Medicaid rebates have been a fact of life in the pharmaceutical industry for 25 years. But the Affordable Care Act repeal-and-replace debate may open up the possibility of eliminating the mandatory rebates – and the requirement that all drugs be covered by the program.
An opt-out for states from the Medicaid rebate program could give them more latitude for responding to high-priced new product introductions, a former Ohio and District of Columbia Medicaid official told the House Energy and Commerce Health Subcommittee on Feb.1.
John McCarthy, the former director of the Ohio Medicaid program (and former deputy director of DC’s program) suggested in prepared...
The Centers for Medicare and Medicaid Services is considering imposing price inflation rebates on Part B drugs furnished to enrollees in Medicare Advantage plans in addition to those covered by fee-for-service Medicare.
Doctors are increasingly falling victim to financial scams due to their high incomes, busy schedules, and trust in professional networks. Recognizing the tactics scammers use and the reasons behind physicians’ susceptibility is essential for protecting medical professionals.
US lawmakers will undoubtedly continue to work on pharmacy benefit manager reform legislation in 2025, given its bipartisan support. But policies impacting rebates that could lead to higher premiums in Part D may be a tough sell in the midst of the benefit redesign.
Medicare coverage with evidence development final guidance includes few substantive changes from the proposed version despite biopharma stakeholder concerns.
Pharmacy benefit manager sues Federal Trade Commission claiming chair Khan has orchestrated a campaign against PBMs that is not based in fact.
Alternatives to the top pharmacy benefits managers argue health plan-PBM integration is leading to anti-competitive tactics that make it impossible for some employers to switch PBMs.
The UK regulator approved 16 medicines containing a new active substance in the first half of this year, while the European Commission issued marketing authorizations for 20 NAS-containing drugs.
