Most Clicked PCMA SmartBrief Stories

1. Filing of first biosimilar offers glimpse of possible savings for U.S.

PCMA SmartBrief | Jul 25, 2014

The FDA application filed Thursday by Sandoz for a biosimilar drug is just the beginning in realizing the huge savings that biosimilars can bring to the U.S. compared with expensive biologics, Jason Millman writes. The U.S. biosimilars market's development will be key amid payers' concerns about a projected increase in the country's drug spending over the next few years, Millman writes. Washington Post (tiered subscription model), The (07/24)

2. CMS withdraws planned limits on hospice drugs in U.S.

PCMA SmartBrief | Jul 21, 2014

The CMS pulled its proposed restrictions of private insurance coverage for hospice drugs under Medicare because they were blocking some terminally ill patients' access to drugs. Prior approval for coverage of anxiety drugs, laxatives, anti-nauseants and analgesics will now be required. "Based on discussions with stakeholders, we are adjusting our rules so that beneficiaries enrolled in hospice will continue to have access to their medications," said CMS spokesman Raymond Thorn. Reuters (07/18) Hill, The (07/18)

3. Medicare Part D plans pay less than Medicaid, DOD

PCMA SmartBrief | Jul 22, 2014

Medicare Part D plans have lower average prescription costs than Medicaid or the Defense Department, Government Accountability Office data show. The savings are due in part to the commercial plans' formularies that use out-of-pocket payments to advocate generic drug usage, industry expert Adam Fein writes. Drug Channels (07/22)

4. Study: Anti-preferred pharmacy network bill would deal a $21B blow to Medicare

PCMA SmartBrief | Jul 24, 2014

A proposed bill mandating networks include any pharmacy willing to meet contract terms in Medicare Part D would cost taxpayers $21 billion over 10 years, a study by The Moran Company found. (subscription required) (07/23)

5. Federal court says tax credits are illegal for plans bought on

PCMA SmartBrief | Jul 22, 2014

A three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit ruled 2-1 that tax credits for health insurance plans bought through the federally run exchange violate the Affordable Care Act. The law specifies tax credits for plans bought through state-run exchanges, which the writers of the law expected all states would set up. An appeal is likely. Reuters (07/22) CNBC (07/22)

6. PCMA: Drugstore lobby pushes legislation undermining cost-saving pharmacy networks

PCMA SmartBrief | Jul 23, 2014

The independent drugstore lobby's push for legislation requiring Medicare Part D plan networks to include any pharmacy willing to meet contract terms "is a backdoor attempt to ban the popular, low-premium plans that encourage shopping at more affordable pharmacies," said PCMA President and CEO Mark Merritt. A new study by The Moran Company found the definition of a "medically underserved area" is so broad that 95% of all Medicare beneficiaries are affected. The study also found that the legislation would increase federal spending by $21.32 billion between 2015 and 2024. Chain Drug Review (07/22)

7. Is Sovaldi overpriced?

PCMA SmartBrief | Jul 22, 2014

Drugmakers have a right to price their products such that development costs are recovered, but if every hepatitis C patient in the U.S. were treated with Gilead's Sovaldi at the current price, the company's return on investment would be more than 20 to 1, write Drs. Troyen Brennan and William Shrank of CVS Caremark. Journal of the American Medical Association (free content) (07/20)

8. Personalized medicine's high cost exemplified by Kalydeco's $300,000 price

PCMA SmartBrief | Jul 21, 2014

The more than $300,000-a-year price of using Vertex Pharmaceuticals' Kalydeco to treat cystic fibrosis is a very good example of personalized medicine's high cost, according to this article. Drugmakers charge high prices for their products because they can, says Barry Werth, author of "The Antidote." New York Times (tiered subscription model), The (07/19)

9. Tenn. AG says "any willing pharmacy" rule doesn't apply to TennCare

PCMA SmartBrief | Jul 22, 2014

A Tennessee law that requires insurers to accept into their networks any pharmacy willing to meet contract terms does not apply to the state's Medicaid pharmacy program, according to state Attorney General Robert Cooper Jr. Bloomberg BNA (subscription required) (07/22)

10. Report: Billions of dollars wasted due to abuse of REMS

PCMA SmartBrief | Jul 24, 2014

A Generic Pharmaceutical Association report released Wednesday found that brand-name drugmakers are manipulating the FDA's risk evaluation and mitigation strategies to repel generic competitors. Matrix Global Advisors reported that such manipulation has delayed the arrival of 40 potential generic drugs, which costs consumers about $5.4 billion yearly. "This study raises serious concerns about whether safety protocols are being inappropriately used to inhibit access to cheaper alternatives," said Sen. Richard Blumenthal, D-Conn. Reuters (07/24)

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