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May flashback: NICE paved the way for Ocrevus, recommended Spiranza, CMS brings more transparency

Updated: Jun 7, 2019

May 16, 2019

May flashback: CMS makes efforts to reduced the prices of prescription drugs and to increase transparency

Trump Administration has continued its efforts to reduce the prices of prescription drugs. Improvements made in the Medicare Advantage and Medicare Part D, which provides services to older patients. The change allows the patients to compare the prescription drugs, their prices enabling the patients to demand the optimum value for the money.

Now patients have the right to know prices of the prescription drugs. As per the rule, part D plans have to adopt the tools which provide information to the clinicians regarding the information of the prices and the out-of-pocket cost for drugs during the prescription. This rule makes the pharmaceutical companies more competitive with the prices. Also, this rule makes the hospitals to publish chargemaster prices and other efforts to bring transparency.

As per the rule, electronic prescribing or electronic health records (EHR) systems will be provided with the information regarding the costs. Some plans are already offering this service.

After the implementation of this plan, Part D enrollees will receive an Explanation of Benefits document which should be filled with the information of the increase in prices and lower-cost therapeutic alternatives. Filling the document enables the physicians and patients better understanding of the efficacy and costs, thereby enhancing adherence.

This rule also “gag clauses,” which makes the pharmacist not to provide the information of lower-cost ways.

As per the new law, CMS can negotiate on the discount of Part D’s “protected” therapeutic classes.

May 30, 2019

May flashback: NICE paved the way for Ocrevus, recommended Spiranza

NICE has recommended nusinersen for the treatment of children with spinal muscular atrophy. Biogen markets Spiranza. 

Patients with SMA usually die before the age of 2. Currently, there are no medications available for the treatment; only supportive care was possible to minimize the disabilities, improve quality of life, and address complications. 

The prevalence of SMA in the UK is around 600 to 1200 children. 

Earlier in the month NICE was unable to make the recommendation because of the high cost of the product and uncertainties with the lost term cost. 

On the other hand, NICE has recommended ocrelizumab (Ocrevus, Roche) for treating the patients with primary progressive multiple sclerosis (PPMS) in adults. The approval follows the commercial agreement between the company and NHS, which makes the product available at a lower price. 


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