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<< Older News  |  September 20, 2021

News

All News > Prescription Drug Costs

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Drug Plan Fails, Signaling Thorny Path for Democrats' $3.5 Trillion Bill
The New York Times; subscription may be required Link to more items from this source
Sept. 16, 2021

"A Democratic plan to lower prescription drug prices as part of the party's $3.5 trillion social policy package failed in a House committee on Wednesday after moderates refused to support it, highlighting internal divisions that could complicate the legislation's path to enactment."

Tags: Prescription Drug Costs

Democrats' Stumble on Drug Prices Shows Power of Industry
The New York Times; subscription may be required Link to more items from this source
Sept. 16, 2021

"The dynamic is familiar to lawmakers who have worked on health issues: Health industries are large and powerful lobbies, and they do not enjoy having their revenues cut. As with measures that might reduce payments to hospitals, doctors and insurance companies, the House's attempt to take a bite out of drug companies has generated a backlash."

Tags: Health Plan Policy  •  Prescription Drug Costs

Value-Based Pricing of Prescription Drugs Benefits Patients and Promotes Innovation
Center for American Progress Link to more items from this source
[Opinion]
Sept. 13, 2021

"The ability of drug companies to price their products based on their assessment of what the system will bear has led pharmaceutical companies to invest their research and development funds into the health conditions and drugs that they either expect or know to be profitable ... Switching to a value-based pricing system would better serve patients and improve the efficiency of health care spending in the United States ... [and] would promote, rather than hinder, pharmaceutical innovation, especially into the health needs that are currently unmet."

Tags: Prescription Drug Costs

House Democrats Reveal Health, Paid Leave Policies in Budget Package
Mercer Link to more items from this source
Sept. 13, 2021

"Draft bills to add new benefits to Medicare, create a government-run paid family and medical leave benefit for US workers, and boost penalties for mental health parity violations were unveiled ... by key House committees.... A major concern for employers is whether [any proposal to] let the government negotiate drug prices will extend those negotiated prices to private plans."

Tags: Health Plan Design  •  Health Plan Policy  •  Medicare  •  Prescription Drug Costs

Biden Proposes Government Price Controls on Prescription Drugs
Cato Institute Link to more items from this source
[Opinion]
Sept. 10, 2021

"The Biden proposal would reduce the prices Medicare pays for prescription drugs ... It would also [impose] the prices Medicare sets to govern its own purchases ... on private payers in the form of price controls [and] impose additional price controls on private transactions by limiting how much drug companies could increase their prices from year to year."

Tags: Prescription Drug Costs

HHS Report to White House Competition Council: Comprehensive Plan for Addressing High Drug Prices
Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS] Link to more items from this source
Sept. 9, 2021

"The Report presents principles for equitable drug pricing reform through competition, innovation, and transparency; describes promising legislative approaches; and summarizes actions already underway or under consideration across the Department of Health and Human Services (HHS)." [2-page Executive Summary and 29-page Full Report]

Tags: Prescription Drug Costs

Community Pharmacies Stepped Up During COVID -- and Changed for Good
Wired Link to more items from this source
Sept. 7, 2021

"Today's community pharmacists administer vaccines, manage chronic disease, supply birth control, optimize medication regimens, and in some cases assess genetic markers for personalized medicine, to name just a few services.... The pandemic closed many health care practices and opened doors for pharmacies to step in."

Tags: Prescription Drug Costs

Senate Version of Drug Pricing Bill May Not Apply to Those with Job-Based Insurance
The Hill Link to more items from this source
Sept. 1, 2021

"Democrats' signature drug pricing measure ... would allow [HHS] to negotiate lower drug prices, a long-held Democratic goal. The House measure would apply those lower negotiated prices not only to seniors on Medicare, but also to the roughly 150 million Americans who get health insurance through their employers. But in the Senate, the push is running into an obstacle from the complicated rules in the upper chamber."

Tags: Prescription Drug Costs

A Framework for Categorizing and Analyzing Prescription Drug Pricing Reform Options
The Brookings Institution Link to more items from this source
[Opinion]
Aug. 31, 2021

"[P]olicymakers should think about reform options as fitting within three sets of categories: [1] those focusing on patients' out-of-pocket costs; [2] those targeting problematic incentives for various stakeholders within the system; and [3] those addressing the high prices of particular drugs."

