PhRMA Sues CMS to Block Medicare Drug Pricing Model
- Reports
- 2
- Developments
- 1
- Repetition
- 50%
New informationRepeats or wire copies
What happened
The Pharmaceutical Research and Manufacturers of America filed a lawsuit in the US District Court for the District of Columbia challenging the CMS Global Benchmark for Efficient Drug Pricing (GLOBE) model. This model, a 'most favored nation' pricing policy for Medicare Part B, uses international benchmarks from 19 countries to calculate manufacturer rebates. The lawsuit asks the court to declare the rule unlawful and vacate it entirely.
From ajmc.com, medicaldaily.com
Why it matters
The challenge targets the statutory authority of CMS to impose nationwide price setting policies. If the GLOBE model is upheld, it would require drugmakers to pay rebates when their prices exceed those in comparable countries. The outcome could significantly alter the pricing structure for drugs covered under Medicare Part B.
From ajmc.com, medicaldaily.com
Who's involved
Who could feel it
Possible knock-on effectsThese are possibilities Brind reasoned out, not predictions, and not advice. Most are not stated in any report.
- Permanente Medical GroupsSpeculative
Changes to Medicare pricing could affect the revenue and operational costs of Permanente Medical Groups.
- JapanSpeculative
The lawsuit could remove the mandatory use of Japanese benchmark pricing.
Possible ripples
Who this could reach next, traced step by step from the reporting. Possibilities worth considering, not forecasts.- Lawsuit may remove Japan's drug prices from Medicare benchmarkThe lawsuit could remove the mandatory use of Japanese benchmark pricing for Medicare drugs.Possible
- How could the legal challenge to the CMS pricing model affect the Department of Health & Human Services?Legal challenge to CMS pricing model creates regulatory uncertainty for HHSPossible
- CMS pricing challenge could disrupt Humana's Medicare risk modelsHumana may face disruption to risk models if CMS drug pricing is overturnedPossible
- Lawsuit challenges CMS pricing model for Medicare Part BThe GLOBE model challenge could alter Medicare Part B drug pricing and rebates.Possible