Rebate rule would help ensure seniors with diabetes don’t pay more for their medicine than their insurer
By Holly Campbell | March 25, 2019
Misaligned incentives in Medicare Part D are increasing costs for seniors with diabetes. While insurers negotiate larger and larger rebates with biopharmaceutical companies each year, seniors...
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Bipartisan lawmakers urge Administration to rethink proposed changes to six protected classes policy
By Tom Wilbur | March 22, 2019
At the end of 2018, the Centers for Medicare & Medicaid Services (CMS) introduced a dangerous proposed rule that would weaken the Medicare Part D six protected classes policy. The six protected...
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New analysis shows 820,000 prescriptions would be in jeopardy if ICER’s value framework is used in Medicaid
By Katie Koziara | March 20, 2019
A new analysis from Xcenda found that if Medicaid were to use one-size-fits-all value assessments like the Institute for Clinical and Economic Review’s (ICER) framework as the basis for accessing...
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The PBM story you haven’t heard: Hidden fees quadrupled in two years
By Robert Zirkelbach | March 20, 2019
In the ongoing conversation around the role of pharmacy benefit managers (PBMs) in the supply chain, a new report further illuminates incentives that tie PBM revenue to higher list prices for...
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New report: Using march-in authority would jeopardize U.S. innovation
By Tom Wilbur | March 19, 2019
In 1980, Congress passed the Small Business Patent Procedures Act, better known as the Bayh-Dole Act, which created a uniform framework for transferring government-funded research into useful...
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OptumRX: Sharing rebates with patients is “worth it”
By Holly Campbell | March 18, 2019
PhRMA has long advocated for sharing the $166 billion in rebates and discounts given by biopharmaceutical companies to the government, insurers, and pharmacy benefit managers (PBMs) with patients...
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Changes to the six protected class policy are the wrong prescription for Medicare and HIV patients
By Tom Wilbur | March 15, 2019
For over 10 years, one of the cornerstones of the Medicare Part D program has been to ensure the sickest and most vulnerable patients have access to the clinically critical medicines they rely on....
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Special 301 submission calls for a level playing field for American innovators
By Megan Van Etten | March 13, 2019
The Office of the U.S. Trade Representative (USTR)’s 2019 Special 301 Report – scheduled to be released this spring – brings critical attention to overseas intellectual property (IP) and market...
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New analysis finds Average Sales Price system has led to significant cost savings for Medicare and seniors
By Nicole Longo | March 7, 2019
When Congress created the Medicare Part D program as part of the Medicare Modernization Act of 2003 (MMA), it also implemented changes to Part B to make it market based with the creation of the...
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New “Prescription for Medicare” campaign focuses on impacts of wrong and right solutions for Medicare
By Juliet Johnson | March 6, 2019
Today, we are launching the “Prescription for Medicare” campaign which focuses on ensuring that changes made to Medicare are the right prescription for seniors. There’s a lot of talk in Washington...
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