Drug Pricing

PRI’s scholars responded to today’s action by the Centers for Medicare & Medicaid (CMS) announcing 15 additional drugs under Medicare Part D that will be subject to government price setting effective January 1, 2027.  The action was authorized by the Inflation Reduction Act signed by President Biden in August 2022. ...

Reforms Can Improve Competition and Generate More Savings By Wayne Winegarden  | January 7, 2025 READ PDF Executive Summary Reforms that will strengthen the biosimilar market and expand savings opportunities include: Reforming (ideally repealing) the Inflation Reduction Act’s price control measures. Improving the incentives underlying the current buy-and-bill system to ...

The Centers for Medicare & Medicaid Services has proposed a rule expanding Medicare and Medicaid patients’ access to anti-obesity drugs such as GLP-1s. Congress is also considering such a move. Expanding coverage to these patient groups makes sense. Read the entire op-ed here.

Biden administration is proposing that Medicare and Medicaid cover Ozempic and other GLP-1 drugs for weight loss. It’s unclear what the Trump administration will do with its predecessor’s proposal. Democrats may be trying to goad Medicare under Trump into slapping price controls on GLP-1s — something progressives have long wanted ...

Time to Bring Hospital Pricing Out the Shadows, It’s Long Overdue Just one in five hospitals is complying with federal price-transparency rules today, according to a new report from the group Patient Rights Advocate. Put differently, hospitals are keeping the prices of their services secret in violation of the law. ...

A federal judge in New Jersey recently dismissed a lawsuit seeking to strike down the Inflation Reduction Act’s program of price controls for prescription drugs dispensed through Medicare. It was the fifth suit of its kind to fail this year. Democrats have cheered the IRA’s price controls for supposedly making ...

Despite Achievements, Barriers That Discourage Biosimilar Use Remain By Wayne Winegarden  | December 2, 2024 READ PDF Executive Summary The Inflation Reduction Act’s price controls discourage biosimilar development. Payment system inefficiencies, such as the buy-and-bill payment system and rebate walls, disincentivize the use of lower cost biosimilars. Despite the savings ...

Colorado’s Prescription Drug Affordability Board recently declared that Stelara, a popular treatment for Crohn’s disease and other autoimmune conditions, is “unaffordable.” Soon, the board’s five unelected members could decide whether to impose an “upper payment limit” on the medication. The decision could have significant consequences not just in Colorado but ...

The Democrats’ days in control of federal healthcare policy are numbered. But they were able to do quite a bit of damage during President Biden’s term. The scheme of price controls they’ve put in place for drugs dispensed through Medicare is a case in point. Ten drugs in Medicare Part ...

Most government support programs provide benefits directly to people, whether it is SNAP (Supplemental Nutritional Assistance Program), TANF (Temporary Assistance for Needy Families), or housing voucher benefits. But when it comes to healthcare, our government provides healthcare benefits by paying institutions, not patients. Shouldn’t funds follow the patient – not ...