Pharmacy Benefits & Drug Pricing
Expert articles and analysis related to pharmacy benefits & drug pricing.
AI Summary — Last 30 Days
In the past 30 days, pharmacy benefits and drug pricing within federal value-based programs have seen structural changes with significant implications for ACOs, MA plans, and Part D sponsors. CMS is advancing finalized 2027 Medicare Advantage and Part D regulations that revamp risk adjustment and plan payment, aiming for better alignment between prescription drug benefit design and population risk profiles. Meanwhile, the launch—and now partial delay—of the CMMI BALANCE model signals CMS’s intent to use value-based frameworks to expand access to GLP-1s and related obesity therapies in Medicare and Medicaid, but operational uncertainties around implementation persist ([AHA report](https://news.google.com/rss/articles/CBMiqwFBVV95cUxOaWZ0U213aUU2QUpaYl9SdVNkWnNvQmpLbWo1SnlybXhKRzNEMjlobEdNRVJjVGdQWXFOUWdLcjBOSk1XdzU0ODc1THVQMEg3Z1RhcWxSNXpIcjZHU1lUX20xYlFzNXNsS0d0VGhHUF9sdDhGNFhqOHJQTVVoWHdUc1ppRlZCeFVRaVRoSlhxb
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