New Swipes At Rx Industry Despite Stable Costs
Source: Life Science Leader
By John McManus, president and founder, The McManus Group
On the last full day of President Trump’s tumultuous presidency, CMS released a proposal to dramatically restrict access to Part D drugs for patients with serious medical conditions.
Effective in 2022, the “Part D Payment Modernization Model” will permit Part D and Medicare Advantage plans to change therapy for patients stabilized on anticonvulsants, immunosuppressants, antidepressants, antineoplastic, and antipsychotics. The change would apply to HIV/AIDS medications in the following year. In addition, the proposal allows plans to restrict formularies to just one drug per therapeutic class, instead of the two drugs per class, as has been the case since Part D was enacted.
A freeze by the new Biden administration on Trump-era regulations will hit at least two rules aimed at lowering drug prices, including one dealing with insulin and EpiPens for under-served patients.
Biden freeze hits two Trump drug price rules kyma.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from kyma.com Daily Mail and Mail on Sunday newspapers.
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The federal government has agreed to postpone a last-minute Trump administration rule aimed at lowering drug prices by restricting rebates from drug companies to pharmacy benefit managers, which had sued to block the rule.
In stipulation filed Friday in Washington federal court, the Department of Health and Human Services and the Pharmaceutical Care Management Association, an industry organization, agreed that the effective date would be Jan. 1, 2023, rather than 2022. The PCMA had argued that the original effective date would upend already in-progress negotiations between PBMs, drug companies and health plans for the 2022 health plan year.
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