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Amgen has negotiated 75 value-based contracts – agreements that SVP Josh Ofman sees as one area where biopharma and payer views are aligned. However, tension between the two sides remains high in pricing and reimbursement negotiations when it comes to rebates and other issues.
Latest From Pricing Debate
Brazil wants to drive competition and lower drug prices by obliging health authorities to publish the prices paid for all drugs bought by the national health system. A voluntary system has already helped save $1bn and cut the price of Gilead’s Sovaldi by around 30%.
FDA regulatory reforms have been framed as part of the drug pricing debate. Commissioner Gottlieb has reframed the goal as lowering the cost of capital by increasing predictability. That probably won’t lower drug prices – but it might lower the cost of future acquisitions for drug companies.
Agency eager to hear suggestions on the subject, also known as product hopping, but even reform advocates were cautious of stifling meaningful reformulations of products.
Payer groups suggest during FDA's Hatch-Waxman meeting that agency prioritize NDAs moving into the same class to push prices lower.
Although stakeholders are interested in value-based models that link a drug’s performance to emerging evidence of improved patient outcomes, such agreements are difficult to implement and too limited in scope to drive a shift to value-based reimbursement. The authors suggest a new, structured approach to bring these contracts into the mainstream, thus transforming product reimbursement and fueling the shift from volume to value.
There appears to be bipartisan interest in beefing up HRSA’s ability to oversee the 340B program – but the next step is likely to be more hearings and fact-finding, not immediate legislative changes.
HRSA Administrator George Sigounas made his public debut during the annual 340B coalition summer conference in Washington, DC. The setting was significant giving the prominence of the drug discount program on the Trump Administration agenda, but Sigounas didn’t offer much insight into the potential changes to come.
Medicare payments to hospitals for drugs provided under the 340B program would be reduced to average sales price (ASP) minus 22.5%, which CMS believes is more closely aligned with the discounted price obtained by the providers.
Threat of Independent Payment Advisory Board action to lower drug spending in Medicare alleviated for another year. Estimated spending growth in the program does not reach targets that would prompt cuts.
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