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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
CMS outlines possible approach to point-of-sale rebates in Medicare Part D, recognizing that using rebates to lower cost sharing for 'many' would increase premiums for all.
Data and intelligence will drive revolutionary changes in healthcare, and today's power brokers will need to adapt. Viren Mehta, founding partner of Mehta Partners LLC, considers how business consolidation in the complex US pharma market reflects the race to tap as yet under-exploited data troves, and how the resulting exploitation of those data may benefit a broader set of stakeholders.
Concerns with promoting competition and reducing consumers' 'pain in the pocketbook' are key tenets of the Trump Administration's approach to lowering prescription drug pricing, Grogan says.
Further evidence of the impact of pricing pressure in the US was provided when Sun Pharma reported a sharp fall in profits in Q2 (although it beat the expectations of some analysts). Sun also expects a delay in EU approval for its late stage psoriasis asset, tildrakizumab, but US approval timelines appear unchanged, at least for now.
Insurance practices are a big driver of drug pricing problems, according to Azar, a former Lilly exec who spent six years at HHS under George W. Bush, providing him valuable experience in department operations.
In effort to speed competition and lower drug prices, US regulator will prioritize review of generic drug applications likely to be ready for approval on or shortly after the expiration of first-filer's exclusivity; experts say the move appears to formalize what once had been an informal Office of Generic Drugs policy.
FTC Acting Chairman Ohlhausen predicts agency will continue to focus on competition issues involving barriers to generics but says 'we need to learn more about how these markets are working today.'
Pharmacy Benefit Managers are a key part of the medicines market in the US, but their role is complex. Viren Mehta, founding partner of Mehta Partners, LLC considers how their business model has evolved over the years, where it is headed, and how PBMs impact others in the healthcare ecosystem.
QuintilesIMS Institute study funded by the National Organization for Rare Disorders concludes orphan drugs accounted for only 7.9% of US total drug spending in 2016, bolstering advocacy group's view that rare disease treatments are not responsible for rising healthcare costs. US FDA analysis finds most orphan drugs do not expand their labeled indications into non-rare disease settings.
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