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Prescription Drug Pricing

Expert articles and analysis related to prescription drug pricing.

198 articlesLast 30 Days

AI Summary — Last 30 Days

In the past 30 days, the Trump administration’s CMS has finalized significant updates to Medicare Advantage and Part D payment models, including implementation of a revised risk adjustment methodology for 2027 that further separates MA-PDs and PDPs, reshaping plan incentives and potentially impacting drug spending and population health strategies (Avalere Health Advisory, HFMA summary). Meanwhile, CMS’s BALANCE program, aimed at expanding access to GLP-1 therapies for obesity and related comorbidities via value-based contracts, has seen delays in its Part D component, reflecting ongoing operational and budgetary tensions as payers and providers grapple with the integration of high-cost drugs into accountable care models (KFF analysis).

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