What Are the Key Components of the American Patients First Blueprint?

At the 2018 National Association of Specialty Pharmacy (NASP) Annual Meeting and Educational Conference, Ron Lanton III, Esq., executive director and senior counsel for Frier Levitt Government Affairs, discussed the key components of the American Patients First drug pricing blueprint and how the plan could affect specialty pharmacy.


"There are a couple of components in there that we’re watching. There’s really 4 pillars within the blueprint. First is trying to drive down patient out-of-pocket costs. Second is trying to drive down drug pricing costs as well, and that’s got a lot of people’s attention for a number of reasons. The third is looking at changing innovation because I believe Secretary Azar talked a lot about how other countries around the world are taking advantage of America’s innovation, so they want to address that. And then the fourth is negotiation.
The key components that really struck me when I was looking at it were the negotiation portions of it because they talked a lot about how they would try to merge Medicare Part B with Part D, so I’m not really sure how they’re going to do that. A lot of the things they mentioned in the blueprint were big picture ideas, they were talking about what can the president do immediately to lower drug prices and what can the HHS do through rulemaking or some other mechanism to take action to lower prices. But the negotiation thing is a little bit concerning to me, at least for specialty pharmacies because for pharmacists that are really used to getting the Medicare Part B reimbursement, what does that mean? Giving most of that power back to Part D where pharmacy benefit managers do a lot of the negotiating, that’s got me a little concerned so I’m trying to figure out how that’s going to impact specialty, home infusion, those kind of people.
The other thing they mention a lot about is value-based care. So I think that with a world without drug rebates, we’re trying to figure out how value-based care can step in and fill that void. They talk a lot about biological products, so I know that’s something that’s coming on the market. I think there are 11 biologically approved products through the FDA. And they also talked about how the FDA was trying to get, not only that, but also greater utilization of generics. So I think those few points within the Patients First Act are something we should keep a watch on."

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