Healthcare Economist May 29, 2024
Recently, the Inflation Reduction Act (IRA) is getting a lot of attention, particularly for its provision that allows CMS to start drug price negotiation for selected drugs 9 (small molecules) or 13 (biologics) years after drug launch. However, the Centers for Medicare and Medicaid Innovation (CMMI) has proposed a number of a number of payment models intending to address pharmaceutical cost, spending, and reimbursement. In fact, in 2023 CMS proposed 3 new models to reduce out-of-pocket (OOP) cost for Medicare and Medicaid beneficiaries. These previous initiatives are nicely summarized in a paper by Liu et al. (2024).
Most recently, in response to President Biden’s February 2023 executive order, CMMI proposed 3 new models related to drug prices: (i) Medicare High-Value...
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