Our Drug Rebate Prediction Is Coming True: Now Can We Turn Our Attention to the Value of Drugs?

Posted by Pratap Khedkar on Tue, Feb 12, 2019

We predicted last year that prescription drug rebates’ days could be numbered as more healthcare stakeholders clamor for price transparency. Judging by the new rule proposed by Health and Human Services Secretary Alex Azar and Inspector General Daniel Levinson, this has now come to pass. The proposal aims to wipe out the behind-the-scenes negotiation tool—which has been linked to a growing discrepancy between a drug’s list and net prices—and instead share the savings directly with Medicare patients. 


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Collaboration Sparks a New ‘Value of Drugs’ Discussion, and Pharma Needs to Speak Up

Posted by Joe Stevens on Wed, Feb 06, 2019

The industry’s current value and payment system is being scrutinized as pharma companies continue to expand their traditional, treatment-based drug discovery models to include potential cures. The Institute for Clinical and Economic Review (ICER) is collaborating with the U.K.’s National Institute for Health and Care Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health to address some of the perceived challenges in pharmaceutical valuation methodologies, namely how the industry should be evaluating high-cost, but potentially curative, treatments.


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Even in a Favorable Regulatory Environment, Will Biosimilars Gain Traction in the US This Year?

Posted by Pratap Khedkar on Fri, Jan 25, 2019

Christina Corridon co-wrote this blog post with Pratap Khedkar.

Despite 16 approvals in the last four years, just six biosimilars currently are being marketed stateside. The U.S. biosimilars market hasn’t progressed as anticipated, yet some experts are wondering whether the biologic follow-ons can redeem themselves with a breakout year in 2019.

The U.S. biosimilars market has a tough road ahead. The WAC list price differential between biosimilars and the originator drugs is hovering around 30%, on average, which likely isn’t speeding biosimilars’ adoption in the U.S. Rather than playing the long game and waiting for the U.S. landscape to become more attractive, some biosimilar manufacturers like Momenta are choosing to exit the market. And others like Pfizer have shuttered their preclinical biosimilar programs to focus their efforts elsewhere. On the flip side, the Trump administration has zeroed in on drug pricing and biosimilars as priorities—and, of course, the two are intertwined.


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Trump’s Medicare Pricing Policy Could Mean Big Disruptions to Medical Benefits

Posted by Howard Deutsch on Tue, Nov 13, 2018

Gustavo Poblete co-authored this blog post with Howard Deutsch.

The Trump administration rolled out a significant policy proposal aimed at reducing the prices that Medicare pays for prescription drugs covered under the Part B medical benefit. While the policy is positioned as a “pilot” covering half the country, it will, if implemented as proposed, bring substantially greater disruption to drug pricing, contracting and distribution than purportedly envisioned by the government. Manufacturers with drugs covered under the medical benefit will need to fully reevaluate their strategies to adapt.


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Who’s the Real Target of Trump’s Medicare Price Policy?

Posted by Howard Deutsch on Mon, Nov 05, 2018

Bill Coyle, Pratap Khedkar and Gustavo Poblete co-authored this post with Howard Deutsch.

When President Trump announced at the Department of Health and Human Services that the federal government would be taking “revolutionary” action on drug prices, he had harsh words for the “global freeloading” by foreign nations that demand low prices while saddling Americans with the high prices that fund pharmaceutical industry R&D. And he came with a plan: Medicare Part B prices will be lowered by indexing to drug prices in other wealthy nations.


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