Drug Pricing Negotiation
Expert articles and analysis related to drug pricing negotiation.
AI Summary — Last 7 Days
CMS is moving to further formalize the Medicare Drug Price Negotiation Program through rulemaking, intensifying operational and actuarial questions for MA-PD plans, Part D sponsors, ACO-aligned providers, and specialty pharmacy partners as negotiated prices begin reshaping formularies, rebate economics, beneficiary affordability, and total-cost-of-care benchmarks (HFMA summary). At the same time, rising prescription drug spending—especially GLP-1 utilization—continues to pressure Medicare and Medicaid trend, reinforcing a VBC tension between expanding access to high-value therapies for obesity and cardiometabolic risk while preserving shared-savings economics and premium stability (Healthcare Dive). The policy debate is broadening beyond IRA negotiation to foreign reference pricing and PBM/MA oversight, signaling that drug-cost containment is becoming a central lever in the Trump administration’s Medicare affordability agenda and a near-term strategic risk for organizations managing population-level pharmacy spend.
Related Articles
How Foreign Reference Pricing Embeds Valuations And Risks Undermining Global Innovation
That is the title of my new Health Affairs Forefront piece out today with Lou Garrison and Richard Xie. An excerpt from the article is below: United States policy makers increasingly argue that Americ...
Pharmaceutical Manufacturer response to Most Favored Nation (MFN): Delay, Hide or Confuse?
Today I attended the very interesting ISPOR Health Policy Leadership Exchange (HPLE) in Washington DC on the topic of Most Favored Nation (MFN). There were a number of important points made and I’ll s...
Medicare Drug Price Negotiation Program Proposed Rule Summary
HFMA provides a detailed summary of the proposed rule to codify the Medicare Drug Price Negotiation Program (“Negotiation Program”) and establish certain new policies for the Negotiation Program and t...
CMS Proposes Rule to Govern the “Medicare Drug Price Negotiation Program”
CMS Proposes Rule to Govern the “Medicare Drug Price Negotiation Program” King & Spalding
Hospitals irate after Eli Lilly follows through on 340B ultimatum
The drugmaker stopped paying 340B discounts to hospitals that didn’t comply with its new paperwork requirements late last week. Hospitals are urging HRSA to step in.
Florida launches probe into CVS for alleged anticompetitive pharmacy practices
The investigation by Florida’s attorney general comes as states look to check pharmacy benefit managers for allegedly driving up drug costs.
340B bill would levy various restrictions on participating hospitals
Legislative language overhauling the 340B Drug Pricing Program faces a long and uncertain path in Congress but would have significant implications if some of the provisions become law. A preliminary b...
Update: Litigation about the 340B program’s ‘patient’ definition could affect hospital savings
Note: This story is an update to prior coverage. Providers weighing in on potentially disruptive litigation involving the 340B Drug Pricing Program say a ruling in favor of the drug manufacturer would...
Cassidy's new plan to overhaul 340B: Rebates, contract pharmacy limits and more changes
Cassidy's new plan to overhaul 340B: Rebates, contract pharmacy limits and more changes Fierce Healthcare
STAT+: Cassidy proposes bill to rein in 340B drug discount program
Placing new limits on the 340B drug discount program would be a fresh challenge for hospitals as they confront funding cuts.