Massachusetts Wants To Rein In Drug Prices By Limiting What Medications Are Covered By Medicaid
But advocates and drug companies say that would harm patients and be a radical departure from how Medicaid operates now. The decision could have a nationwide impact as states look at ways to bring down spiking drug costs. Meanwhile, a new study supports the industry's argument that even as list prices rise, net prices are going down with discounts like rebates.
The New York Times:
Massachusetts, A Health Pioneer, Turns Its Focus To Drug Prices. It’s In For A Fight.
Massachusetts, which led the nation in expanding health insurance coverage, now wants to rein in the growth of prescription drug spending for low-income people on Medicaid, but its proposals have met an icy reaction from patients and drug companies. The state has asked the Trump administration for permission to limit the number of drugs that will be covered in its Medicaid program, seeking to exclude “drugs with limited or inadequate evidence of clinical efficacy.” (Pear, 3/31)
Wholesale Drug Prices May Be Rising, But Rebates Are Taking A Bigger Bite
As anger mounts over the cost of prescription medicines, a new analysis finds that brand-name drug makers increased their list prices by 5.5 percent in last year’s fourth quarter, but after subtracting various allowances, their net pricing fell by 1.1 percent. And the average concession off the list price, which is also known as the wholesale price, was 41 percent, according to Sector & Sovereign Research, which tracks the pharmaceutical industry. These concessions included rebates paid to pharmacy benefit managers, allowances given to wholesalers, fees paid to retailers, provisions for returned goods, and the cost of any copay card or coupon programs. (Silverman, 3/30)
In other drug pricing news —
FDA Charts Biosimilars' Future — But Drug Makers Aren't All On Board
In his recent public appearances, Food and Drug Administration Commissioner Scott Gottlieb has sounded a repeating note: drug prices are too high, and especially prices for complicated protein-based drugs called biologics. The answer, he says, is in part encouraging generic biologics, called biosimilars, to enter the market. And one way in which the FDA can do so, Gottlieb told an assembled crowd of insurers at an industry conference earlier this month, is to set clearer standards for what these drugs have to prove to be considered equivalent — or interchangeable — to the originals. (Swetlitz, 3/30)
To Boost Generic Competition, Analysis Says, FDA Should Approve Drugs OK’D By Foreign Regulators
As Americans grapple with sometimes unpredictable generic drug pricing, a group of academics argue there may be a way to mitigate the problem. They suggest that the Food and Drug Administration should be authorized to speed approvals of copycat medicines that were already endorsed by regulators in other countries in hopes of providing fresh supplies that might lower prices. The rationale is there are enough foreign regulators — such as in Canada, Europe, and Australia — that take a similarly stringent approach to the FDA for approving generic drugs. And as they see it, this form of reciprocal approval could increase competition by providing incentives for companies to enter the U.S. market and lowering the cost of FDA approvals, according to their analysis, which was published in BMJ. (Silverman, 3/30)