CER Daily Newsfeed

Copay Accumulator And Maximizer Programs: Stakes Rise For Patients As Federal Rulemaking Lags

(3/18, Kimberly Westrich, Lisabeth Buelt, Arjun Narain, John Michael O’Brien, Health Affairs Forefront) comments “...This article explains why health care payers are implementing copay accumulator and maximizer programs and how these programs affect patient care and the broader health system. We also examine ongoing legislative and regulatory developments at both state and federal levels, offering insights for health care decision makers as they prepare for impending regulatory guidance.” Full

New ACP Guidelines Recommend Adding Triptan to NSAID or Acetaminophen for Migraines

(3/18, Chelsie Derman, HCPLive) reports “...‘Comparative effectiveness evidence showed that the combination of a triptan (sumatriptan) and an NSAID (naproxen) had the greatest net benefit, with a larger net benefit than monotherapy with a triptan (moderate-certainty evidence), an NSAID (aspirin, celecoxib, diclofenac, ibuprofen, or naproxen; high-certainty evidence), acetaminophen (low-certainty evidence), or a CGRP antagonist-gepant (low-certainty evidence),’ ACP wrote in a statement.” Full

Drug Pricing 'Watchdog' Launches New Initiative With English, Canadian HTA Orgs

(3/17, Gabrielle Wanneh, Inside Health Policy) reports “...   Dan Ollendorf, chief scientific officer for ICER, told Inside Health Policy HEMA hopes to foster independent and critical assessment of new methods for assessing the value of health care interventions. ‘We don't think of HEMA as an extension of our work on drug pricing as much as an opportunity to inform how we approach, analyze, and deliberate on the findings of our work. The fields of health economics and health technology assessment are very dynamic, and HEMA will help us keep abreast of new methods and approaches that might be useful for our work,’ Ollendorf said.” Subscription Required

Lilly, J&J, Pfizer and Sanofi Back Teva Fight Against IRA Drug Negotiation Program

(3/18, Kevin Dunleavy, Fierce Pharma) reports “...In a proposed amicus brief, Eli Lilly, Johnson & Johnson, Pfizer and Sanofi have added that the CMS ‘has exceeded its already vast authority under the IRA by promulgating a guidance that sweeps in medications that Congress did not intend to price control.’ The pharma giants argue that the CMS' practice of starting a time clock for drug price negotiation eligibility the moment a particular small molecule or biologic is approved-and making this same timeline apply to all subsequent approvals for products that use the same active ingredient-deprives companies of their chance to gain ‘competitive returns’ for their drugs. The drugmakers add that this can make it unfeasible to undergo the R&D needed to discover new indications for a previously approved drug.” Full

Trump’s HHS Backs Rejection of Drug Discount Plan Rebate Model

(3/18, Nyah Phengsitthy, Bloomberg Law) reports “...HRSA on Monday doubled down on its argument that implementing a rebate model is inconsistent with the 340B statute and requires approval from the HHS secretary. The agency, however, signaled that it could be open to further consideration of the plan. ‘The statute does not prohibit rebate models in the abstract, but it does prohibit instituting rebate models unilaterally,’ HRSA wrote. ‘The Agency advised Plaintiffs that that the Secretary had not “provided for” the rebates that Plaintiffs proposed “to date.” The Agency never said never.’” Subscription Required