Latest news and updates about the Medicare and pharmacy industries.

May 10: List Prices Coming to TV Drug Ads, Telehealth Changes to MA Plans Could Save Enrollees Millions, and More

Posted on in Industry Updates by Amplicare Team

Here’s the latest in the world of pharmacy and healthcare:

1. Expect to see some changes to TV drug ads come July. This week, CMS finalized a proposal to include list prices in TV ads for drugs which cost $35 or more for a 30-day regimen or a typical course of treatment. Not everyone is pleased with the new plan — critics have argued that including prices in these direct-to-consumer ads is not likely to lower drug prices and doesn’t adequately represent what consumers actually pay.
Read more from The New York Times.

2. Enrollees in Medicare Advantage plans could save nearly $560 million in 10 years, according to the U.S. Government Accountability Office. The savings would come thanks to pending plan changes expanding access to telehealth and telemedicine coverage. For its part, CMS is expected to save roughly $700,000 due to a more efficient grievance and appeals process, but those savings will be offset by the extra $4.2 million it will pay to the Medicare Trust Fund to cover benefits while appeals are heard.
Read more from mHealth Intelligence.

3. The American Hospital Association (AHA) is not a fan of the Centene-WellCare merger. Last week, the industry group asked the DOJ to stop Centene’s $17.3 billion acquisition of WellCare Health Plans. Both companies are major players in government-sponsored health plans, including Medicaid and the Affordable Care Act, which raises concerns about the potential for reduced competition in related services.
Read more from Modern Healthcare.

4. A new plan to lower drug costs could significantly increase federal spending. A report from the Congressional Budget Office (CBO) estimated that the HHS’ plan to end legal protections for drug rebates will increase federal spending by $177 billion. Part D premiums are also expected to increase as a result of this rule. In the report, CBO recommended the HHS focus on its other efforts, particularly those around transparency, to reduce drug costs.
Read more from Fierce Healthcare.

5. Nearly half of the U.S. population is on a prescription medication. A survey from the National Center for Health Statistics found that about 46% of people used one or more prescription drug in the past 30 days — a slight decrease from 10 years prior. The study also found that the types of drugs used differed by age groups. For instance, asthma medication was most frequently used in the youngest group (ages 0-11) while antidepressants were common among young and middle-aged adults.
Read more from Bloomberg.

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