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Cathy Kelly

Senior Writer

Washington, DC
Cathy Kelly has been covering reimbursement and market access news for more than a decade for "The Pink Sheet" and other publications that are now part of Informa's pharmaceutical intelligence resources. Her expertise spans legislative, regulatory and public policy topics as well as coverage trends in public and private insurance markets. Cathy is especially interested in following the ongoing transformation of the US health care system and its effect upon major stakeholders in the biopharma industry. She is based in Washington D.C.
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Latest From Cathy Kelly

Rybelsus, Other Treatment Improvements For Chronic Disease Have OptumRx’s Attention

UnitedHealthcare’s pharmacy benefit manager highlights potential cost pressures from upcoming novel or improved treatments for diabetes, wet AMD, HIV and migraine, as well as luspatercept for beta thalassemia, in its latest pipeline report.

Pricing Strategies Reimbursement

The 800-Lb. Gorilla: Drug Costs Loom Large In Medicare Oncology Care Model

Drug costs make up 60% of the total cost of cancer care, participants in the Medicare Oncology Care Model have found. But efforts to manage spending under the demonstration have so far focused instead on areas that represent a smaller portion of overall costs, such as hospitalizations.

Reimbursement Medicare

Value-Based Contracts: Medicaid Best Price Concerns Could Be Eased With CMS Guidance

Absent any legislative remedy, an administrative fix could provide manufacturers with confidence that value-based arrangements won’t trigger a new best price, Duke Margolis policy experts propose.

Reimbursement Medicaid

Curative Gene Therapy Coverage May Need Government-Funded Risk Pools

Former US FDA commissioner Scott Gottlieb makes a case for regional or national risk pools to ensure pediatric patients get timely access to gene therapy like the upcoming treatments for sickle cell disease.

Pricing Debate Policy

House Draft Drug Pricing Bill Offers Aggressive Policies But Near-Term Prospects Look Weak

If nothing else, the purported draft may be a preview of what Democrats might do if they prevail in 2020. Proposal calls for HHS price negotiation, international reference pricing, price inflation rebates and structural Medicare Part D changes. 

Pricing Debate Legislation

Cigna/Express Scripts Gene Therapy Solution Involves Plans ‘Pre-Paying’ For Coverage

Approach designed to avoid price “shock” when coverage for Luxturna or Zolgensma is requested. Plans would agree to certain per member per month payments to enroll in the program, which would cover both plan and patient costs for gene therapy.
Gene Therapy Reimbursement
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