In the report accompanying FY 2023 HHS appropriations legislation, the House committee also addresses biosimilar uptake in Part D, Medicare dispensing fees for oral COVID-19 drugs and NIH grants for expanded access to investigational ALS drugs.

US legislation attempts to address manufacturer, pharmacy benefit manager impact on patient costs in addition to health plan benefit designs. Critics suggest it’s too easy on manufacturers but that may help its chances with Republicans.

For biopharma manufacturers, chipping away at the rebate rule is a relatively painless drug pricing “pay for” compared to price control policies.

Outcomes and disease progression could be clear cut, lending the rare disease treatment to innovative contracting. But the amount of money at stake is likely to complicate things.

Commission policy statement highlights situations where rebates lead to formulary exclusion of lower-priced insulin. But concern is also relevant for other drug classes, including highly-anticipated coverage decisions for biosimilars to Humira.

Commission policy statement highlights situations where rebates lead to formulary exclusion of lower-priced insulin. But concern is also relevant for other drug classes, including highly-anticipated coverage decisions for biosimilars to Humira.