Demos Bio Consulting’s Post

Medicare's first price negotiations under the Inflation Reduction Act target 10 high-cost drugs, potentially saving $6 billion annually for Medicare and $1.5 billion for recipients. Discounts may reach 38% to 79% off list prices, though these discounts are not directly reflective of what Medicare Part D plans actually pay. As we look ahead, it's important to stay informed and question how much of these savings will directly benefit patients. Syneos Health experts, Leigh Ann Bruhn, Rich Halberg, and Paul Tyahla unpack more here: https://lnkd.in/eTNm_z-U #WonderMore #Medicare #DrugPricing #HealthPolicy

It would be so great if we were living in a society and a political landscape where a triumph like this could just be celebrated by all. This is an example of government working for the average American! Truly saving lives. BREAKING NEWS: The Biden-Harris administration just announced that Medicare has negotiated lower prices for 10 prescription drugs that will save seniors $1.5 billion in out-of-pocket costs each year. Authorized by the Inflation Reduction Act, this price list marks the first time in U.S. history that Medicare has negotiated the prices of drugs directly with manufacturers. This will help seniors afford vital medication and make health care more affordable for all. https://lnkd.in/gDXXhTwy

I'm pleased to see that the House panel has passed a bill to ban spread pricing and only allow a flat service fee for government plans. While this is a great step forward, our self-funded clients have been operating in this manner for years. The key is to prioritize the lowest net cost for employees and members while also benefiting the plan itself. Spread pricing has been a significant negative for everyone except the PBM, so it's crucial that other mechanisms are in place to prevent PBMs from capturing revenue in other ways. Healthcare professionals, what are your thoughts on the pros and cons of this legislation? Check out the link below to learn more. https://lnkd.in/ePAyVPfb

CMS's press release on 1st round of IRA Rx negotiations said CBO predicted "predicted about $100bn savings over 10 years from drug negotiations, and a $3.7bn savings in the first year alone." Then CMS highlighted its achievement of $6bn net savings to Medicare if the prices it achieved had been in effect in 2023. Experts told me NOT to compare those numbers. A more reasonable comparison per people familiar with how CBO did their work is to look at CBO's projection that net prices of the drugs targeted for the program would decrease 50% on average & compare to Medicare's 22% lower net spend announcement. More nuanced analysis here: https://lnkd.in/e-4wZQsV

Thanks so much for this thoughtful article Sarah Karlin-Smith! With any rollout, we know from history nothing will be perfect, but it's definitely a start, and hopefully, we can all come together to make those changes, for the betterment of our healthcare system..

In Q4 2024, Medicare beneficiaries will see adjusted coinsurance for 54 Part B drugs. Under the IRA, manufacturers must provide rebates if a Part B drug's price rises faster than inflation. Click here to see "Around the World of U.S. Healthcare", which is published by KPMG Healthcare. https://bit.ly/3TYIBti

There isn’t one recipe for Medicare coverage: find the best mix for your needs and budget during #MedicareOE. Compare your 2025 choices — like Medicare drug plans and Medicare Advantage Plans — to see what’s right for you. The new $2,000 cap on out-of-pocket costs for Medicare drug plan-covered drugs means reviewing your options could help you save: https://lnkd.in/guhVtiBf

🌟 The landscape of employer-sponsored pharmacy benefits is evolving rapidly, and the latest surge in coverage for GLP-1 drugs is a testament to that. GLP-1 medications, known for their effectiveness in managing diabetes and aiding weight loss, are becoming a focal point in employer benefits plans. This shift not only addresses critical health issues but also reflects a broader commitment to employee well-being. 📈 #EmployeeWellbeing #HealthcareInnovation #BenefitsManagement #PharmacyBenefits #GLP1Drugs #EmployerSponsoredHealthCare

On June 30th, 2023, CMS released revised guidance for the Medicare Drug Price Negotiation Program, a requirement of the Inflation Reduction Act. CMS doubled-down on their expectation for plans to give preferential access to negotiated drugs on their formularies. Are you interested in hearing payers’ reactions to the revised guidance first-hand? If so, please contact us at IRA@magnoliamarketaccess.com to get a copy of the Magnolia Market Access’ Fall 2023 Inflation Reduction Act Payer Insights Survey to gain these critical insights. To learn more about our work, visit https://lnkd.in/grBFc4pG. #ira #MagnoliaMarketAccess #MMA #HealthCareCosts #inflationreductionact #survey #payers #healthcare #marketaccess

In Q4 2024, Medicare beneficiaries will see adjusted coinsurance for 54 Part B drugs. Under the IRA, manufacturers must provide rebates if a Part B drug's price rises faster than inflation. Click here to see "Around the World of U.S. Healthcare", which is published by KPMG Healthcare. https://bit.ly/4eZl4ki