Medicare In The Business Of Setting ‘Fair’ Drug Prices: How Will Value Factor In?
New law directs HHS to consider comparative effectiveness information as it approaches price negotiations with manufacturers. But it’s not clear what that means and stakeholders will watch for greater clarity from implementing regulations. ICER’s Steve Pearson weighs in on what they might say.
You may also be interested in...
It's not clear that the proposed revisions and additions to the Centers for Medicare and Medicaid Services’ existing coverage with evidence development study design requirements would address what some experts view as a program failure – the fact that sponsors of the vast majority of technologies subject to CED have not generated the data CMS is looking for.
But premiums in future years made need to keep pace with accelerating Medicare spending on Alzheimer’s drugs.
Eisai/Biogen’s promising Phase III data fueling the companies’ hopes that Medicare will relax coverage restrictions for their Alzheimer’s treatment candidate. If the sponsors fail to change the NCD, lecanemab will need to rely on a registry for reimbursement after full approval.