Member: RADAR on Drug Benefits

Demos Could Result From ‘Most Favored Nation’ Order

September 24, 2020

The Trump administration’s long-awaited executive order that seeks to tie U.S. drug prices to costs in other countries may represent more presidential campaign talking points than real policy that will take effect quickly. But analysts expect that the overarching issue of drug pricing will stick around, regardless of which candidate wins on Nov. 3.

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Execs Detail Payers’ Role in COVID-19 Vaccine Distribution

September 24, 2020

As the pharmaceutical industry hurtles toward completing a COVID-19 vaccine, payers and PBMs have begun to draft vaccine distribution plans based on emerging guidance from federal public health leaders. Insurance industry leaders say that they anticipate the government and its chosen distributor, McKesson Corp., will handle most of the early work in distributing vaccines, but that payers should anticipate taking a role in educating members and directing inoculations to appropriate populations in later stages.

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New Process Might Help Make CAR-T Therapies Less Expensive

September 24, 2020

This summer, a drug called Tecartus (brexucabtagene autoleucel) became the third chimeric antigen receptor T-cell (CAR-T) therapy approved by the FDA. CAR-T therapies, which use a patient’s genetically modified immune cells to target and fight cancer cells, are a cutting-edge type of treatment that comes with eye-popping price tags, ranging from $373,000 to $475,000. However, a new report from OptumRx highlights an “industry trend to watch” that could eventually provide some relief to payers worried about how to finance CAR-T treatments.

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Industry Experts Weigh In on Medicaid Best Price Waiver Proposal

September 24, 2020

During a Sept. 17 virtual session of the America’s Health Insurance Plans (AHIP) National Conference on Medicare, Medicaid & Dual Eligibles, health insurance industry leaders were cautiously optimistic about the impact of CMS’s recent proposed rule seeking to promote value-based purchasing (VBP) for prescription drugs, despite mixed reviews from some industry stakeholders (RDB 7/9/20, p. 1).

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Pharma Industry Spends Big on Lobbying Amid COVID-19, Upcoming Election

September 24, 2020

by Jinghong Chen
Over the past six months, the pharmaceutical industry spent more than $156 million on lobbying even as drugmakers have been racing to produce coronavirus vaccines and treatments. The Pharmaceutical Research and Manufacturers of America (PhRMA) spent $14.43 million in the first half of 2020, according to the U.S. Senate Lobbying Disclosure Act Database. Lobbying expenditures from Gilead Sciences jumped by 26%, going from $2.94 million in the first half of 2019 to $3.71 million over the same period in 2020. Meanwhile, drugmakers have distributed thousands of checks to lawmakers ahead of this year’s election, according to a recent Stat analysis. The industry has traditionally supported Republican candidates, and it donated nearly $200,000 to Senate Majority Leader Mitch McConnell (R-Ky.) this year. Among the 14 lawmakers who’ve received more than $100,000 from the industry in 2020, 11 are Republican lawmakers and six are senators up for reelection.

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