ICER Will Explore Link Between Reasonable Drug Pricing And ‘Fair’ US Formulary Policies
Study will examine prior authorization and other access restrictions at 15 of the largest US commercial payers for a group of 27 drugs.
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A new pilot program by the insurer is offering a $500 debit card to patients who switch from the blockbuster Novartis psoriasis drug to Lilly's rival Taltz or other preferred drugs.
The other seven drugs on the initial list for negotiation are already heavily rebated and CMS could choose not to go much lower than current net prices, SSR Health report points out.
There was lots of criticism of pharmacy benefit managers (and a fair amount of pharmaceutical manufacturers) at the oversight hearing. However, Democrats may be more cautious about preserving the benefits PBMs provide versus the downsides in developing reforms.