but little has dealt with the inevitable industry response to the new incentives. Because there are thousands of ways to squeeze the balloon. Bottom line is that costs for seniors will decrease (for these drugs), costs will jump elsewhere, innovation isn't dead, but it will likely be directed in some unexpected ways--not all of them necessarily good. I go through all of this in today's Union Healthcare Insight post written by yours truly (it's been a minute since I've gotten to write, so that's fun). We'll be covering much of this in an upcoming webinar, so don't forget to register; links are in the post below. And as always: like, subscribe, and share!
