Cell & Gene Therapies (CGT) offer potentially curative treatment to patients with chronic and hereditary conditions but carry high price tags. One proposal to overcome such financing challenges is to create a national risk pool.
AMCP Summary of Medicare Part B Most Favored Nation Model
On November 20, HHS released an Interim Final Rule with Comment Period (IFC) establishing a Most Favored Nation (MFN) Model for Medicare Part B drugs. The MFN Model will calculate the payment rate for included drugs based on a price that reflects the lowest per capita GDP-adjusted price among a group of OECD countries, with an additional flat payment based on the average payment for MFN Model drugs in 2019 adjusted quarterly for inflation.
Related
The Academy of Managed Care Pharmacy (AMCP) thanks the Centers for Medicare & Medicaid Services (CMS) for the opportunity to provide comments in response to Medicare Drug Price Negotiation Program: Draft Guidance, Manufacturer Effectuation of the Maximum Fair Price in 2028 (Draft Guidance). CMS issued this draft guidance to describe the processes and requirements for manufacturer effectuation of the maximum fair price (MFP) in 2028 for selected drugs payable under Medicare Part B and/or covered under Medicare Part D.
The Academy of Managed Care Pharmacy (AMCP) thanks the Department of Health and Human Services (HHS) for the opportunity to provide comments in response to the Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making (RFI).
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