Medicare’s Power To Negotiate Drug Prices Will Harm Patients With Chronic Illnesses, Advocates Warn
Medicare Advantage's negotiating tool -- requiring patients to try lower-cost treatments before the more expensive ones -- is derided as a "fail first" process to those who oppose the strategy. “Consumers may have to go through one or more drugs before they can get a particular treatment they really need,” said Ellen Albritton, a senior policy analyst at Families USA. Meanwhile, there are already signals that implementing the new rules is going to be complicated.
The Hill:
Patient Groups Rattled By New Medicare Power To Negotiate Lower Drug Prices
A new federal policy intended to drive down drug prices could have a negative effect on patients, particularly those with chronic conditions, according to health advocates. The policy announced Tuesday by the Department of Health and Human Services will give some private insurers the option to require patients try cheaper drugs before turning to more expensive ones, regardless of what their doctor prescribes. (Hellmann, 8/9)
Stat:
Private Medicare Leverage Over Drug Costs Would Boost PBMs And Biosimilars
In its latest effort to attack high drug costs, the Trump administration wants to allow privately run Medicare Advantage plans to require patients to pursue step therapy, which means anyone who needs a costly, physician-administered drug must first try a cheaper medicine to see if it works. With about 19 million beneficiaries covered by these plans, the move is projected to save 15 percent to 20 percent of the $11.9 billion spent on Part B drugs, which are infused or injected medicines. Some of these are pricey specialty drugs for hard-to-treat diseases and ailments. (Silverman, 8/8)
In other news from the pharmaceutical industry —
Reuters:
CVS Health Beats Profit Estimates, Defends PBM Business
CVS Health Corp beat analysts' estimates for quarterly profit on Wednesday and the drugstore operator defended its pharmacy benefits management business in the face of the Trump administration's move to clamp down on escalating drug costs. Shares of CVS Health, which agreed to buy health insurer Aetna for $69 billion in December, rose 3.6 percent to $67.76. (Banerjee, 8/8)
The Wall Street Journal:
Rite Aid, Albertsons Call Off Merger Amid Investor Opposition
In a surprise move, Rite Aid Corp. and Albertsons Cos. called off their planned $24 billion merger on the eve of a shareholder vote in the face of mounting protests from investors. Some of Rite Aid’s biggest shareholders had planned to vote against the pharmacy’s planned merger with privately held grocer Albertsons, unconvinced by the companies’ argument that a deal was necessary to fend off competition from Amazon.com Inc. and others. (Haddon and Lombardo, 8/9)
Reuters:
American Medical Association Opposes Merger Of CVS And Aetna
The American Medical Association, which represents U.S. physicians, urged the U.S. Justice Department on Wednesday to stop CVS Health Corp's plan to buy insurance provider Aetna Inc, saying the deal could result in higher prices for prescription medicines. The AMA said that the $69 billion deal, announced in December, would lead to a "substantial reduction" of competition in pharmacy benefit (PBM) services market and the Medicare Part D prescription drug plan for seniors. (Bartz, 8/8)