Drug Pricing and Affordability

Keep up with our comprehensive coverage of administrative and legislative activity and what it means for industry, plans, providers, and patients.

Nicole Meyerson

CMS Best Price Discount Stacking Proposal May Trigger AMP Cap

Requiring manufacturers to stack all discounts provided through the supply chain could increase Medicaid rebate liability and complicate rebate dynamics.

Ekemini Isaiah

Key Stakeholders of the 340B Drug Discount Program

Key 340B stakeholders include the federal government, patients, pharmacies, drug manufacturers, PBMs, plans, and the 340B prime vendor.

Ekemini Isaiah

What Is the 340B Prescription Drug Discount Program?

Section 340B of the Public Health Service Act requires significant discounts on outpatient drugs for “covered entities"—safety-net providers and programs.

Sarah Alwardt

Should Competitors of Negotiated Drugs Review Their Evidence Strategy?

Manufacturers of therapeutic alternatives to negotiation-eligible drugs should examine their value and evidence strategy in response to new dynamics.

Madison Davidson

EOM Payment Methodology Updated as Start Date Approaches

Amid stakeholder speculation for the future of the EOM, CMMI continues to plan for July 2023 implementation and released key payment methodology details.

Webinar: Demystifying IRA Drug Price Negotiation

Avalere experts will explore the potential implications of the Inflation Reduction Act (IRA)’s Medicare drug price negotiation program guidance and discuss implementation strategies for the near- and long-term.

Mark Gooding

Medicare Drug Price Negotiation Guidance: Avalere Experts Respond

Guidance adds clarity on drug selection, maximum fair price application (MFP), evidence submission, and manufacturer engagement, but leaves questions on determining MFP.

Kylie Stengel

Implications of Policy Reforms on Pharmacy DIR in Part D

The use of DIR in Medicare Part D has increased in recent years, and both the IRA and CMS rulemaking are likely to influence DIR dynamics in the future.

Massey Whorley

CMMI Drug Pricing Model Concepts

CMMI releases long-awaited response to President Biden’s executive order on drug pricing with a directive for the Centers for Medicare & Medicaid Services (CMS) to develop three models.

How Health Plans Use Value-Based Drug Pricing

Health plans and other payers can manage drug expenditures through value-based approaches that tie drug pricing to patient outcomes.

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