Pharma Group Order Strikes Down Patient Assistance Rule

PhRMA, the pharmaceutical industry group, recently won a court order striking down the so-called "Patient Assistance Rule," which affects the Best Price pharmaceutical manufacturers must report to CMS for discounts under the Medicaid Drug Rebate Program and the 340B Drug Discount Program. The rule was meant to help curb the practice of "accumulator adjustment programs" used by insurance companies to divert pharmaceutical rebates from the patient to the insurer. The court held that HHS acted beyond its statutory authority by adding requirements to the Best Price formula and that there were “feasibility concerns” with the pharmaceutical company reporting on accumulator adjustment programs since those programs are typically not negotiated by the drugmaker with the insurer thus the drugmaker may not necessarily even know about the programs. Read more.

This article was submitted by Robert L. Yates, Office of Indiana Attorney General. If you would like to submit content or write an article for the Health Care & Life Sciences Section, please email Kara Sikorski at ksikorski@indybar.org.

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