CVS ‘Guaranteed Net Cost’ Program Is Alternative To High Price/High Rebate Model
Program likely to generate fewer rebates so it remains to be seen whether payers will embrace the new model in a big way.
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Trump’s proposal to remove safe harbor protection for PBMs and biopharma will accelerate challenges to the traditional biopharma models, argues Viren Mehta of Mehta Partners LLC. Nimble new companies represent an innovation engine that can succeed without hiding behind the regulatory veil, and will foment rapid change, including in how drugs are valued and paid for.
Gilead’s authorized generics for Epclusa and Harvoni will be first alternatives to benefit from preferred coverage on the pharmacy benefit manager's National Preferred Flex Formulary.
Company says 75% of Medicare Part D patients who aren't eligible for low income subsidies abandon the PCSK9 inhibitor at the pharmacy counter due to $370 co-pay, which may now range from $25-$150 per dose.