The IRA and health equity, gene therapies, state PDABs, #AMCP2024, and more

April 16, 2024

Welcome to NPC This Week! We hope you'll join us each week for a look-ahead at the policy, research, and industry conversations that matter to the future of biopharmaceutical innovation. The DMs are open if you have suggestions — and please share with your network. - Michael Pratt , NPC Chief Communications Officer

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NPC Highlights

Health Equity: Managed Healthcare Executive spotlighted a report on the critical issues of health equity and patient engagement within the Medicare Drug Price Negotiation Program. The report was a collaboration between NPC, the Innovation and Value Initiative (IVI) , Alliance for Aging Research , and Leavitt Partners, LLC .?

Value Viewpoint: In her latest “Value Viewpoint ,” Kimberly Westrich analyzes several new reports related to ICER, including a Cencora brief assessing the potential impact if ICER value assessment results were applied to Medicare Part B coverage decisions. Subscribe to her weekly newsletter for a fly-around of important value-focused articles, reports, and events!?

#AMCP2024: Through April 18, the NPC research team is in New Orleans for the 2024 AMCP Annual Meeting ! Chief Science Officer Jonathan D. Campbell , Chief Strategy Officer Kimberly Westrich , Associate Director of Research Tyler D. Wagner , and Research Associate James Motyka are onsite sharing NPC's latest research on value assessment, formulary decision-making, and copay accumulators and maximizers.?

• Reception and Breakfast: We're honored to host a Student and New Practitioner Networking Reception and a Chapter Leadership Academy Breakfast to offer students and early career professionals an opportunity to network with established experts in the field. See NPC’s full schedule here .?
• Meeting Preview: Ahead of the event, Ms. Westrich shared what she's most looking forward to at #AMCP2024 in an article for the American Journal of Managed Care . ?

Industry News

IRA Impacts: In Health Affairs Forefront , Duke-Margolis Center for Health Policy’s Nitzan Arad, Grace Hoover, and Mark B. McClellan joined SSR Health’s Richard Evans in exploring the policy implications of the first 10 drugs selected for the Medicare Drug Price Negotiation Program and making recommendations to CMS to encourage predictability and minimize the risk of unintended consequences.?

• More: In BioSpace , John Stanford, executive director of Incubate, shares concern about the development of future small molecule drugs due to IRA price controls.?

Gene Therapies: Medicare administrators said they will increase the new technology add-on payment to hospitals for two newly approved gene therapies that treat sickle cell disease.?

Medicaid: According to a new study published in JAMA Health Forum, easing three types of coverage restrictions on hepatitis C drugs would likely improve uptake in state Medicaid plans. ?

Delayed Access: New data published by the Canadian Health Policy Institute shows that publicly-insured Canadians waited an average of four years to access new drugs — roughly 2.5 years longer than Americans insured under Medicare and 2.2 years longer than publicly-insured Europeans.?

ICYMI

State PDABs: ?

• Virginia: Virginia Gov. Glenn Youngkin vetoed a bill that would have created a new Prescription Drug Affordability Board (PDAB) empowered to cap the cost of prescription drugs. Youngkin said the board’s approach “could limit access to treatments and hinder medical innovation, especially for life-threatening or rare diseases.”?
• Colorado: Some caregivers and patients with rare illnesses are raising concerns that potential price caps determined by the state’s PDAB could discourage access to vital medications.?

March-in Rights: Drug price control advocates are pushing the Biden administration to break patents and license generic versions of a prostate cancer drug — despite the repeated denials of similar requests.?

Value-Based Care: Three organizations — America’s Health Insurance Plans (AHIP), the American Medical Association (AMA), and the National Association of Accountable Care Organizations (NAACOS) — teamed up to share a playbook on best practices to boost value-based care payment arrangements.?

340B: Emboldened by recent court rulings, the Maryland and Kansas legislatures cleared bills that would prohibit conditions applied by drug manufacturers in the 340B program intended to ensure patients?—?rather than contract pharmacies?—?reap savings on prescription drugs.?

IRA Impacts: Another article in Health Affairs Forefront explores whether the growing availability of real-world data and advancements in technology could power robust outcomes tracking and ultimately support new payment models.?

PBMs: Pharmacy benefit managers (PBMs) are resorting to scare tactics in an attempt to dissuade policymakers from moving forward with needed reforms, writes Steven Anderson, president and CEO of the National Association of Chain Drug Stores.?

• More: “With ever-increasing power gained through consolidation and integration, PBMs essentially impose taxes on Americans by inflating prescription drug prices, and by imposing fees and terms that force pharmacies to sell medications below-cost, and ultimately to close their door,” says Anderson.?

Mark Your Calendar

April 15-18: NPC's research and leadership teams will be attending and presenting at #AMCP2024 in New Orleans, LA. View our research presence here.

April 18: NPC President and CEO John O’Brien will join Nkarta Therapeutics CEO Paul Hastings, Christie 55 Solutions Partner and Executive Director Richard Bagger, and other distinguished speakers at the Rutgers Business School’s Annual Healthcare Symposium. This year’s theme is “Innovation and Patient Access After the Inflation Reduction Act."

April 30: Dr. O'Brien will be participating in a panel discussion focused on the future of value-based contracting as part of Asembia's Specialty Pharmacy Summit, April 28–May 2, 2024, in Las Vegas.

May 5-8: NPC will be participating in the ISPOR 2024 conference in Atlanta.

May 8-9 : Join the National Health Council for its 2024 Science of Patient Engagement Symposium! Taking place at the historic National Press Club in Washington, D.C., the theme this year is “Patient Experiences Through Their Lifespan.”

May 16: At the Financial Times U.S. Pharma and Biotech Summit in New York City, Dr.?O’Brien will join a panel on “Solving the U.S. Drug Pricing Problem.” Dr. O'Brien will be joined by Sarah Emond, President and CEO, the Institute for Clinical and Economic Review, and Greg Baker, CEO, AffirmedRx. Save 20% off your in-person or digital registration with the code FTNPC. Register here!