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From the CMS document “Medicare Drug Price Negotiation Program: Selected Drugs for Initial Price Applicability Year 2027“: On January 17, 2025, CMS announced the selection of the below list of 15 drugs covered under Medicare Part D for the second cycle of negotiations (initial price applicability year 2027), based on total gross covered prescription drug…

One of the greatest baseball announcers of all time passed away today. Bob Uecker. The voice of the Milwaukee Brewers. Mr. Baseball. He was certainly the ‘soundtrack to summer’ growing up in Wisconsin. For Brewers fans like me, his calls are those of Brewers history and lore. Brewers TV play-by-play announcer Brian Anderson recalls some…

A recent paper by Kacerek and Mattingly (2025) aims to answer why certain drugs are defined as “specialty” drugs and others are not. They first cite an Office of the Inspector General (OIG) report: The OIG found that there was no standard definition in Medicaid and that Medicaid programs used more than 100 different characteristics to…

What options do payers have for setting prices for high-cost drugs? Examples include volume discounts, performance based contracts and coverage with evidence. However, is there a comprehensive taxonomy one can use for defining all these different pricing and payment options? The closest we have come is a new paper by Ardito, Ciani & Drummond (2024).…

“I’d like to see Generalized Cost Effectiveness Analysis become the norm for how we assess value.” – Rep. Jake Auchincloss (D-MA 4th District) See the full interview here. To learn more about GCEA, check out the GCEA User Guide published last year.

Today, the American Cancer Society’s Cancer Action Network released a report titled “Out of Pocket Costs for Follow-Up Tests After Abnormal Screening Mammogram and Their Impact on Breast Cancer Survival.” The empirical analysis was conducted by myself and some colleagues at FTI Consulting (Shanshan Wang, Shurui Zhang, Citseko Staples Miller, and Sophia Mildred Setterberg). An…

At the end of last year, CMS finalized a rate cut for Medicare reimbursement to physicians. The CMS Fact Sheet states: …average payment rates under the PFS [Physician Fee Schedule] will be reduced by 2.93% in CY 2025, compared to the average amount these services were paid for most of CY 2024 This sounds like…

That is what an analysis from PwC finds, at least with respect to stock market returns. Our PwC equal-weight index of 50 pharma companies analyzes the sector’s total shareholder returns performance relative to the S&P 500 Equal Weighted Index. From 2018 through November 2024, the PwC pharma index returned 7.6% to shareholders, compared with more…

Tyler Cowen is an economist from George Washington University and a libertarian. Thus, you would expect his answer to this question would be ‘always’. In a recent Bloomberg article discussing whether to privatize government assets (e.g., USPS), he makes a more nuanced argument. First, for consumer goods, it is nearly always good to privatize. Cowen…

When conducting evidence synthesis, many individuals use the PICO framework. PICO stands for population; intervention; comparator(s); and outcome. This helps to describe the research question that the evidence synthesis aims to answer. However, recently Remiro‐Azócar (2024) proposed PICOSI framework. PICOSI stands for: Population Intervention Comparator(s) Outcomes Summary effect measure; Intercurrent events In fact, Canada’s Drug…