HHS Cracks Down On Drug Companies Taking Advantage Of Loophole In Medicaid’s Complex Payment Structure
The new guidance, which officials say will cut back on the companies' "abusive behavior," concerns the rebates that drug makers have to pay back to states when a patient receives one of their medicines. In other pharmaceutical news: the administration is preparing to put action behind its rhetoric on drug pricing; some say Medicare's new negotiating powers could lead to increased hospitalizations; and more.
Stat:
HHS Takes Aim At Drug Companies For 'Abusive Behavior' In Medicaid
Top federal health officials are heralding new guidance they say will keep drug makers from taking advantage of a loophole in the Medicaid program’s complex payment structure for certain medicines. The new policy, first laid out in a February law, will help states and the federal government save money when drug makers increase the price of their drugs faster than inflation. The Department of Health and Human Services detailed the complicated algebra related to the change in new letters to states and drug companies. (Swetlitz, 8/9)
Kaiser Health News:
Trump Administration Sinks Teeth Into Paring Down Drug Prices, On 5 Key Points
Three months after President Donald Trump announced his blueprint to bring down drug prices, administration officials have begun putting some teeth behind the rhetoric. Many details have yet to be announced. But experts who pay close attention to federal drug policy and Medicare rules say the administration is preparing to incrementally roll out a multipronged plan that tasks the Centers for Medicare & Medicaid Services (CMS) and the Food and Drug Administration with promoting competition, attacking the complicated drug rebate system and introducing tactics to lower what the government pays for drugs. (Tribble, 8/10)
Modern Healthcare:
Medicare Part B Change Could Lead To Increased Hospitalizations
The CMS' plan to allow Medicare Advantage plans to require patients to try low-cost generics before stepping up to more expensive therapies could have an unforeseen consequence: increased hospitalizations. The CMS announced late Tuesday that MA plans can impose step therapy on Part B drugs starting next year. Step therapy allows a plan to determine whether patients should try a low-cost generic before working their way up to a costlier product if the initial treatment is ineffective. (Dickson, 8/9)
Stat:
Lawmakers Urge Trump To Ensure Access To TB Drugs As UN Meeting Nears
As United Nations negotiators attempt to draft a manifesto for combating tuberculosis, more than 100 members of Congress are urging President Trump to ensure the U.S. makes a “meaningful” contribution to what they called a “crucial” effort. In a letter sent on Wednesday, the bipartisan group of lawmakers emphasized the need for the U.S. to take the lead in eradicating a public health scourge as a U.N. meeting nears to address the problem. Their missive, however, was also sent as a contentious, behind-the-scenes struggle takes place at the U.N. that pits the U.S. against dozens of other countries over issues that affect the poorest nations, in particular. (Silverman, 8/9)
Stat:
Vertex Won't Give U.K. Data Needed To Review A New Cystic Fibrosis Drug
The battle between U.K. authorities and Vertex Pharmaceuticals (VRTX) over the cost of its cystic fibrosis medicines took another twist as the drug maker declined to provide information about its newest treatment to a cost-effectiveness watchdog. In doing so, the company is delaying the approval process used to make the new treatment available to patients. The move is the latest bit of brinkmanship between the drug maker and government officials, who have been haggling for more than two years. And the impasse underscores the rising friction that can occur when cash-strapped governments confront high-priced medicines, an issue that is engulfing a growing number of countries, prompting patients to complain they have become pawns. (Silverman, 8/9)
California Healthline:
Key California Lawmaker Calls Eli Lilly’s Behavior ‘Disingenuous And Offensive’
Seven months after a controversial California law took effect requiring advance notice of planned price increases on prescription drugs, many pharmaceutical companies appear to be in compliance. But not Eli Lilly. The Indianapolis-based drugmaker — one of the largest producers of insulin — has been under fire from consumer advocates for jacking up prices on its lifesaving diabetes medication. And the company has chosen not to follow the California law, which requires it not only to disclose but justify significant price hikes to drug purchasers. (Feder Ostrov, 8/9)