Drug Pricing

A coalition of the nation's largest pharmacies are suing Allergan over what they alleged is a multiyear anticompetitive scheme to shield the company's dry eye drug Restasis from generic competition.

The Congressional Budget Office believes the president's proposal to eliminate low-income beneficiaries' cost sharing for generic drugs would cost more than $18 billion dollars over 10 years, despite the fact that the White House Office of Management and Budget previously said the proposal would be nearly budget neutral.

CMS might consider making plans factor drug rebates and pharmacy price concessions in Medicare Advantage and Part D bids to save Medicare beneficiaries money at the pharmacy counter, Washington Analysis states in a note to its clients.

An Avalere analysis that asserts generic drug costs are rising for seniors in Part D due to plans putting generics on higher-cost tiers is “mostly founded on general speculation versus reliable fact,” a spokesperson for America’s Health Insurance Plans alleges.

Generic drug costs are rising for seniors in Part D, even though prices for the drugs remain flat, because plans are putting generics on higher formulary tiers, according to an Avalere analysis.

Many beneficiaries would pay much more for drugs if the administration moves doctor-administered Part B drugs into the Part D retail drug benefit, according to an Avalere analysis.

The U.S. Supreme Court Monday (May 21) declined to take up a case brought by a coalition of drug makers challenging consumers' standing to sue over money lost due to a product design that allegedly wastes a portion of that product.

CMS officially put drug plans on notice to stop using so-called gag orders that prohibit pharmacists from telling customers when it is more expensive to use insurance to buy drugs.

CMS' Medicare Evidence Development & Coverage Advisory Committee will meet in August to consider a National Coverage Determination for chimeric antigen receptor (CAR)-T cell therapies after UnitedHealthcare requested such a determination to make sure there is a level playing field across Medicare for coverage of the expensive therapies.