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This is Part 5 of “Behind the Counter,” an in-depth video series demystifying the complex world of patents and drugpricing. When patents for name brand medicines expire, the price of that medicine drops significantly as generic versions enter the market.
The historic Inflation Reduction Act of 2022 has fundamentally improved the affordability of and access to prescription drugs for millions of people with Medicare. The law laid out aggressive timelines for implementing the Medicare DrugPrice Negotiation Program.
And the findings may provide further impetus for legislative action to curb practices that critics say contribute to the rising cost of prescription drugs. For the second time in less than a year, the U.S.
Passage of laws to address pharmacy middlemen has been the top priority of the pharmaceutical industry, particularly after they suffered a stinging defeat when Democrats passed their drugpricing law in 2022. The pharma industry spent millions on advertising to promote PBM legislation, and it appears it will get most of what it wanted.
As the debate over drugpricing intensifies, some proposals—like the Most Favored Nation model—may sound appealing in theory, but they carry serious unintended consequences.
Teva Pharmaceutical, the world’s largest generic drugmaker, was fined $503 million by European antitrust regulators for delaying competition to a blockbuster multiple sclerosis medicine.
Dozens of state attorneys general are urging Congress to pass a law prohibiting pharmacy benefit managers from simultaneously owning pharmacies, arguing such a move would boost competition and create more affordable prescription drugprices for Americans.
Notably, momentum has stalled in reaching licensing deals that are designed to make lower-cost generic drugs available in parts of the world where brand-name medicines are unaffordable, and few companies have pursued technology transfer agreements.
During 2023, drugmakers substantially raised prices on five widely used medicines without any new clinical evidence to justify the increases, leading patients and health insurers in the U.S. to spend an additional $815 million last year, according to a new report.
spending on prescription drugs was almost $800 billion. Although low-cost generic drugs filled 91% of all prescriptions, the 9% of prescriptions filled with a branded medicine accounted for 84% of drug spending. In 2024, total U.S.
In May 2024 , nearly 90% of pharmacies were closed for a day as thousands of pharmacists protested over “over drug shortages, pharmacy closures and fears medications could be sold online, as well as higher pay.”
Three independent pharmacies have filed separate lawsuits accusing GoodRx, which markets a prescription drug discount card, of conspiring with several pharmacy benefit managers to fix reimbursement fees, the latest skirmish over the opaque pharmaceutical supply chain in the U.S. and, consequently, represent a lucrative market.
A Further Examination of Pharmacy Benefit Managers Nicholas Saraceno, Editor March 29th 2024 Podcast Brandon Newman joins The Pharmaceutical Commerce Podcast to discuss the evolving role of PBMs, including the importance of drugprice transparency.
The NHC supports the efforts to reduce out-of-pocket costs for Medicare beneficiaries and appreciates CMS’ work to establish a process that seeks to incorporate patient perspectives into drugpricing policy. This will allow other stakeholders (e.g.,
A proposed Senate bill that would prohibit companies that control health insurers or pharmacy benefit managers from owning pharmacies rattled investors on Wednesday, but some Wall Street analysts believe the legislation is unlikely to gain much traction, at least for now.
Next week, Drug Channels Institute (DCI) will release our 2025 Economic Report on U.S. drugpricing, reimbursement, and dispensing system. Pharmacies and Pharmacy Benefit Managers. It’s the 16th edition of our popular and comprehensive examination of the entire U.S.
How Recent Executive Orders Impact the DrugPricing Landscape Nicholas Saraceno, Editor May 30th 2025 Podcast Alice Valder Curran outlines the steps manufacturers should take to better prepare for upcoming executive actions on drugpricing and market access.
From protecting the 340B DrugPricing Program to expanding payment pathways through state-level reforms and Medicare Advantage opportunities, Kraus emphasized the critical role pharmacists play in evolving care models.
In an unusual move, an audit of commercial health plans by Tennessee officials found that Express Scripts, one of the largest pharmacy benefit managers in the United States, violated state laws in its dealings with pharmacies, according to newly released documents.
Or would it unravel under the weight of economic retaliation, manufacturing disruptions, and rising drugprices? Table of Contents The Ripple Effects of Tariffs on DrugPricing Manufacturing Dependencies and Global Disruption Impact on Pharma Marketing and Innovation Budgets Can the Industry Adapt or Will It Fracture?
How Recent Executive Orders Impact the DrugPricing Landscape Nicholas Saraceno, Editor May 30th 2025 Podcast Alice Valder Curran outlines the steps manufacturers should take to better prepare for upcoming executive actions on drugpricing and market access.
This pathway’s expanded use and shifting Centers for Medicare & Medicaid Services (CMS) policies are reshaping reimbursement practices and therapeutic equivalence standards for 505(b)(2) drugs.
