About pharma
CVS Health and Walmart Announce New PBM Pharmacy Network Agreement: The two corporate giants have reconciled in a multiyear contract whereby Walmart pharmacies will continue as retail outlets for CVS’s PBM business.
DTC tax deductions back on the chopping block—and this time, the ax might just fall: To give you an idea of how mad Congress is at pharma companies, senators are now reintroducing legislation to make Direct to Consumer advertising a non-deductible expense. This change would include all media types.
Grassley, Klobuchar Introduce Bill to Allow Importation of Canadian Drugs: One solution to lower pharmaceutical costs is purchasing them from cheaper sources abroad. This bipartisan proposal would set conditions for Canadian pharmacies from which Americans could purchase their medications. But there are a few potential problems: First, one can expect Canadian prices for export to increase as demand increases. Second, Canada does not have enough drugs in its entire system to supply US needs. Finally US manufacturers will see a drop in profit (because sales prices are lower outside this country) and export less to Canada. As usual, the concept seems good and it plays well politically, but in practice it is not even a short-run solution.
Stakeholders Offer Feedback on New National Drug Code Format: The five digit National Drug Codes are used as a HIPAA standard to specify medications. However, the FDA says it will run out of numbers in the near future and is considering expanding designations using more digits. This change would involve reassignment of existing drugs as well as adopting a new system for new ones. The expanded digital format also needs to be incorporated in standard reporting systems, like fields in electronic billing.
About Insurance
CMS seeking feedback on ways to address ACA exchange ‘silver loading’: Silver-level plans are the ones for which the federal government, is, by law, required to subsidize premiums for eligible enrollees. Since the Trump administration did away with cost sharing subsidies in 2017, health plans reacted by raising premiums substantially for these subsidized products. Now the government wonders why so many are signing up for these plans and is seeking ways to reduce the numbers. CMS just announced its proposed payment and benefit parameters for 2020. Comments are open until 2/19/19. Among other items, the proposal increases the individual maximum deductible by $200 and for family coverage by $400; its also raises premiums about one percent .