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There’s that word again: transparency

When Mike Ferguson, President & CEO of the Self-Insurance Institute of America (SIIA) polled the audience recently at the organization’s Spring Forum, the number one topic attendees wanted to learn more about was price transparency.

No surprise, that. After all, the goal of health insurance and prescription drug plans is to make treatment available to the greatest number of people at the lowest possible cost.

Pricing transparency is a good idea that is also still a work in progress

Transparency is a big deal for us at VativoRx as well. Just last month we wrote about the topic:

“Both the government and PBM-driven efforts to create greater transparency toward the goal of lowering healthcare costs are moving quickly. Those efforts have begun to pay off in recent years – costs are already going down for prescriptions — and we expect that progress to continue through the 2020s.”

For more on pricing transparency and the PBM industry’s point-of-view, read our article, Using transparency to drive prescription costs lower.

Pharma Tariffs and Specialty Drug Cost Management: What Health Plans and TPAs Should Be Watching

On April 2nd, the White House signed a proclamation imposing new tariffs on patented pharmaceutical products under Section 232 of the Trade Expansion Act of 1962, the same national security trade authority underlying longstanding tariffs on steel and aluminum. The headline rate is 100%. But for health plans and TPAs managing specialty drug costs, that number requires context before it becomes useful for strategic rebate management and financial planning.

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When Drug Negotiation Reaches Part B

For years, Medicare drug price negotiation was mostly discussed as a Part D story. That changed in January, when CMS selected 15 drugs for the third cycle of negotiation, including the first drugs payable under Medicare Part B. Negotiations take place in 2026, and any negotiated prices from this cycle take effect in 2028.

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