CMS

Breaking Down the Cost of Sickle Cell Disease Gene Therapies

February 2, 2024 - Earlier this week, the Biden–Harris administration announced its plans to address the expensive price tag of sickle cell disease, looking for a way to widen access despite the cost. In an announcement by the United States Centers for Medicare and Medicaid Services (CMS), the organization noted that sickle cell disease will be the first focus...

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500 Drugs from Over 140 Brands Are Expected to Cost More This Year

by Veronica Salib

Last week, just before the end of 2023, Reuters published an article breaking a story from data analyzed by 3 Axis Advisors, a healthcare research firm. The analysis evaluated anticipated drug price...

WMIF: FDA Commissioner Discusses Revamping Accelerated Approval

by Alivia Kaylor

In a recent conversation at the 2023 World Medical Innovation Forum (WMIF), sponsored by Mass General Brigham Hospital and Bank of America (BoA), in Boston on June 13, 2023, prominent figures in the healthcare industry, Lindsey Baden, MD,...

Preventing Prescription Drug Fraud

by Veronica Salib

The National Center for Drug Abuse Statistics (NCDAS) notes that approximately 6% of people over 12 in the United States abuse prescription drugs annually, amounting to 16 million people. Additionally, about two million people who abuse...

AMA Supports Biden’s Medicare Proposal, Prescription Drug Policies

by Samantha McGrail

The American Medical Association (AMA) recently strongly supported the Biden Administration's proposal for Medicare Advantage (MA) and prescription drug benefit policies in an official letter. In...

CMS Proposes Delay of Medicaid Value-Based Payment Requirements

by Samantha McGrail

CMS recently proposed delaying Medicaid value-based drug payment requirements for state purchasing agreements with drug manufacturers until July 2022.  The rule, called “Medicaid Program...

CMS Rule Allows Payers to Negotiate Prescription Drug Pricing

by Jessica Kent

CMS has issued a final rule allowing payers to negotiate prescription drug pricing based on how well these drugs work for patients, a policy that could reduce overall healthcare spending and...

Pharma Organizations Sue HHS Over Most Favored Nation Drug Rule

by Samantha McGrail

UPDATE 12/23/2020: Judge Blake of the US District Court for the District of Maryland has granted a temporary restraining order on the Most Favored Nation rule. Top pharmaceutical organizations...

CMS Seeks Faster Medicare Coverage for Newly Approved Devices

by Samantha McGrail

Today, CMS issued a proposed rule that would create a new, accelerated Medicare coverage process for innovative products that FDA deems “breakthrough,” including new implants or gene-based...

States Sue Mallinckrodt Over Underpaid Medicaid Drug Rebates

by Samantha McGrail

A coalition of 28 states and territories recently sued Mallinckrodt ARD LLC over accusations that the pharmaceutical company violated the False Claims Act and knowingly underpaid Medicaid drug rebates...

GSK to Manufacture 1B Doses of COVID-19 Vaccine Adjuvant System

by Samantha McGrail

GSK recently announced it will manufacture one billion doses of its pandemic vaccine adjuvant system, in 2021, to support the development of various adjuvanted COVID-19 vaccine candidates. For more...

Court Tells Mallinckrodt to Pay $650M in Back Medicaid Rebates

by Samantha McGrail

Global pharmaceutical company Mallinckrodt recently announced that the US District Court for the District of Columbia upheld CMS’ decision over Medicaid rebates for the company’s...

CMS Launches New Billing Code for Coronavirus Testing

by Samantha McGrail

CMS announced last week that they developed a new billing code for providers and laboratories to test patients for the coronavirus, or SARS-CoV-2.  For more coronavirus updates, visit our...

CMS Moves to Foster Access to Generics, Biosimilars in New Rule

by Ana Mulero

The Trump administration put out a proposed rule on Wednesday that aims to foster access to generics and biosimilars through a push for price transparency around pharmaceutical drugs administered under...

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