Drug Pricing & Pharmacy
Expert articles and analysis related to drug pricing & pharmacy.
AI Summary — Last 7 Days
CMS drug-pricing and Part D policies are converging into a material Medicare market disruption: KFF reports that 4.3 million beneficiaries will see MA-PD or stand-alone PDP plan terminations at the end of 2026, while CMS’s proposed 2028 MA/Part D rule would implement reconciliation-law changes including Part D compensation reforms and tighter MA network-directory requirements. For VBC stakeholders, the near-term risk is churn—ACO-aligned MA populations, medication adherence programs, preferred pharmacy relationships, and care management attribution could be disrupted as plans exit, consolidate, or redesign benefits in response to IRA-era Part D liability, emerging international reference pricing pressure in Part B, and continued 340B rebate-pilot disputes. Medicaid and Medicare affordability politics are also intensifying around high-cost drugs, with the GLP-1 “Bridge” concept and the finalized Medicare Part B International Reference Pricing Model signaling that CMS is pairing price controls with benefit-design changes—creating new savings opportunities but also operational uncertainty for risk-bearing providers managing pharmacy-sensitive chronic disease.
Related Articles
How Changes in Drug Price Policy Affect Your Wallet and Part D Plan
How Changes in Drug Price Policy Affect Your Wallet and Part D Plan Kiplinger
PBM influence is only growing, American Medical Association report finds
The 10 largest PBMs are also part of a company that owns a health plan.
Brand Drugmakers Raise Median Net Launch Price of New Drugs 35% In Just Three Years
Brand Drugmakers Raise Median Net Launch Price of New Drugs 35% In Just Three Years AHIP
Inside the 340B Rebate Pilot Standoff: Court, Congress, Drugmakers
Administration Finalizes Medicare Part B International Reference Pricing Model
Administration Finalizes Medicare Part B International Reference Pricing Model Health Affairs
Administration Finalizes Medicare Part B International Reference Pricing Model
Administration Finalizes Medicare Part B International Reference Pricing Model Health Affairs
AHA urges court to reject drug industry intervention in 340B rebate program case
AHA urges court to reject drug industry intervention in 340B rebate program case American Hospital Association
Price of new drugs up 35% since 2022: 6 things hospital leaders should know
Price of new drugs up 35% since 2022: 6 things hospital leaders should know Becker's Hospital Review
The U.S. Pays Triple What Other Countries Pay for Drugs. Here’s What the Evidence Says About Fixing It.
The U.S. Pays Triple What Other Countries Pay for Drugs. Here’s What the Evidence Says About Fixing It. AcademyHealth
Roche’s changing plans show how MFN is complicating European drug launches
Roche will seek European approval for its promising new breast cancer pill giredestrant later than it once expected, highlighting how US drug pricing pressure may be affecting pharmaceutical companies...