Drug Pricing & Access
Expert articles and analysis related to drug pricing & access.
AI Summary — Last 30 Days
CMS is positioning drug pricing as a VBC lever through the Medicaid GENEROUS Model, extending manufacturer and state deadlines amid strong pharma interest, but KFF cautions that savings will depend on confidential model terms, interaction with existing Medicaid rebates, and state uptake. In Medicare, biosimilar adoption is becoming a provider-performance issue for ACOs and other value-based payment participants, while Part D strategy is shifting around GLP-1 coverage pressure and 2027 risk-adjustment changes that could redistribute MA-PD and PDP payments. Together, these moves signal that drug affordability is being pulled deeper into value-based contracting, formulary design, and population health economics—creating upside for organizations that can manage therapeutic substitution and total-cost accountability, but exposing ACOs, plans, and states to policy uncertainty and manufacturer negotiating dynamics.
Related Articles
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That is the title of my latest Perspectives from the Healthcare Economist article published in The Evidence Base this week. Here is the teaser: In this guest column, healthcare economist Jason Shafrin...
Federal 340B overhaul bill unlikely this year
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An Arm and a Leg: The Accidental Architect of America’s Drug Patent Problem
An Arm and a Leg launches its “101” series with the story of Alfred Engelberg, a lawyer who’s been crusading to improve access to generic drugs by fixing loopholes in a law he helped draft more than 4...
45 state attorneys general back PBM transparency
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