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Latest Morning Briefing Stories

Administration To ‘Unleash’ Medicare Advantage Plans’ Bargaining Power On Some Drug Prices

KHN Morning Briefing

As a negotiation tool, Medicare Advantage plans will now be able to require patients getting drugs in a doctor’s office or the hospital to try lower-cost medicines before moving up to more expensive ones in a process called step therapy. Insurers already had this option in Part D drug plans — which cover prescriptions such as those purchased by beneficiaries at pharmacies. But the option is now being expanded.

FDA Had ‘Fox Guarding The Henhouse’ When It Came To Regulating Powerful Class Of Fentanyl

KHN Morning Briefing

The agency entrusted enforcement of the drugs to the companies that were making them, documents show. “People were getting hurt — and the FDA sat by and watched this happen,” Dr. Andrew Kolodny, an opioid policy researcher at Brandeis University, tells The New York Times. Meanwhile, under pressure, another pharmaceutical wholesaler agrees to boost oversight of its opioid distribution.

If Medicare Was Allowed To Negotiate Drug Prices Like Other Agencies, It Could Save $2.8 Billion In A Single Year

KHN Morning Briefing

Medicare currently isn’t allowed to negotiate drug prices, but analysts looked at agencies that can — like the Department of Veterans Affairs — and crunched some numbers. As drug prices continue to rise, officials scramble to find ways to curb the cost hikes. Meanwhile, Medicare beneficiaries will pay lower premiums on their prescription drug plans next year.

The Latest Culprit In The High Drug Price Blame-Game: The Pharmaceutical Rebate

KHN Morning Briefing

The drug rebate is similar to any other rebate on a product you’re buying — but instead of you getting to keep the money, it’s the insurer or employers who usually reap the benefit. There’s been a lot of movement lately, both from the pharma industry and the White House to eliminate the system. Meanwhile, Democrats are eyeing an unusual ally in their fight to let Medicare negotiate drug prices.

Democrats’ New Bill To Allow Medicare To Negotiate Drug Prices Would Give Government Leverage If Talks Fail

KHN Morning Briefing

Part of the problem with letting Medicare negotiate drug prices has always been that the government has no power in the talks. But the bill would let HHS give a competitive license to another company to make a generic version of the drug. Few see the measure gaining traction at the moment, though. Lawmakers also advanced legislation that would eliminate pharmacist “gag clauses.”

Results From Promising Alzheimer’s Trial Are ‘Encouraging’ But Fall Short Of Massive Hype Around Drug

KHN Morning Briefing

The drug showed success with patients who had the highest dosage for over 18 months, but there will need to be more studies before experts get really excited. “I don’t know that we’ve hit a home run yet. It’s important not to over-conclude on the data. But as a proof of concept, I feel like this is very encouraging,” said Dr. Reisa Sperling, director of the Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital in Boston.

Lawmakers Urged To Take Steps To Prevent Addiction Treatment Centers From Engaging In Patient-Brokering

KHN Morning Briefing

The practice involves a third party — often a treatment center that may not meet adequate care standards — paying a recruiter to fraudulently enroll an addicted patient in a flexible individual market plan offering out-of-state coverage. In other news, pop singer Demi Lovato, who has been an outspoken advocate about mental health and substance use problems, was hospitalized after a reported overdose.