2028 Physicians Prescription 
PM360
SEPTEMBER 21, 2023
As many in the industry now know, the Inflation Reduction Act (IRA) is the most significant reform of Medicare prescription drug coverage since the creation of Part D and has wide-ranging implications for the healthcare industry. After this period, CMS will begin to include physician-administered drugs covered under Part B in the program.
Nixon Gwilt Law
MAY 26, 2023
The following Category III CPT codes are effective as of January 1, 2023, and are set to expire January 1, 2028, unless each code is individually modified to extend its expiration date or provide permanent payment. Remote Therapeutic Monitoring (“RTM”). For information on how Nixon Gwilt helps DTx companies, click here.
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Clarivate
OCTOBER 25, 2023
While more expensive than type 2 diabetes drugs, blood thinners follow a similar pattern of high prescription volumes. The dearth of cancer drugs (only blood cancer drug Imbruvica made this first list) stems from CMS only pursuing negotiations for Part D drugs in 2026 and 2027, then expanding to Part B drugs in 2028. With 27.5%
Clarivate
AUGUST 20, 2024
Moreover, the initial set of negotiated prices represents the first step of a process that eventually will reshape the pricing and reimbursement landscape for prescription drugs under Medicare as CMS gradually replaces private payers as the chief negotiating partner for some of the drug industry’s largest-selling treatments.
World of DTC Marketing
JULY 28, 2022
Nationwide, prescription drug spending last year is estimated to be $328 billion among all payers, including private insurance, Medicare Part D, and patients’ out-of-pocket expenses. Nearly 9 in 10 older adults take prescription medication. Still, the pharma industry is fighting hard to keep it off the table.
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