Pharmacy Value Management
Expert articles and analysis related to pharmacy value management.
AI Summary — Last 30 Days
CMS is moving pharmacy value management toward direct affordability interventions and tighter utilization infrastructure: under the Trump administration, CMS launched $50/month Medicare access to selected GLP-1 obesity drugs, creating a temporary bridge program that could reset beneficiary expectations, plan liability, and population-health ROI assumptions for high-prevalence cardiometabolic disease management (Healthcare Finance). At the same time, the economics remain unstable for payers and risk-bearing providers because GLP-1s may be cost-effective clinically but budget-disruptive at scale, while Medicare Advantage rebate mechanics continue to advantage MA-PD plans over stand-alone Part D plans and shape how drug benefits are used for enrollment and retention strategy (KFF). For ACOs, Medicaid managed care plans, and delegated-risk groups, the strategic issue is shifting from “whether” to cover high-value drugs toward how to manage indication, adherence, prior authorization, outcomes measurement, and total-cost accountability across pharmacy and medical spend.
Related Articles
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.
[World Report] Are Trump's drug pricing policies saving anyone money?
Experts question the effectiveness of the Trump administration's strategies to cut pharmaceutical costs in the USA. Washington Correspondent Susan Jaffe reports.
STAT+: Trump’s pharma deals get tested
We still have a lot of questions about Trump's MFN deals with pharma companies.
Opinion: The innovation trap: How pharma weaponizes a word to extend monopolies
“Just because a company invests does not mean it has invented anything novel,” Tahir Amin and Rohit Malpani write in this excerpt from “Pharma Monopoly.”
Jeff Davis Comments on 340B Drug Pricing Program Lawsuits
Jeff Davis Comments on 340B Drug Pricing Program Lawsuits Bass, Berry & Sims PLC