Congress grills pharma executives

Seven CEOs from large pharmaceutical firms were brought before Congress today. And they got an earful from both Demogratic and Republican Congressmen. The executives were critique for selling too many opioids. They were critiqued for legal manuevers to extend brand name drugs’ patent life. But most of all, they were critiqued for high drug prices.…

Are value-based pricing arrangements more common than we thought?

The answer appears to be ‘yes’ according to a survey by Mahendraratnam et al. (2019). After surveying subject matter experts that were senior representatives from payer organizations and pharmaceutical manufacturers on value-based pricing arrangements (VBA), they found: More than 70% of VBAs implemented between 2014 and 2017 were not publicly disclosed. Furthermore, although consideration of…

Payer coverage of FDA-approved drugs

Many people think that once a treatment is approved, your insurance automatically covers the treatment.  However, that is no longer the case.  Some health plans may keep certain drugs off of formularies.  Others health plans have drugs on formulary but may require step edits (failing another drug first before moving to the novel treatment) and…