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The Medicare & Medicaid Programs

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    Trends in the Marketplace

    The Increasing Exploitation of Patient Assistance Programs

    Copay accumulator programs have only one purpose; increase profits for payers. Patients don’t gain an advantage, nor do manufacturers. On top of that, providers face the difficulty of helping patients manage a process they don’t understand. And somehow, the whole concept has gotten worse. Patient Assistance Programs offered by manufacturers are intended to relieve the patient’s financial burden when filling their prescription. From the patient perspective, this is great. This blog takes a closer look behind the curtains to reveal

    Fractures in The 340B Program

    The 340B Program remains controversial. Hospitals and other Covered Entities (providers qualified to buy drugs at 340B prices) that benefit from the program describe it as a lifeline that keeps them in business. Pharma sees 340B as a program that has grown well beyond its original purpose, and at their expense. This controversy has created fracture lines that run in many different directions. The fractures are being created by lawsuits, government regulations, federal law, and other factors. We’ll describe the

    The Impact of Medicare Price Negotiations

    The Inflation Reduction Act (IRA) passed on August 16th, 2022 brings big changes for the pharmaceutical industry. On August 31st we had a live discussion on the law’s anticipated impact. Here is a summary of our discussion: Inflation Penalty The intent of the law is to impose penalties on manufacturers who raise drug prices faster than inflation. Penalties will begin very soon; however, recent Consumer Price Index (CPI) inflation rates allow increases of around 13.5% without any penalties assessed. Manufacturers

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      Manufacturers Restricting 340B Sales to Contract Pharmacies

      • Abbvie
      • Amgen
      • AstraZeneca
      • Boehringer Ingelheim
      • Eli Lilly
      • Merck
      • Novartis
      • Novo Nordisk
      • Sanofi
      • UCB
      • United Therapeutics
      • and more…