Four months ago, a small pharmaceuticals company bought a medicine used to combat a rare growth disorder in children and quickly raised the list price by 150%. Such a dramatic boost — from $5,882 to $14,705 per vial — is the sort of move that often draws attention at a time when many Americans complain about rising drug costs.
According to Trump, patients could see cost reductions of 30% to 80%, but experts question the feasibility and practicality of implementing such a policy within the complex United States drugpricing and supply system. Kennedy Jr, is permitted to develop a new rule that ties American drugprices to those of other nations.
Almost uniformly, the 11 formularies made the drugs available fairly when judged on three criteria: eligibility based on clinical data, restrictions placed on prescribers, and step therapy, which requires patients to try other medicines before insurers approve a prescription.
Wes Moore signed a bill that will allow a state board to extend its mandate for lowering prescription drug costs to all residents, not just those employed by government agencies. In a notable development, Maryland Gov.
The advent of the first generic GLP-1 drugs could help Medicare negotiate a lower price for the highly sought after diabetes and obesity medication semaglutide , according to experts familiar with the price-negotiation program and STAT’s review of documents from the first round of negotiations.
Known as the negotiators between health plans, pharmacies and drug companies, pharmacy benefit managers are currently entangled in a national conversation about reform. The pharma industry has long blamed PBMs for rising drugprices, pointing to opaque rebate and profit structures , and proposed policy shifts could take them to task.
AI in value-based pricing and RWE generation AI has the potential to transform value-based pricing (VBP) by leveraging machine learning for dynamic pricing models that adjust drugprices based on real-world patient outcomes.
How Recent Executive Orders Impact the DrugPricing Landscape Nicholas Saraceno, Editor May 30th 2025 Podcast Alice Valder Curran outlines the steps manufacturers should take to better prepare for upcoming executive actions on drugpricing and market access.
LONDON — People in England with sickle cell disease will now be able to access the world’s first CRISPR-based medicine under a pricing and reimbursement agreement reached between U.K. health officials and Vertex Pharmaceuticals. The deal is notable because the U.K.’s
regulatory approval for its groundbreaking HIV prevention drug , the company has another hurdle to clear — ensuring the medicine can be accessed in low-income countries where the disease remains a stubborn problem. Now that Gilead Sciences has won U.S. As far as Gilead is concerned, the groundwork exists to meet that goal.
That could be expedited due to impending deadlines related to the implementation of the Inflation Reduction Act’s Medicare drugprice negotiation program, or extended if OMB has further questions for HHS. The contents of the proposal will not be public during the review period. HHS took this step after a Washington, D.C.
A group of academics is arguing that countries seeking access to a groundbreaking HIV prevention drug from Gilead Sciences should issue compulsory licenses if the company fails to modify an existing licensing program with half a dozen generic makers.
For the second consecutive year, the pharmaceutical industry saw its reputation slip among patient advocacy groups, largely due to ongoing concerns over pricing issues, according to a new survey.
3 M&A activity cools under policy pressure As of now, M&A activity is currently in a holding pattern due to the aforementioned US drugpricing and tariff uncertainty. Deals have evolved in the sense that they now include lower upfront payments, and structures that are much more milestone-heavy.
Deep Dive Library Events Press Releases Topics Sign up Search Sign up Search Pharma Biotech FDA Clinical Trials Deals DrugPricing Gene Therapy An article from Dive Brief Actithera draws new investors to radiopharma drug pitch The four-year-old biotech raised about $75 million in a Series A round that involved nine venture capital firms.
After a Canadian regulator began requiring application fees from drug companies more than a decade ago, the odds that a drug — other than cancer treatments — would receive a recommendation for government funding rose dramatically, according to a new study.
can stay competitive in science, biomedical innovation, and drug development. We’ve Want to stay on top of the science and politics driving biotech today? Sign up to get our biotech newsletter in your inbox. Good morning, there’s been a lot of discussion lately about how the U.S.
Most Popular FDA investigating Elevidys safety; Nektar shares spike on eczema data Kymera adds Gilead as research partner, while advancing new candidate with Sanofi Oz hints at impending CMS rule to force drugprice transparency Hundreds of laid-off HHS staff have been reinstated, RFK Jr. You can unsubscribe at anytime.
Want to stay on top of the science and politics driving biotech today? Sign up to get our biotech newsletter in your inbox. Today, we talk about the likely confirmation of FDA nominee Marty Makary, go in-depth on NIH nominee Jay Bhattacharya, and see how much 23andMe CEO Anne Wojcicki is willing to pay for her own company.
Final thoughts Budget cuts may be coming, driven by drugpricing changes or economic pressures. Build in the ability to track key metrics such as time to therapy, abandonment rates, and financial impact of hub performance. Be ready to defend your hub by showing how it directly improves prescription lift, fills, and patient adherence.
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