Search Results for "Medicare"

The Drug Pricing Lab commissioned Milliman to prepare a report exploring the impact of changes in Medicare Part B program costs on beneficiaries’ premiums and Social Security payments. This report focuses on the 2022 Part B premium for beneficiaries with various income levels to illustrate the payment dynamics and discusses the implications for related programs.

The Drug Pricing Lab engaged Milliman to prepare a report summarizing the pricing dynamics affecting utilization of biosimilars in the current Medicare Part D marketplace and under the proposed Part D benefit design in the Build Back Better Act.

This report was commissioned by the Drug Pricing Lab.

The infrastructure bill includes a drug waste provision from the Recovering Excessive Funds for Unused and Needless Drugs (REFUND) Act, which requires manufacturers to rebate the amount wasted back to CMS. An estimated $3 billion over 10 years can be recouped and invested in roads, bridges, and other infrastructure initiatives.

Why Congress should not follow the National Academy of Science, Engineering, and Medicine’s recommendation to remove the JW modifier.

Medicare cannot indiscriminately cover the cost of Aduhelm for the treatment of Alzheimer's disease without first evaluating whether it truly works.

Meanwhile, pharmaceutical companies would stand to make a lot more money.

Many promising ideas won't work as expected, and that's all the more reason for CMS to evaluate how medical care is delivered to its patients.

CMS delays the effective date of MCIT rule on "breakthrough" designation after concerns raised by physicians, including Peter Bach.

Research Biostatistician, Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center

Research Data Analyst, Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center

The Drug Pricing Lab engaged Milliman to conduct an independent analysis of the Production Plus Profit Pricing (P-quad) policy proposal. The Milliman analysis estimates the projected spending on U.S. biologic and biosimilar drugs under a referent scenario where there is no biosimilar entry or competition, the existing ‘status quo’ scenario under the current biosimilar environment, and the Drug Pricing Lab’s P-quad policy proposal. 

This report was commissioned by Drug Pricing Lab.

Senior Project Portfolio Manager, Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center

Director, Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center

Two options are proposed if Gilead wishes to offer the discounts to the full array of government programs.

Recent draft pieces of legislation and regulation take aim at the rising cost of drugs, targeting drugs that claim the largest share of the health care budget and that face limited competition from generics or biosimilars.

Drug prices in the U.S. are highest among developed countries, effectively setting the upper bound for reference prices elsewhere.

Dr. Peter Bach responds to PhRMA's stance of opposition to H.R. 3 Lower Drug Costs Now Act of 2019.

Biosimilars will not effectively lower the price of biologic drugs after the period of market exclusivity.

Milliman analyzes the impact of the proposed rule to implement point of sale rebates in Medicare Part D.

Pharmacy benefit managers (PBMs), such as Express Scripts, CVS Caremark, and Optum Rx, are some of the larger companies that administer the Medicare Part D prescription drug benefit.

Dr. Peter Bach, alongside Kathy Sego, Dr. Douglas Holtz-Eakin, and Dr. Mark Miller, testified before U.S. Senate Finance Committee at its first hearing of the session, Drug Pricing in America: A Prescription for Change, Part I.

Our response to the Trump administration’s Request for Information on implementing an international pricing index model for Medicare Part B drugs.

According to the Drug Pricing Lab analysis, The Wall Street Journal published an article showing $9.1 billion retained by insurers over the course of 9 years from Medicare Part D plans.

The Drug Pricing Lab takes issue with The New York Times "Fact Check" on the recent Trump Administration proposal to pilot alternative reimbursement for Part B drugs.