Pharma and Payers Gear Up for 2023

December 16, 2022

Coming off the heels of an upset in the US mid-term elections, drugmakers and payers are preparing for what is set to be a tumultuous upcoming year. A major upcoming event on the minds of stakeholders is the beginning of Medicare negotiations with pharma to lower drug prices, a key provision of the Inflation Reduction Act. This only applies to a few drugs and with Medicare, but some fear it may portend future, more comprehensive legislation.

According to Girisha Fernando, “And although these changes are not likely to occur immediately, it would make sense for drug makers to address the problems that led to mandated price negotiation, and thus avoid efforts to thwart the process, such as suing the government or reformulating drugs. That won’t sit well with legislators, and drug firms could end up finding themselves with pricing solutions provided – and mandated – by the government. In addition, payers, including Medicare, who participate in negotiations should consider patient outcomes, rather than just the traditional elements that are part of negotiations, including the volume of drugs purchased from each company.”

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(Source: MedCity News, December 15th, 2022)

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