The drug price reform arena is active, with a major announcement on drug rebate reform and GLP-1 weight-loss drug price reductions.
About The Podcast:
Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
On this episode, Marc discusses the fact that drug price reform arena is active, with a major announcement on rebate reform and GLP-1 weight-loss drug price reductions.
Key Takeaways:
Cigna’s Express Scripts PBM announced it will begin introducing net pricing and migrate in part away from drug rebates.
Consumers will get the benefit of the lowest price at drug counters. The new model will save members an average of 30% each month on brand drugs.
It will also enhance how it pays pharmacies.
Cigna says it will deploy the strategy for its plan offerings and offer the net price options as the default to all employer groups and clients.
It is a step forward but is not real reform – it does not eliminate rebates, is a hybrid approach, and many plans and employer groups may still maintain the rebate structure.
PBMs should not write the reform script, and the government should eliminate rebates entirely.
President Trump announced major concessions of GLP-1 weight-loss drugs for self-pay and Medicare, including a $50 co-pay cap.
There is much confusion surrounding when Medicare cost-sharing reductions go into force, whether those with obesity alone will truly benefit, and Medicare cost impacts.
The concessions do not impact Medicare drug price negotiations, and the president should ensure broad drug price reform across lines of business.
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Resources:
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
