HHS Drug Pricing Plan: Mum On National Cost Effectiveness Program, Cautious On QALYs
Biopharma likely approves of the Administration’s concern that QALYs, a commonly used metric in cost effectiveness evaluations, may not be appropriate for drug pricing reform policies because it could disadvantage people with disabilities.
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Medicare Price Negotiation Lite? Congress Targets Post-Exclusivity Drugs, Preserves Launch Price Discretion
Legislative deal on drug pricing reform includes a version of US government price negotiation for a subset of Medicare drugs. Only 10 will be selected for negotiation the first year but some analysts believe as many as 100 could be subject to negotiation by 2030.
CMMI payment demonstrations are viewed as way of skirting statutory obstacles to experimenting with new approaches to reimbursement and could lead to significant drug pricing reforms if legislative efforts fail. However, HHS is not signaling an intent to pursue transformational new models at this point.
Germany uses government facilitated price negotiations between publicly funded insurers and manufacturers that are based on an independent assessment of how much added value a drug provides.