Tags: Prescription Drug Costs

States Are Pushing to Shed Light PBM Business Practices
Morning Consult Link to more items from this source
Aug. 30, 2021

"More than 100 bills targeting pharmacy benefit managers have been introduced across the country this year, after the three biggest PBMs processed roughly 77% of all U.S. prescription claims in 2020.... [A]ttorneys general from 33 states and Washington, D.C., filed an amicus brief in support of a North Dakota law that would impose state oversight and require PBMs to disclose some financial information.... [M]ultiple states are investigating the business practices of PBMs, particularly how they manage state health plans."

Tags: Health Plan Design  •  Prescription Drug Costs

2021 Prescription Drug Policy Trends
National Conference of State Legislatures [NCSL] Link to more items from this source
Aug. 27, 2021

"Prescription drug access and affordability is one area legislators looked for common ground, and over 700 bills were introduced in 48 states and Puerto Rico. Of those, at least 104 laws have been enacted in 33 states. This number kept pace with 2020 where almost the same number of bills were proposed."

Tags: Local Regulation  •  Prescription Drug Costs

CBO Simulation Model of New Drug Development
Congressional Budget Office [CBO] Link to more items from this source
Aug. 27, 2021

"This paper presents the Congressional Budget Office's simulation model for analyzing legislative proposals that may substantially affect new drug development. The model uses estimates of changes in expected future profits or development costs to estimate the percent change in the number of drug candidates entering the various stages of human clinical trials. Given changes in decisions to enter at each stage, the model estimates when and by how much the number of new drugs entering the market will change." [CBO Working Paper 2021-09]

Tags: Prescription Drug Costs

Biden Brings Plan for Prescription Drug Pricing Reform to Congress
Pharmaceutical Technology Link to more items from this source
Aug. 19, 2021

"Biden promised the proposed steps would see some of the market's priciest drugs fall by tens of thousands of dollars per year in cost -- but how feasible is his plan likely to be?"

Tags: Prescription Drug Costs

State Drug Price Transparency Gains Momentum, Increasing Challenges for Manufacturers
Sidley Austin LLP Link to more items from this source
[Guidance Overview]
Aug. 16, 2021

"Developments include the passage of new laws, implementing regulations, and guidance documents.... State price reporting requirements reflect a patchwork of burdensome requirements that are evolving quickly, significantly complicating compliance efforts."

Tags: Prescription Drug Costs

How Would Drug Price Negotiation Affect Medicare Part D Premiums?
Henry J. Kaiser Family Foundation Link to more items from this source
Aug. 13, 2021

"The debate over a budget reconciliation package in the coming weeks, and possibly months, is likely to focus heavily on the savings to Medicare, which can be used to expand Medicare benefits and fund other health care priorities. However, by lowering Medicare spending for Part D, which covers retail prescription drugs, drug price negotiation proposals would also be expected to lower premiums that beneficiaries pay for Part D coverage."

Tags: Medicare  •  Prescription Drug Costs

CMS Proposes Pulling Model That Ties Part B Drug Prices to Those Paid Overseas
FierceHealthcare Link to more items from this source
Aug. 9, 2021

"The Biden administration has pulled a Trump-era regulation that ties Medicare Part B prices for certain products to prices paid overseas. The proposed rule released [August 6 by CMS] comes in response to a series of legal defeats that the Biden administration faced over the controversial model."

Tags: Medicare  •  Prescription Drug Costs

Senate Uses Murky Math as It Shelves Drug Pricing Rule to Fund Infrastructure
Kaiser Health News Link to more items from this source
Aug. 5, 2021

"Tossing Trump's reform under the steamroller to offset other costs offers a window into the convoluted process of congressional budgeting: Senators say the plan will provide billions of dollars of savings, even though the federal government has never spent a dime on the rebate rule. And it focuses attention on the intractable problem of bringing down drug prices: The rule would take money from drug industry brokers and provide refunds to consumers, which would suggest it was saving them and Medicare money. Yet budget analysts said the process would cost the government billions of dollars."

