All in All, It’s Just Another Crack in the Rebate Wall

Posted by Joe Stevens on Mon, Nov 11, 2019

Howard Deutsch co-wrote this blog post with Joe Stevens.

As the end of 2019 nears, a critical drug pricing question remains unanswered: Is the pharma “rebate wall” crumbling or are the rumors of its demise exaggerated? With the current “high list price, high rebate” model, pharma has been operating in a worst of both worlds scenario, taking blame for high list prices without reaping profits commensurate with those prices. Looking to break this cycle, pharma companies are beginning to bypass government and regulatory bodies, health insurers and PBMs in their efforts to address the rebate issue themselves, and we think that’s a wise move.


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The Rebate Rules Are Changing. Here’s What Pharma Needs to Do to Prepare

Posted by Howard Deutsch on Wed, Mar 20, 2019

Pranava Goundan co-wrote this blog post with Howard Deutsch.

In the classic political film, “The Candidate,” Robert Redford’s character, fresh off his victory, turns to his election strategist and asks, “What do we do now?” And the movie ends right there. The pharmaceutical industry now is facing a similar moment. After years of advocating for more transparent pricing and criticizing the rebate-for-access model for its perverse pricing incentives, pharma is on the cusp of partly getting its wish. But our movie doesn’t end there, so we must answer that question: What do we do now?


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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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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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