In May, the Trump administration published an executive order requiring drug companies to bring prices in line with those paid by other developed nations, otherwise known as Most Favored Nation (MFN) pricing. Although the June 11 deadline has come and gone, no details have been released as to whether drug companies have opted to negotiate or if the government will implement any enforcement action.
Pharmacy Benefit Managers Under Scrutiny
“When pharmacy benefit managers [PBMs] came into being 30 years ago, they were seen as an important component of the prescription distribution system [because] they could guide benefits and money between the patient, pharmacy and the manufacturer,” says Angus Worthing, MD, president of the Alliance for Transparent & Affordable Prescriptions (ATAP). Health insurance companies hire…
UnitedHealthcare Updates Reimbursement for Infliximab Biosimilars
On April 1, UnitedHealthcare updated reimbursement for infliximab biosimilars in response to concerns that formulary requirements are leaving practices underwater.
The CMS Reveals First 10 Drugs for Medicare Drug Negotiation
The long-awaited list of the first 10 Part D drugs to be included in the new Medicare Price Negotiation process includes the commonly prescribed rheumatology drugs Enbrel and Stelara. Initial negotiations with the drug manufacturers will begin this fall.
ACR Expresses Concerns with MedPAC’s Drug Pricing Recommendations
In April, the Medicare Payment Advisory Committee voted to recommend a change in the add-on payment for Part B drugs, including reducing payment for more expensive drugs. The ACR sent a letter to MedPAC expressing concerns about the significant impacts such policies would have on rheumatologists.
Advocacy Highlights & Fall Treats: Reflections from the GAC Chair
Outgoing Government Affairs Committee Chair Blair Solow, MD, offers advocacy updates from 2022 and seasonal reflections on how to stay focused on efforts that matter when faced with daunting challenges.
How the U.S. Will Set Up New Medicare Drug Price Talks
WASHINGTON—The U.S. government will soon begin hiring experts and collecting the data needed to launch direct negotiations over prescription drug prices for older and disabled people, a top Biden administration official told Reuters. President Joe Biden last week signed into law the Inflation Reduction Act, introducing new policies to tackle climate change, taxes and the…
ACR Works for Modifications to Build Back Better Act
The ACR has long supported efforts to reduce drug prices through many of the provisions included in the House-passed version of the Build Back Better Act. However, the current wording of one provision puts patient access to Medicare Part B treatments at risk.
High Cost of Specialty Drugs Demands Action
Amid rising drug costs and the growing influence of pharmacy benefit managers on patient care decisions, physicians are increasingly called upon to advocate for affordable, evidence-based treatments for their patients.
Drug Pricing Bills Move Forward
This week, the U.S. House of Representatives released a long-anticipated plan that contains provisions to reduce U.S. drug prices according to an international price index.