Tags: Prescription Drug Costs

DOL Posts Comments Received on Reporting on Pharmacy Benefits and Prescription Drug Costs
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL] Link to more items from this source
[Opinion]
Aug. 3, 2021

Tags: Health Plan Administration  •  Prescription Drug Costs

CMS: Part D Premiums Projected to Increase Nearly 5% in 2022
FierceHealthcare Link to more items from this source
July 30, 2021

"The average Part D premium is projected to increase by nearly 5% from $31.47 to $33 in 2022.... The announcement comes amid several potential major changes to Medicare being debated in Congress."

Tags: Medicare  •  Prescription Drug Costs

How Drug Pricing Legislative Proposals Would Lower Costs for Consumers and Businesses
Center for American Progress Link to more items from this source
[Opinion]
July 27, 2021

"[1] Seniors would have lower out-of-pocket prescription drug costs ... [2] Americans with private insurance would have lower premiums and out-of-pocket costs ... [3] Businesses would benefit from lower drug costs ... [4] People living with diabetes would have access to affordable insulin ... [5] Disabled people would see lower costs for critical treatments ... [6] People of color could see more equitable health outcomes ... [7] Women would benefit from lower prices on some of the most expensive drugs."

Tags: Prescription Drug Costs

HR 3 Could Save Patients Thousands of Dollars on Prescription Drugs
Center for American Progress Link to more items from this source
[Opinion]
July 27, 2021

"HR 3 would allow the secretary of [HHS] to negotiate lower prices on many of the highest-priced drugs -- plus all insulin -- directly with pharmaceutical companies. These lower prices would also be available to private insurers and employers, allowing tens of millions additional people to benefit from the negotiation process."

Tags: Prescription Drug Costs

ERIC and Mercer Response to EBSA RFI: Reporting on Pharmacy Benefits and Prescription Drug Costs (PDF)
The ERISA Industry Committee [ERIC] and Mercer Link to more items from this source
[Opinion]
July 26, 2021

"ERIC and Mercer request that the Departments consider issuing a delay for the Final Rule, in order to give employers time to negotiate and execute new contracts that will ensure they receive the required reporting information from all third-party vendors.... Plans and issuers will need at least 12 months to prepare the required data for submission to the Departments and [OPM].... Collecting data can be a daunting task for self-insured employers if they have carved out their pharmacy benefit to a PBM."

Tags: Health Plan Administration  •  Prescription Drug Costs

PBMs: 21st Century Robber Barons
National Community Pharmacists Association [NCPA] Link to more items from this source
[Opinion]
July 23, 2021

"[PBMs] produce some of the same anti-consumer, anti-small business, anti-competition results as the robber barons from more than a century ago. For many years, the FTC has allowed PBMs to grow bigger and exert their market leverage to the benefit of Wall Street shareholders and at the expense of small businesses and consumers. But lately there have been some signs of changing attitudes."

Tags: Prescription Drug Costs

Biden's July Executive Order Includes Drug Pricing Provisions. But Will They Do Enough?
Kaiser Health News Link to more items from this source
[Opinion]
July 19, 2021

"[Of] all the policy ideas aimed at reducing the cost of drugs, importation seems the least likely to happen.... It does seem likely ... that the newly appointed FTC chair would be sympathetic to cracking down on market conduct that delays the entry of generic drugs or biosimilars. Still, reducing drug prices by 60% would require legislation[.]"

Tags: Prescription Drug Costs

Drug Pricing and Other Healthcare Policy Changes Targeted in Executive Order on Promoting Competition
Sidley Austin LLP Link to more items from this source
[Guidance Overview]
July 14, 2021

"Initiatives [described in the Executive Order] include calls to combat 'excessive pricing,' to enhance domestic pharmaceutical supply chains, to reduce the cost of drugs to the Federal government, and to address 'price gouging'; additional actions to support the implementation of Canadian drug importation and to promote low-cost generics and biosimilars. A number of the proposals may be inconsistent with existing statutory and regulatory authority, with litigation likely to follow if these proposals are finalized and implemented."

Tags: Health Plan Costs  •  Health Plan Design  •  Prescription Drug Costs


<< Older News  |  September 20, 2021

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