Drug Pricing & Pharmacy
Expert articles and analysis related to drug pricing & pharmacy.
AI Summary — Last 30 Days
CMS is accelerating drug-spend control through payment-model and plan-contracting levers: the finalized GLOBE model brings most-favored-nation-style pricing pressure to Medicare Part B drugs, even as its scope and financial impact were narrowed and PhRMA has sued the Trump administration—signaling that specialty drug pricing will remain a contested but central VBC affordability lever for oncology, infusion, and hospital-based service lines (AHA). In parallel, CMS is proposing MA/PBM transparency and flat-fee PBM compensation requirements, while KFF reports 4.3 million Medicare beneficiaries will see MA-PD or PDP plan terminations at the end of 2026, raising near-term risks for medication continuity, network navigation, and population health management among ACOs, MA partners, and pharmacy-aligned care models (KFF). The strategic throughline is a shift from volume-based drug margin and rebate economics toward administratively enforced price benchmarks, PBM accountability, and pharmacy payment models tied to quality—creating both downside disruption for incumbent revenue streams and openings for VBC organizations that can manage medication access, adherence, and total-cost performance under tighter pricing and contracting rules.
Related Articles
CMS finalizes GLOBE drug pricing model
CMS finalizes GLOBE drug pricing model American Hospital Association
CMS finalizes model that aims to bring most-favored nation pricing to Part B
CMS finalizes model that aims to bring most-favored nation pricing to Part B Fierce Healthcare
HRSA approves 10 drug companies for participation in the 340B Rebate Model Pilot Program
HRSA approves 10 drug companies for participation in the 340B Rebate Model Pilot Program American Hospital Association
HRSA discloses manufacturers approved for revised 340B rebate pilot
Ten drugmakers will see 21 of their drugs move from upfront discounts to after-the-fact payments in the drug discount program at the start of next year, an expansion from the Trump administration’s fi...
STAT+: Trump’s watered-down Medicare drug pricing rule saves 96% less than initial proposal
WASHINGTON — The Trump administration published a final rule aimed at lowering Medicare prices for drugs administered in doctor offices. It applies to only four companies. The Global Benchmark for…
CMS sets GLOBE ‘most favored nation’ Medicare drug price model
CMS sets GLOBE ‘most favored nation’ Medicare drug price model Modern Healthcare
CMS finalizes GLOBE Medicare demo but savings trail projections
The Centers for Medicare and Medicaid Services finalized a demonstration program aimed at lowering the prices of drugs in Medicare, but with significantly lower expected savings than previously projec...
The pharmacy pays $1,302. The patient pays $299
By JOHN SAMARAS A US retail pharmacy pays $1,302 to acquire one month of branded Wegovy. That figure comes from the Centers for Medicare and Medicaid Services National Average Drug Acquisition CostCon...
AHA, others file amicus brief supporting hospital in challenge to Lilly 340B policy
AHA, others file amicus brief supporting hospital in challenge to Lilly 340B policy American Hospital Association
HRSA names 10 drugmakers for revised 340B rebate pilot ahead of 2027 launch
HRSA names 10 drugmakers for revised 340B rebate pilot ahead of 2027 launch Fierce Healthcare