"I do believe the tone and the rhetoric has changed. Right now, Medicare is required to pay for all drugs in those special classes, with only a minor discount.Įxecutives at rival PBMs have also welcomed the new proposed rules, many expressing relief that the administration has heard what they had to say and reinforced their role in the system.
This week the Trump administration proposed allowing Medicare Part D pharmacy drug plans to be more selective on branded drugs from what are known as the six special therapeutic classes, which include cancer treatments and H-I-V antiviral drugs. Two years ago, Express Scripts very publicly pushed back at drug maker Gilead by excluding its $85,000 Hepatitis C drug Sovaldi in its plans, when the pharmaceutical giant refused to provide a discount on the treatment. Miller has been an outspoken advocate for the role of PBMs in strong-arming drug makers to lower their prices. Pharmacy benefit managers are companies that control which drugs are covered and negotiate discounts on branded drugs with manufacturers.ĭr. Steve Miller, Express Scripts chief medical officer told CNBC at the Forbes Health Care conference in New York. We actually said 'let's look at international benchmarking … let's look at Medicare Part B and make it more competitive.' When you look at what they're actually proposing it's what the PBMs do," Dr.
"These are actually all the solutions we put in our response to the blue print.
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