The news this week is mixed on whether or not the Trump Administration’s push to lower the cost of prescription drugs is working. CVS is launching their own program to target expensive new drugs, while the US Health Secretary repeats the desire to eliminate drug rebates. Anthem is taking steps to make it easier for Medicare Advantage clients to utilize their benefits and much more in this week’s Innovation Partners BioBlog.
CVS launches program targeting expensive new drugs
CVS Caremark is taking aim at high drug launch prices. The company announced it will enable its clients to exclude coverage of drugs with extremely high launch prices. The move is directed at the rising costs of prescription drugs in a bid to get manufacturers to lower costs. According to CVS, launch prices have risen steadily for several years.
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U.S. health secretary says agency can eliminate drug rebates
U.S. Health and Human Services Secretary Alex Azar said it was within his agency’s power to eliminate rebates on prescription drug purchases. Rebates are negotiated in the United States by pharmacy benefits managers (PBMs) to lower the cost of medicines for their clients, including large employers and health plans that cover tens of millions of Americans. Drugmakers say they are under pressure to provide such rebates to the few pharmacy benefits managers that dominate the market.
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Companies report no signs of drugmakers cutting prices, despite Trump pledge
Despite President Trump’s prediction that drugmakers would make ‘massive’ cuts, the price cuts haven’t materialized. Express Scripts, Humana, MedImpact, Optum RX and Prime Therapeutics all wrote in letters to Senators Elizabeth Warren and Tina Smith that they have not received commitments from drug manufacturers to lower drug prices. So far, Merck is the only drugmaker to announce cuts.
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States Rush to Rein In Prescription Costs, and Drug Companies Fight Back
A bi-partisan effort is underway throughout the United States to clamp down on rising drug prices. States are forcing pharmaceutical companies o disclose and justify price increases and trying to regulate middlemen who play a crucial role by managing drug benefits for employers and insurers while taking payments from drug companies in return for giving preferential treatment to their drugs. Twenty four states have passed a total of 37 bills aimed at curbing drug prices, but drug makers are fighting back, filing suit, for example, in California to block new laws.
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Trump readies new round of controversial Medicaid changes
The Trump Administration appears set to allow states to add restrictions to the nation’s health program for the poor that could end up pushing tens of thousands of people off of coverage. The GOP continues to agitate to reshape Medicaid. A look at the proposed restrictions and how it may impact Medicaid coverage.
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OIG: Medicare overpaid hospitals by as much as $21.5M due to bundled payments
Medicare overpaid hospitals nationwide as much as $25.8 million for an advanced mode radiation therapy used to treat difficult-to-reach tumors. The new report from the HHS Office of the Inspector General indicates that some hospitals received both bundled payments that included the therapy as well as line-item payments for the same service.
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Anthem partners with Walmart to expand access to over-the-counter drugs
Anthem Medicare Advantage members will be able to use OTC plan allowances to purchase medications and supplies at Walmart. Previously, Medicare Advantage members had to call their orders in or use a catalog to place orders for OTC medications and items such as support braces and pain relievers. The new program should make it easier for members to use their benefits at more than 4,700 Walmarts nationwide.
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