Pharmacy & Drug Pricing
Expert articles and analysis related to pharmacy & drug pricing.
AI Summary — Last 7 Days
CMS’s Trump-era pharmacy agenda is moving toward tighter utilization management and data-driven benefit design: the GLP-1 Bridge pilot began covering obesity drugs in Medicare on July 1, and CMS is preparing to share utilization data with payers—creating new opportunities and risks for ACOs managing cardiometabolic populations, total cost of care, and adherence pathways. At the same time, CMS’s proposed overhaul of drug prior authorization is sharpening the tension between access, administrative burden, and spending controls, while scrutiny over Medicare drug negotiation timing—such as the asserted seven-year delay for an AbbVie blockbuster—underscores how formulary and statutory interpretations can materially shift long-run Part D and Part B affordability pressures for value-based contracts (GLP-1 pilot rollout; prior authorization proposed rule).
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