Pharmaceuticals & Drug Pricing
Expert articles and analysis related to pharmaceuticals & drug pricing.
AI Summary — Last 30 Days
Synthesis:
Over the past 30 days, structural shifts in Medicare drug pricing and coverage have focused on the codification and implementation of major elements of the Part D redesign and the continued evolution of value-based models targeting complex therapeutics. CMS finalized 2027 Medicare Advantage and Part D payment rules, including updated risk adjustment models, which are set to impact plan incentives and care strategies for chronic conditions while refocusing MA quality measures on drug adherence and outcomes HFMA summary. Meanwhile, the BALANCE Model’s expansion of GLP-1 access for obesity management saw delays to its Part D component, underscoring ongoing tensions between expanding access to high-cost therapies and aligning payment models with population health goals in value-based care AHA coverage.
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