CER Daily Newsfeed

ICER Hands CMS A Drug Price Negotiation Cheat Sheet On Eliquis, Xarelto

(10/2, Jessica Merrill, Pink Sheet) reports “...The comparative effectiveness analyses found Eliquis and Xarelto warrant a premium price over generic warfarin, but the price would likely be well below the current list prices of the two drugs. ICER said it hopes to assist CMS as it mounts the big effort of developing a new drug price negotiation program.” Subscription Required

ICER Weighs in on Medicare Price Negotiations with New Appraisals of BMS' Eliquis, J&J's Xarelto

(10/2, Fraiser Kansteiner, Fierce Pharma) reports “...If CMS ultimately calls upon ICER’s expertise, the watchdog could assume a role somewhat like that of England’s National Institute for Health and Care Excellence, which reviews evidence on new medicines and negotiates prices. That’s a possibility many in the U.S. pharmaceutical industry have long feared.” Full

All Pharma Companies in the First Round of Medicare Price Negotiations Agree to Participate

(10/2, Nicole DeFeudis, Endpoints News) reports “...Johnson & Johnson, Amgen and Novartis have all signed negotiation agreements ahead of the Oct. 1 deadline, they told Endpoints News on Monday. Novo Nordisk also agreed to participate, Endpoints learned on Sunday. Merck, Boehringer Ingelheim, Bristol Myers Squibb and AstraZeneca previously announced their intentions to agree to the negotiations. Companies that do not comply would face a heavy tax or risk losing out on Medicare and Medicaid coverage altogether.” Full

Video: Dr Kristin Oaks: When You Eliminate Waste, You Make a Better Patient Experience

(10/3, Maggie L. Shaw, The American Journal of Managed Care) “Fee-for-service care is not really in line with how primary care physicians think or how primary care should be delivered; the crux of value-based care is wanting patients to have the care they want and need, noted Kristin Oaks, DO, Agilon regional medical director at Central Ohio Primary Care.” View Video

How Vermont’s All-Payer ACO Model Paves the Way for Value-Based Care

(10/3, Victoria Bailey, RevcycleIntelligence) reports “...The model uses an ACO structure to align financial incentives across payers through risk-based payments tied to provider performance. With the goal of rewarding quality over quantity, healthcare stakeholders see the model as a promising path to value-based care. In the following article, RevCycleIntelligence breaks down how the Vermont All-Payer ACO Model was developed, how the model impacted healthcare quality and spending, the strategies behind the model’s success, and the challenges encountered by the sole participating ACO.” Full