Big Pharma’s Verbal Gymnastics On Drug Price Negotiations
I found this article worthy of top billing tonight due to the laughter I get from hearing Big Pharma talking out of both sides of its mouth. As we know, brand drug makers lobbied hard against the passage of the Inflation Reduction Act’s (IRA) Medicare drug price negotiations and have filed numerous lawsuits to stop it (all without success so far). Brand drug makers argued passage would cripple innovation and the drug industry. Since that time, the first ten drug prices have been set and brand companies have been arguing to their investors that the IRA will not have negative impacts on long-term margins.
With the possibility of Democrats again winning both houses of Congress and the White House, Big Pharma is in panic mode due to commitments by Democrats to expand Medicare drug price negotiations. In comes the brand pharmaceutical lobby, PhRMA, which is now arguing that recent statements by some drug companies that the drug prices will not impact long-term financials doesn’t mean the law won’t hinder the potential for innovation. This led to questions about whether drug maker CEOs were being honest with investors, which forced PhRMA to clarify that the email declaring concerns was not intended as a formal response to the CEOs.
PhRMA still insists that companies are not taking on new development or finishing development for certain types of drugs because of the law. PhRMA points to a few studies to back up its points. But there is really little evidence thus far to suggest this overall.
The verbal gymnastics by PhRMA is comical.
(Article may require a subscription.)
#ira #branddrugmakers #drugpricing
Frustrated With High Prices And Conflicts, Employers Going Straight To Providers
Frustrated with rising costs and the built-in conflicts of having an insurer administering all aspects of an ERISA self-insured employer plan, more and more employers are working around carriers and looking at direct contracting with providers. A new report and survey from Brighton Health Plan Solutions shows that 75% of 150 employer sponsors surveyed are looking at direct contracting. This could result in a 6% to 20% increase in savings.
#employercoverage #healthcare
CMS Continues Crackdown On Exchange Enrollment Fraud
The Centers for Medicare and Medicaid Services (CMS) has been cracking down on agent and broker access to the Exchange enrollment system due to major accusations of fraudulent moving of individuals in the Exchanges. CMS has now blocked two private sector enrollment websites from accessing consumer information through the federal Obamacare marketplace.
#exchanges #obamacare #aca #marketing #fwa
New Jersey Tackles Medical Debt
New Jersey announced that thousands of eligible individuals and families will have some or all of their medical debt eliminated. 17,905 New Jersey residents who had owed $61.6 million to Prime Healthcare hospitals and an additional 31,748 residents owing more than $38.4 million to other providers through collections agencies were helped.
#medicaldebt #healthcare
Appelate Court Decision On NSA Explained
Good Health Affairs Forefront blog explaining the appellate decision striking a Biden administration regulation on what arbitrators must consider during disputes over no surprise bills. The panel found that the regulation exceeded the agencies’ authority because it imposed three requirements not mentioned in law.
I don’t doubt the agency exceeded its authority, but it was right to fight for a level-playing field. While the court says the regulation “place[d] a thumb on the scale in favor of the insurer-determined QPA in derogation of the other congressionally mandated factors,” the truth is the law already favored providers and now that will be even more so. Congress should get some backbone and fix this.
(Article may require a subscription.)
#nsa #surprisebilling #nosurprisesact
— Marc S. Ryan
