CER Daily Newsfeed

CMS Moves Forward with Medicare Drug Price Negotiations

(10/3, Denise Myshko, Managed Healthcare Executive) reports “...ICER’s modeling did not use quality-adjusted life year (QALY) as its framework assessment. For this review of Eliquis and Xarelto, ICER instead relied on the equal value life year (evLY), a measure that values all life-extending treatment effects equally for all patients, regardless of preexisting disability or age. The use of evLY was done in keeping with CMS guidance. CMS has said the negotiation process will consider the selected drug’s clinical benefit, the extent to which it fulfills an unmet medical need, and its impact on people who rely on Medicare.” Full

Patients Up Next For Drug Price Input

(10/3, Lauren Gardner, Katherine Ellen Foley and David Lim, Politico) reports “...The next public step in CMS' implementation of the watershed negotiations will focus on gathering patient input on the first drugs chosen - a key factor in how the agency will calculate the drugs' prices. The listening sessions will launch Oct. 30 and run through Nov. 15, just as the Biden administration is ramping up talks with the affected companies, POLITICO's Robert King writes.” Full

Delegation Of Chronic Care Management In The Medicare Shared Savings Program

(10/4, Sean Cavanaugh, William H. Shrank and Farzad Mostashari, Health Affairs Forefront) comments “...To achieve the highest-value care for Medicare beneficiaries, we need better integration between risk-taking primary care providers and more specialized services that provide deeper disease-specific expertise. This is a shared priority for CMS and the ACO community, and is a stated goal of the Innovation Center. We believe that part of the solution lies close at hand and merely requires the enactment of a small regulatory change. This change is consistent with CMS’s strategy of using ACOs as the ‘chassis for care transformation’ and could catalyze the deeper coordination between primary care and specialty care that CMS has been seeking to create.” Full

Brazil Publishes Real-World Evidence Guide

(10/4, Francesca Bruce, Pink Sheet) reports “...The Brazilian medicines regulator has published a guide for companies conducting real-world evidence studies. Already in force, it is open to comments until 2024 and updates may be made.” Subscription Required