Part B Reform: HHS Proposal Is Intriguing – But Bigger Message Is Timing
“Immediate” actions on drug pricing reform aren’t necessarily happening soon, given that the competitive bidding proposal is just a request for information.
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CMS using authority from previously abandoned competitive acquisition program; vendors may get ability to use formularies and apply utilization management techniques like prior authorization and step therapy.
Distributors, specialty pharmacies and PBMs are in a better position now to act as vendors then they were a decade ago, when Medicare unsuccessfully tried to implement a Medicare Part B prescription drug competitive acquisition program, HHS Secretary Azar points out.
Past support for so-called ‘march in’ rights is a red flag for biopharma innovators, but after two days of confirmation hearings, industry can be somewhat reassured.