Despite a busy 2022, drug pricing remains a hot topic at the federal and state levels, with a number of recent developments and trends worth monitoring heading into 2023. In the past year, the FTC increasingly focused on the...more
1/10/2023
/ Biden Administration ,
Drug Pricing ,
Enforcement ,
Federal Trade Commission (FTC) ,
FTC Act ,
Inflation Reduction Act (IRA) ,
Investigations ,
Legislative Agendas ,
Medicare ,
Medicare Part D ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Rebates ,
Regulatory Agenda
States remain at the forefront of legislative efforts on a range of issues relating to drug pricing, such as increasing price transparency, capping out-of-pocket costs for insulin, and limiting certain PBM practices. These...more
9/15/2022
/ Disclosure Requirements ,
Drug Pricing ,
Health Care Providers ,
Manufacturers ,
Medicare Part B ,
Medicare Part D ,
Out-of-Pocket Expenses ,
Pharmaceutical Industry ,
Pharmacies ,
Prescription Drugs ,
Price Transparency ,
Regulatory Agenda ,
Section 340B ,
State and Local Government ,
State Legislatures
Federal efforts on drug pricing are increasingly focusing on the role of pharmacy benefit manager middlemen. A recently proposed Senate bill seeks to eliminate certain PBM practices, such as spread pricing and unfair claw...more
Among the drug pricing developments to watch in 2022, those at the top include legislation that would allow Medicare price negotiation and alter antitrust rules for the pharmaceutical industry, Federal Trade Commission...more
1/31/2022
/ Drug Pricing ,
Federal Trade Commission (FTC) ,
Legislative Agendas ,
Medicare ,
Medicare Part D ,
Pharmaceutical Industry ,
Prescription Drugs ,
Price Transparency ,
Proposed Legislation ,
Rebates ,
Section 340B
On September 9, 2021, the Department of Health and Human Services ("HHS") released its widely anticipated "Comprehensive Plan for Addressing High Drug Prices." The HHS report supports far-reaching legislative and...more
9/20/2021
/ Biden Administration ,
Competition ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Executive Orders ,
Healthcare Reform ,
Medicare ,
New Legislation ,
Pay-For-Delay ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Price Transparency ,
Proposed Legislation
State legislatures continue to push forward on drug pricing with legislation designed to reduce the cost of prescription drugs. Recent steps across a number of states include laying the groundwork for effective...more
Citing concerns about growing consolidation, reduced competition, and increasing prices, President Biden issued on July 9, 2021 a sweeping Executive Order containing 72 initiatives to address competition concerns in a number...more
New challenges may lie ahead for the pharmaceutical industry -
What’s next for drug pricing in the US?
Proposals to alter antitrust and patent laws may signal a renewed focus on drug pricing by federal lawmakers,...more
On April 23, 2021, President Biden signed into law two bipartisan bills aimed at reducing prescription drug prices by supporting generic and biosimilar alternatives to branded drugs.
The Ensuring Innovation Act supports...more
The American Rescue Plan Act of 2021, the US$1.9 trillion stimulus package expected to be passed by Congress and signed into law by President Biden by March 14, 2021, contains the first drug pricing legislative action being...more
On December 10, 2020, the Supreme Court in Rutledge v. Pharmaceutical Care Management Association held that ERISA does not pre-empt an Arkansas law regulating PBM prescription drug payment rates to pharmacies because it...more
12/23/2020
/ Drug Pricing ,
Employee Retirement Income Security Act (ERISA) ,
Health Insurance ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Preemption ,
Prescription Drug Coverage ,
Prescription Drugs ,
Rutledge v Pharmaceutical Care Management Association ,
SCOTUS
The Trump Administration recently announced two final rules that implement policy objectives to lower drug prices by tying certain Medicare Part B payments to prices paid by other countries and by replacing an anti-kickback...more
12/4/2020
/ Anti-Kickback Statute ,
Biden Administration ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
False Claims Act (FCA) ,
Final Rules ,
Medicare Part D ,
Most-Favored Nations ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Safe Harbors ,
Trump Administration
On September 13, 2020, President Trump issued an Executive Order seeking to establish most favored nation ("MFN") pricing for Medicare drug payments. The Trump Administration's Order, 'Lowering Drug Prices by Putting America...more
9/16/2020
/ Anti-Kickback Statute ,
Drug Pricing ,
Executive Orders ,
Imports ,
Medicare ,
Medicare Part B ,
Medicare Part D ,
Most-Favored Nations ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Rebates ,
Secretary of HHS ,
Trump Administration
On July 24 2020, President Trump signed three Executive Orders targeting prescription drug prices and proposed a fourth. The Orders represent the Trump Administration's latest effort to implement previously outlined...more
8/1/2020
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Executive Orders ,
FQHC ,
Healthcare Costs ,
Medicaid ,
Medicaid Drug Rebate Program ,
Medicare ,
Pharmaceutical Industry ,
Popular ,
Prescription Drug Coverage ,
Prescription Drugs ,
Section 340B ,
Trump Administration
With proposed federal legislation on pause, state legislatures continue to target the pricing of pharmaceuticals, passing a number of new laws in 2020. As complexity at the state level continues to increase, pharmaceutical...more
On March 27, 2020, the President signed the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act. The purpose of the CARES Act is to provide emergency assistance and health care response for individuals, families, and...more
4/6/2020
/ CARES Act ,
Coronavirus/COVID-19 ,
Medicaid ,
Medical Devices ,
Medicare ,
Medicare Part D ,
Pharmaceutical Industry ,
Prescription Drugs ,
Relief Measures ,
Supply Chain ,
Virus Testing
On March 27, 2020, the President signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act. The purpose of the CARES Act is to provide emergency assistance and health care response for individuals, families, and...more
On 25 February 2020, the Court of Appeal in Chapelgate Credit Opportunity Master Fund Ltd-v-Money & Others confirmed that the liability of a commercial funder of an unsuccessful action should not automatically be limited to...more
While drug pricing continues to be an important political issue in the United States, it has been state legislatures, not the federal government, that have been able to translate policy proposals into new laws.
Over the...more