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Overview

You cannot turn on the news or read the paper today without hearing about the extraordinary cost of prescription drugs and many pharmaceutical manufacturers raising the list price of their drugs year after year.  On January 31, 2017, President Trump met with representatives from the Pharmaceutical Research and Manufacturers of America (PhRMA) and executives from 6 pharmaceutical manufacturers to discuss just this.   It is a goal of the Trump Administration to lower drug costs in the United States, possibly through “bidding wars” for federal health care program business.  In addition, newly nominated Food and Drug Administration commissioner Scott Gottlieb, M.D.  has also been very vocal as to how the current rebating system for drugs, under commercial insurance plans as well as the Medicaid Drug Rebate Program, contribute to the need for pharmaceutical manufacturers to maintain high list prices for their drug products and raise list prices.  Per Scott Gottlieb, M.D., “the problem is that our current system provides incentives for companies to push list prices higher, only to rebate the money later on the back end. Yet the rebates don’t benefit consumers equally and they don’t necessarily help offset the costs paid by those who need a particular drug. The rebates eventually make their way back to health plans to help offset the collective costs of premiums. But if a patient needs a particular drug, they will increasingly find that they are paying the full, negotiated price at the pharmacy counter. They never see the real ‘net’ price, after the rebate is applied much later. The rebate is paid to the health plan, not the patient buying the drug.” 

Join us as Stephanie Trunk of Arent Fox LLP discusses the current drug pricing environment. Topics will include:   

  • Establishing list prices for drugs in various compendia
  • Drug pricing under various federal health care programs- the Department of Veterans Affairs/Federal Supply Schedule program, Medicare program, Medicaid program, 340B program
  • Reimbursement considerations- Medicare, Medicaid and commercial plans
  • The future of drug pricing, including transparency efforts and price controls

 

 

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