CER Daily Newsfeed

Most Favored Nation Drug Pricing: Anchoring To A Moving Target

(5/6, Pedro Pita Barros, Giovanni Righetti, Luís Sá, Health Affairs Forefront) comments “...A reference country’s price benchmark can also move through a second, more direct channel. If payers or regulators in reference countries accommodate MFN pricing by adjusting their pricing rules—effectively, albeit implicitly, partnering with manufacturers to solve their global pricing problem—prices rise through bargaining itself, rather than through coverage restriction alone. This scenario is already unfolding. In December 2025, the UK government announced what it called a ‘landmark’ pharmaceutical trade deal with the United States and simultaneously confirmed a 25 percent increase in NICE’s cost-effectiveness thresholds (from £20,000–£30,000 to £25,000–£35,000 per quality-adjusted life year).” Full

PhRMA Launches Seven-Figure Ad Aimed at US Drug Discount Program

(5/6, Nyah Phengsitthy, Bloomberg Law) reports “...In the 30-second ad, a group of administrators at a fictional nonprofit hospital manipulate the program to divert 340B benefits to the hospital instead of patients, then use the money for other perks. ‘As scrutiny of the 340B markup program grows, we're launching a campaign to expose how some large hospital systems profit without helping patients,’ Alex Schriver, PhRMA's senior vice president of public affairs, said in an email. ‘340B profits have become an oversight free goldmine for big, tax exempt hospitals and clinics that raise costs for patients, employers and taxpayers.’ ‘Any serious affordability agenda should include hospitals who drive nearly a third of U.S. health care spending,’ Schriver added.” Subscription Required

Patient-Centric Health Care ‘Bundles’ Can Improve Outcomes and Cut Costs

(5/5, Bill Snyder, Vanderbilt Health News) reports “...By eliminating prior authorization, utilization management and other ‘arbitrary hurdles’ common to fee-for-service agreements, and by covering comprehensive clinical and support services, MyHealth Bundles have cut waiting times, improved maternity care and nonsurgical management of osteoarthritis, and saved patients and employers millions of dollars.” Full

Moving Prior Authorization into the 21st Century

(5/5, Dr. Mehmet Oz, CMS) comments “...CMS has engaged extensively with the health tech community, working with vendors to embed electronic prior authorization directly into EHRs, and with health IT developers to ensure that implementation guides reflect real-world workflows. This ecosystem-wide coordination is what separates this effort from previous attempts at prior authorization reform. When data flows seamlessly -- between a provider’s EHR, the payer’s electronic prior authorization interfaces, and a patient’s health record -- the entire system becomes more responsive, more accountable, and more focused on what matters most: getting patients the care they need without unnecessary delays or burdens.” Full

Video: Asembia AXS26: How RWE Fits Into the Product Lifecycle

(5/6, Tommy Bramley, Stephen Appezzato, Pharmaceutical Commerce) “...[Tommy Bramley, SVP of Global Consulting at Cencora] explains that both payers and HCPs are increasingly looking beyond clinical trial data to inform their decisions. For payers, RWE can influence formulary placement, tiering, and utilization management strategies. For HCPs, it offers more practical insight into which therapies are most likely to work for specific patients, particularly outside the controlled conditions of a clinical trial.” View Video

From Insight to Impact: Making Real-World Evidence Actionable in Urology

(5/6, Brooke Ervin, PharmExec) comments “...Having more data does not automatically lead to better decisions. The value of RWE depends on whether it can be translated into insights that clinicians can actually use. Advances in data curation and artificial intelligence are helping move things in the right direction. Natural language processing, for example, is increasingly being used to extract structured variables from physician notes, helping convert previously inaccessible data into formats that can support analysis and decision-making.” Full

Precision Medicine Needs Better Infrastructure — And We Already Have The Models For It

(5/6, June Cha, Ph.D., MPH, Clinical Leader) comments “...As therapies become more targeted, the populations they serve become more specific, and the tolerance for measurement error shrinks. The scientific tools to build better benchmarks exist. The regulatory frameworks to support broader trial participation are in place. Federal investment in healthcare infrastructure is growing. What remains is the work of connecting these pieces deliberately through investment in research-capable community sites and data systems, through investment in the infrastructure that makes trials accessible beyond academic centers, and through a shared commitment to ensuring that the promise of precision medicine is built on evidence drawn from the patients it is meant to serve.” Full