On January 26, we hosted a webinar, The State of National Healthcare Policy and Pricing, featuring experts from Kalderos, Sidley Austin LLP, CSL Behring, Eisai, EVERSANA and King & Spalding. The webinar covered topics on policy initiatives, forthcoming rule changes and current litigation - including:
- Proposals for Part B and D negotiation
- Part D benefit redesign
- inflation rebate
- the Waste Refund Act
- the Accumulator Rule
- Line Extensions
- 340B Litigation
- Importation Rule Litigation
- Federal Drug Pricing and more.
With over 500 registrations and over 300 views on the day of the webinar was one of our most successful ever! We pulled a few questions from the Q&A to have Stephanie Kupski the Director, U.S. Pricing & Government Reporting at CSL Behring share her insights on.
Is Medicaid rebating percentage going up?
Stephanie: Nothing has been proposed as yet on the statutory “base” rebate percentages; only the AMP cap is being removed (so URA is no longer capped at 100% of AMP)
Will there be some kind of federal reporting requirement around pricing and price increases?
Stephanie: So far, no Federal Price Transparency requirements other than Hospitals need to provide patients access to estimated cost of care before treatment.
Is the maximizer connected to participating in the Medicaid program? If so, do you foresee manufacturers moving away from government programs?
Stephanie: It is indirectly in that it impacts BP/AMP if you cannot ensure co-pays went directly to the patient – otherwise, you need to consider co-pay as a price concession to the payer and consider in BP. If a manufacturer’s impact is to greatly increase the rebates paid, they may consider leaving the Medicaid program, but that would be dependent on overall portfolio and use in Medicaid versus not participating (in Medi/340b).
If you’re interested in more expert perspectives like this, we’ve got a great lineup of events throughout the year in our Pricing & Contracting Portfolio. Join us in-person at any of our content-packed conferences: Drug Pricing Transparency Congress, Medicaid and Government Pricing Congress, Commercial Contracts & Chargebacks Conference, IDN/Biopharma Partnering Summit, and the Medicaid Drug Rebate Program Summit.