Drug Pricing
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Anna Moneymaker / Staff via Getty Images
Trump administration affirms drug price talks, but will seek input to ‘improve’ program
Democrats sought answers from RFK Jr. on how the Trump administration would handle Medicare price negotiations after a short CMS statement didn’t clear things up.
By Jonathan Gardner • Updated Jan. 30, 2025 -
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Judge halts Trump freeze on grants as states report healthcare payment portals back online
States and providers regained access to a key healthcare payments portal late Tuesday amid pushback over the Trump administration’s decision to halt federal assistance.
By Rebecca Pifer • Jan. 29, 2025 -
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TrendlineBiosimilars
The arrival of lookalike competition to AbbVie’s Humira in the U.S. presents an opportunity, and a test, for the cost-saving potential of biosimilars.
By BioPharma Dive staff -
Mario Tama / Staff via Getty Images
J&J joins Pfizer in detailing impact of Part D redesign
The pharma expects a modest financial headwind this year from changes to Medicare prescription drug benefits under the Inflation Reduction Act.
By Ned Pagliarulo • Jan. 22, 2025 -
Mario Tama / Getty via Getty Images
Obesity drugsMedicare will negotiate Novo’s GLP-1 drug price. Here’s what that means for Ozempic, Wegovy.
Novo sells semaglutide as Ozempic and Rybelsus for diabetes and as Wegovy for obesity. In price talks, CMS will treat the different forms as a single product.
By Jonathan Gardner • Jan. 17, 2025 -
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Ozempic, Ibrance among next drugs picked by Medicare for price talks
Announcement of the 15 medicines chosen for the second round of negotiations was one of the Biden administration’s final health policy acts.
By Ned Pagliarulo • Updated Jan. 17, 2025 -
RiverNorthPhotography via Getty Images
FTC again goes after PBMs’ business practices in new report
Agency commissioners voted unanimously on Tuesday to publish the report, which makes a similar attack on the drug middlemen as the agency’s first report, but draws on more data.
By Rebecca Pifer • Updated Jan. 14, 2025 -
Win McNamee via Getty Images
As election day nears, Trump and Harris veer in different directions on pharma
Harris aims to broaden some IRA provisions, including Medicare drug price negotiation, while Trump has adopted a more industry-friendly approach.
By Amy Baxter • Oct. 15, 2024 -
Chip Somodevilla via Getty Images
UnitedHealth, CVS push to remove FTC Chair Lina Khan from PBM case
Attorneys argue Khan and two other commissioners are biased against pharmacy benefit managers and should recuse themselves from an ongoing lawsuit against the middlemen.
By Emily Olsen • Oct. 10, 2024 -
Scott Olson via Getty Images
Medicare tweaks rules for second round of drug price talks
The agency will offer earlier meetings with drugmakers as well as solicit more patient feedback on the process.
By Ned Pagliarulo • Oct. 3, 2024 -
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Blue Shield of California sidesteps PBMs with new Humira biosimilar deal
It’s the first time, according to the insurer, that this type of model has been used to bring a Humira biosimilar to market, and it yields a much lower cost than both the brand-name version of the drug and biologic copycats.
By Rebecca Pifer • Oct. 2, 2024 -
Chip Somodevilla via Getty Images
Novo CEO pressed by Senate to cut prices of obesity, diabetes drugs
CEO Lars Fruergaard Jørgensen told lawmakers the company would consider new talks with insurers about the list prices of Wegovy and Ozempic if they pledge to keep the medicines on their formularies.
By Jonathan Gardner • Sept. 24, 2024 -
LD via Getty Images
FTC sues major pharmacy benefit managers over insulin prices
The agency brought action against Caremark, Express Scripts and Optum Rx Friday, and warned that all drug manufacturers “should be on notice” as well.
By Rebecca Pifer • Updated Sept. 20, 2024 -
Scott Olson via Getty Images
Covering Wegovy for heart risk could cost Medicare tens of billions: study
If all newly eligible patients received Novo's GLP-1 drug, Medicare Part D spending could increase by $34 billion to $145 billion each year, according to new research.
By Emily Olsen • Aug. 27, 2024 -
Courtesy of Eisai
UK approves Leqembi, but reimbursement may not follow
Leqembi’s benefits are “too small to justify the significant cost to the NHS,” said the head of a UK agency in charge of determining medicine reimbursement.
By Kristin Jensen • Aug. 22, 2024 -
Mario Tama via Getty Images
Employers foresee higher health costs next year due to rising pharmacy spend
Pharmaceuticals like the in-demand GLP-1 drugs for obesity are expected to drive increases in healthcare spending in 2025, per a new employer survey.
By Rebecca Pifer • Updated Aug. 21, 2024 -
Alex Wong via Getty Images
Medicare drug price cuts could have limited early impact, but grow with time
Some in the industry described the level of price discounts announced by Medicare as a "relief," though they warned of larger implications for drug research in the future.
By Jonathan Gardner • Aug. 16, 2024 -
Scott Olson via Getty Images
Medicare reveals results of drug price negotiations
The first round of pricing talks under new powers granted to the U.S. government involved drugs like the blood thinners Eliquis and Xarelto, as well immune medicines like Enbrel and Stelara.
By Ned Pagliarulo • Aug. 15, 2024 -
lucky-photographer via Getty Images
Cigna CEO promises ‘aggressive’ defense of pharmacy benefit managers
David Cordani’s comments to investors Thursday come as the payer blew past Wall Street’s expectations for the second quarter, helped by significant growth in its health services division — including PBM Express Scripts.
By Rebecca Pifer • Aug. 1, 2024 -
3000ad via Getty Images
PBMs battle bipartisan scrutiny as lawmakers eye reforms
Top executives at CVS Caremark, Optum Rx and Express Scripts made a rare congressional appearance to defend their companies’ drug pricing policies.
By Susanna Vogel , Rebecca Pifer • July 24, 2024 -
Chris duMond via Getty Images
Where Kamala Harris stands on three key pharma issues
The presumptive Democratic nominee has a history of taking on pharma over drug prices and supporting women’s healthcare access.
By Amy Baxter • July 24, 2024 -
Chip Somodevilla via Getty Images
FTC to sue three largest PBMs over drug price practices: WSJ
Antitrust regulators are set to file suit against CVS Caremark, Express Scripts and Optum Rx over how they negotiate discounts for drugs, including insulin, per the report.
By Rebecca Pifer • July 10, 2024 -
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FTC criticizes PBM power over prescription drug market
On Tuesday, regulators updated the public on their yearslong probe of PBM's business practices. The report faults PBMs for profiting at the expense of patients and independent pharmacists.
By Rebecca Pifer • July 9, 2024 -
Michael M. Santiago via Getty Images
FTC targets ‘junk patents’ on Ozempic, other top drugs
The move broadens the antitrust regulator’s campaign against allegedly “improper or inaccurate” patent listings by drugmakers to include top-selling medicines for weight loss, diabetes, asthma and COPD.
By Kristin Jensen • May 1, 2024 -
Courtesy of Teva Pharmaceutical
Alvotech deal could heighten biosimilar pressure on Humira
The agreement may help Alvotech capitalize on a recent policy shift by CVS that has driven major market share declines for AbbVie’s blockbuster drug.
By Jonathan Gardner • April 19, 2024 -
Douglas Cliff via Getty Images
Medicare to cover Novo’s obesity drug for some patients
Two weeks after the FDA updated Wegovy’s label, Medicare changed its stance to allow people with a history of heart disease to receive treatment, a shift that could boost access to the fast-selling medicine.
By Ben Fidler • March 22, 2024
