“Next Phase” For CED Should Focus On Treatments That Lower Cost, MEDCAC Told
The next iteration of CMS’ Medicare coverage with evidence development policy should limit application of the reimbursement tool to treatments that can lower overall health care spending, Center for Medical Technology Policy CEO Sean Tunis told the Medicare advisory committee.
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CMS officials Jonathan Blum, Louis Jacques and Tamara Jensen addressed a number of Medicare Part B-related topics of interest to the biopharmaceutical industry at the FDA/CMS Summit, including reimbursement for high-priced oncology drugs, coverage with evidence development and national coverage determinations.
Based on stakeholder consultations, former FDA and CMS head Mark McClellan and former CMS official Sean Tunis present a potential upside for biopharma in broader use of Medicare coverage with evidence development. Pfizer executives participate in workshop on coordinating expedited drug approval, CED policies.
Biogen value-based contract with UPMC Health Plan ties payments to patient-reported outcomes for Tecfidera and Avonex. The company may seek something similar for Vumerity.