Medicaid Proposal Basing Best Price On ‘Stacked’ Discounts At Odds With Law, US Legislators Say

 
• By Cathy Kelly
  
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Republicans in Congress also amplify biopharma concerns with provisions in a Medicaid proposed rule that would require cell and gene therapy developers to justify pricing through an agency-conducted audit and that could subject drugs that are bundled with services to Medicaid rebate requirements.

Medicaid Cost Saving Proposals Under Fire • Source: Shutterstock

The Centers for Medicare and Medicaid Services proposal to base calculations of Medicaid best price on an aggregate of manufacturer discounts and rebates received by a range of entities in the supply chain could significantly lower the price benchmark. It is also counter to the law and will undercut patient access to therapies, Republican members of the Senate Finance and House Energy & Commerce committees told CMS in recent letters.

The letters respond to a proposed rule published by CMS in May covering the misclassification of drugs, program administration...

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