Medication Access & Pricing
Expert articles and analysis related to medication access & pricing.
AI Summary — Last 7 Days
CMS is moving GLP-1 access from policy concept to operational reality, with Administrator Dr. Mehmet Oz announcing the launch of $50/month Medicare beneficiary access to certain weight-loss drugs—an affordability move that could materially shift Part D utilization, MA risk management, obesity-related population health strategies, and ACO care planning if coverage and total cost exposure are clarified (Healthcare Finance). At the same time, KFF’s focus on the BALANCE and GENEROUS models signals that CMMI drug-pricing demonstrations are becoming central to Medicaid and Medicare cost-control strategy, while stakeholders are raising concerns about downstream effects of Medicaid work requirements on medically complex populations, including cancer patients. The emerging VBC tension is whether federal drug-pricing and access interventions can lower out-of-pocket costs and improve adherence without creating unmanaged utilization spikes, benefit-design friction, or avoidable churn for high-risk beneficiaries.
Related Articles
Stretching Scarce Authorizing Legislation as Far as Possible: A Legislative History of the 340B Drug Pricing Program
Stretching Scarce Authorizing Legislation as Far as Possible: A Legislative History of the 340B Drug Pricing Program Milbank Memorial Fund
Behind the Drug Discounts: 340B, Medicare Negotiation, and Transparency
Behind the Drug Discounts: 340B, Medicare Negotiation, and Transparency Health Affairs
The Interaction Between The Manufacturer Discount Program And Medicare Drug Price Negotiation
The Interaction Between The Manufacturer Discount Program And Medicare Drug Price Negotiation Health Affairs
Access, affordability, ambiguity: Who really benefits from federal prescription drug price policies?
When Cost-Effectiveness Thresholds Drift: Global HTA, MFN Pricing, and the Need for a Coherent Framework
Greater flexibility in cost-effectiveness thresholds used by HTA bodies may appear manageable in isolation. But these shifts can reshape drug pricing far beyond national boundaries. The post When Cost...
STAT+: Trump’s drug-pricing deals set to be tested by new product launches
The public is about to get its first look at the prices of drugs launched since President Trump struck his most-favored-nation deals with 17 drugmakers.
STAT+: Trump’s pharma deals get tested
We still have a lot of questions about Trump's MFN deals with pharma companies.
AHA Statement on Eli Lilly Decision To Move Forward With Policy To Withhold 340B Discounts
AHA Statement on Eli Lilly Decision To Move Forward With Policy To Withhold 340B Discounts American Hospital Association
Eli Lilly threatens to withhold 340B discounts
Eli Lilly threatens to withhold 340B discounts Modern Healthcare
STAT+: Eli Lilly warns hospitals to submit claims data in the next five days or lose their 340B drug discounts
Eli Lilly has told more than 1,000 hospitals participating in the 340B drug discount program to submit claims data over the next five days — or lose price breaks.