AHA submits comments on CMS draft guidance for Medicare drug price negotiation program: https://ow.ly/XvEI50SuaGl #AHAToday
American Hospital Association’s Post
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TEDx Talk Speaker | Booz Allen Hamilton Senior Consultant | Georgetown University Master's in Health Policy | Former White House Intern
This past week, CMS held their patient listening sessions on the new Medicare Drug Price Negotiation Program under the Inflation Reduction Act. Just in time for National Diabetes Awareness Month, the session heard from many patients speakers that have used Novolog or Fiasp, one of the selected 10 drugs up for negotiation. I shared my story on how this drug, Novolog, became my lifeline seventeen years ago; and for the last seventeen years I have continued to watch the price of my insulin rise, absent of it ever changing in effectiveness, molecular composition, or delivery method. In 2026, the first ten drugs with negotiated maximum fair prices will go into effect. Approximately 763,000 Americans on Medicare Part D used Fiasp and Novolog in 2022, and the average spending was $3,323 per enrollee. The negotiations will forever change the landscape of how much is expected to be spent on insulin. This is a crucial step towards pharma accountability. The Medicare Drug Price Negotiation Program will eliminate cost sharing and cap out of pocket spending for people with Medicare Part D, require drug companies to pay a rebate to CMS if they raise their prices faster than inflation, and reduce drug spending by the federal government. In 2026, many more Americans will have access to affordable insulin. While this is not the end of the journey to #insulin4all, it is another step forward! #nationaldiabetesawarenessmonth https://lnkd.in/efBWMz9u
Medicare Drug Price Negotiation Program Patient-focused Listening Session: Emmabella Rudd
https://www.youtube.com/
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Executive Vice President & Managing Director, Consulting | Market Access, Pricing, and Commercialization Strategist | Biopharmaceuticals, Orphan Drugs, & Vaccines
One of the many objectives of the Inflation Reduction Act is to lower prescription drug costs and increase access to life-saving medications. But defining access continues to be a challenge. In preparation for drug negotiations with Medicare, today Centers for Medicare & Medicaid Services held the first of many listening sessions with patients and patient advocates. The goal being to provide patients with a venue for Medicare to understand patient's daily life dealing with their conditions and their thoughts on the value of therapeutic alternatives. I had the opportunity to listen to today’s opening session with CMS for apixaban/Eliquis, one of the ten drugs selected for negotiation for 2026. Unsurprisingly, one of the key themes from today’s speakers were their issues and concerns over continued access to their medications and the healthcare system in general. Concerns over formulary management becoming more demanding, confusion on financial assistance, issues with preferred pharmacy networks, worries over access in rural communities, and issues with basic enrollment in health plans. I commend the CMS for this first of many sessions to better define the situation at hand. However, we must recognize that these listening sessions are only continuing to bring to light the challenges that patients have accessing healthcare. #marketaccess #patientaccess #inflationreductionact #medicare #formulary
CMS to kick off Medicare drug price negotiation listening sessions next week
https://endpts.com
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🚩As CMS prepares to send its initial drug pricing offers under the IRA by Feb 1, it’s clear that the shift towards government price controls in Medicare Part D risks unintended but foreseeable harms to innovation & patient care. Read more on the issue ⬇️
The Arrival of Medicare Drug Price Controls: No Cause for Celebration
https://paragoninstitute.org
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🔍 Healthcare Update: CMS is Changing Its Pricing President Biden's historic Inflation Reduction Act (IRA) mandates drug companies to provide rebates to Medicare when prescription drug prices outpace inflation rates for specific drugs under Medicare Part B. Dive into the details below to understand the anticipated changes in pricing by CMS: 📈 Rebates Requirement: Drug companies to pay Medicare rebates when certain Part B drug prices surpass inflation rates. 📆 Applicable Period: Jan 1 – Mar 31, 2024. 💊 Rebate Deposits: Invoices to drug manufacturers by fall 2025, with rebates deposited into the Medicare Trust Fund. 💰 Cost Reduction: From Apr 1, 2023, potentially lower out-of-pocket costs for specific Part B drugs, with a 20% coinsurance rate. 💡 Stay Updated: CMS ensures transparency, releasing ASP public files in advance. Check CMS.gov for updates. These policy adjustments aim for accessible and affordable healthcare. At PFG MedComm, we are committed to promoting health equity through market access. #Medicare #CMS #PrescriptionCosts #HealthcareUpdates #InflationReductionAct
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Last month, the Centers for Medicare & Medicaid Services named the first ten drugs that will be subject to price negotiation as part of the #IRA. Ashley Jaksa, Market Access Scientific Strategy Lead at Aetion, spoke with The Evidence Base® about how the predictions around this list ultimately played out and the value of quality #RWE for future Medicare drug pricing negotiations. Read the full feature here: https://bit.ly/45Hjsaw.
First drugs selected for Medicare drug pricing negotiation: reactions, speculation and comments
evidencebaseonline.com
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Serial successful CEO, business leader, growth driver, margin and culture grower. Moving companies from OK to good to great, and leading teams to achieve great things
Medicare drug price negotiation factsheet and timeline, good read
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Medicare drug price negotiation is benefitting you. Look at the savings in your home state: https://lnkd.in/g7z3dcHQ
Monthly Medicare Drug Price Negotiation Savings by State
https://www.americanprogress.org
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Need the lowdown on the latest CMS rule on Medicare Part D? Our recap blog, written by our Regulatory Resource Center Lead, Kim Boyd, breaks down all the key points from the recently published CMS-4205-F2 Part D rule, including the fact that it officially names NCPDP (National Council for Prescription Drug Programs, Inc.) standards like SCRIPT, F&B, and RTPB. It's a short, but super informative read to get you up to speed quickly. Don't miss this one if Medicare Part D is on your radar! https://hubs.ly/Q02C66QY0
Part D CMS-4205-F2 Rule Summary: Compliance, Standards, and Deadlines
blog.pocp.com
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Medicare pricing discussions are expected to focus on these 10 drugs this next autumn Read More: https://cutt.ly/vwfHkei1 #medicare #drugs #healthcaremagazine #latestnews #newsupdate #latestupdate #medicare
Medicare pricing discussions are expected to focus on these 10 drugs this next autumn
https://insightscare.com
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CMS publicly released the 2024 Medicare Star Rating data, including the Star Rating Technical Notes, on Friday, October 13th. This data summarizes how Medicare Advantage Organizations (MAOs) performed on various quality measures during the 2022 measurement year and serves as an indication of changing Medicare Advantage spending in 2025 due to changes in Medicare Advantage Prescription Drug (MA-PD) Overall Star Ratings. The publication of the 2024 Star Rating Technical Notes allow for analysis of the measure-level cut points changes. This paper analyzes the latest cut point changes to understand how the Tukey Outlier Deletion methodology and changes in the overall quality performance have impacted Star Rating cut points. Featured Authors: Suzanna-Grace Tritt & Lisa Winters #Medicare #Stars #Ratings #PartD #MedicareAdvantage #MedicareStars #MAPD #CMS #StarRatings #PartCandDStarRatings
Cut to the Point: A Summary of 2024 Star Rating Cut Point Changes
wakely.com
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