Pharma Industry Dealt Rare Defeat As Congress Leaves ‘Doughnut Hole’ Tweak Out Of Spending Bill
Drugmakers had been hoping Republicans would include a measure that rolls back a policy leaving them on the hook for a bigger percentage of prescription costs for seniors who reach the so-called doughnut hole, which is a gap in Medicare coverage. But one pharmaceutical company scored a win.
Stat:
The Donut Hole: Drug Makers Fail In Bid To Change Law On Medicare Costs
Congress has rebuffed drug companies’ appeals to reduce how much they have to pay for some seniors’ prescription costs — a rare defeat for the industry after a frenzied lobbying campaign. Drug makers had pressed Republicans to use a sprawling appropriations deal to roll back a policy that makes them responsible for 70 percent of the prescription costs for seniors who reach the so-called “donut hole” in 2019. The “donut hole” is a gap in Medicare drug coverage in which beneficiaries are on the hook for sky-high prescription costs, up to a certain dollar amount. (Mershon, 3/21)
Stat:
Omeros Scores Major Win In House Spending Package
A tiny eye drug company is about to walk away from Congress with a great big win: an extra two years of charging Medicare higher prices for its cataract surgery drug. Tucked into some of the final pages of the sprawling, 2,232-page spending package congressional leaders unveiled late Wednesday are five pages detailing a complicated policy that represents a major win for Omeros, the Washington state-based company behind the cataract surgery drug Omidria. In fact, the language is painstakingly worded to ensure the policy affects Omeros and its product and almost no other drug companies. (Mershon, 3/21)
Meanwhile, a look at the other industry winners and losers —
Modern Healthcare:
Who In Industry Wins/Loses In Omnibus Bill?
Congressional leaders released the long-awaited $1.3 trillion, two-year spending omnibus after days of wrangling behind closed doors over contentious policies that included an embattled stabilization package for the individual market that would fund cost-sharing reduction payments and a $30 billion reinsurance pool. Here's what did and did not make it into the bill. Total HHS appropriation: $88 billionWinners:Insurers who fought to keep a new policy that phases down their share of the cost of prescription drugs not covered by Medicare while raising it for drugmakers. The National Institutes of Health which received a $3 billion boost in funding, bringing its total budget to more than $37 billion. (Luthi, 3/21)
