News & Views: 10/13 -10/19

October 20, 2020

The Center of Medicare & Medicaid Innovation Director, Brad Smith, announced that CMS may implement monthly caps on costly drugs in the future.

Smith recently spoke at the Better Medicare Alliance - Medicare Advantage Summit where he briefly mentioned the Part D Senior Savings Model, a model which sets a $35 monthly cap on insulin prices for seniors. In the current open enrollment period, over 1,600 plans have elected to participate in this model, which will begin in January 2021. Smith alluded that if the demo goes well, CMS may expand the model to include other costly drugs. To view his speaking portion of the summit, click here.

The Government Accountability Office (GAO) is expected to decide by early this week if they will review the legality of Trump’s $200 drug discount cards before the election.

Democratic leadership has insisted the cards be reviewed quickly, as they believe the drug cards are an attempt to buy votes and not an attempt to lower drug costs for seniors. The discount cards were announced nearly three weeks ago and with the election less than two weeks away, the cards would need to be mailed soon if they are intended to take effect before November 3rd. To read the full article, click here.

  • To review one of the letters to GAO Comptroller General Dodaro, click here.

A Biden administration is likely to introduce a drug pricing model similar to Germany’s model to lower costs for patients.

Germany and the United States have very similar health care systems, with one significant exception being that the German system negotiates drug prices. Germany has an independent organization that studies drugs during the first year that they are on the market and then negotiates a price based on their effectiveness research of the drug. In a 2019 House Ways and Means report, Germany was sited to have spent $823 on pharmaceuticals per capita in 2018 compared to $1,220 in the US. To review the full article, click here.

  • To review the House Ways and Means report, click here.

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