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Weekly View


June 27, 2025

(Programming note: Weekly View will be back in your inbox on July 11th. Have a great July 4th weekend!)

Good morning, everyone.

Earlier this month at the 2025 ACCESS Forum, ICER’s President and CEO Sarah K. Emond, MPP, participated in a panel on the future of US drug pricing and patient access, which doubled as a live episode of the “Prescription for Better Access” podcast. The conversation touched on opportunities available to all stakeholders to de-escalate the arms race between higher and higher prices and more and more access restrictions and cost-sharing for patients.


Sarah Emond joined the stage with “Prescription for Better Access” hosts Mark Hansan and Scott Howell, NPC’s John O’Brien, Accenture’s Ray Pressburger, and Bristol Myers Squibb’s Annette Powers. The live episode recording will be out in early July – listen soon on Spotify, YouTube, or Apple Podcasts!

Let's see what happened this week...

ICER in the News

Medicaid cuts target weight-loss drug coverage as costs soar

Pluribus News

Pluribus News' Sophie Quinton spoke with ICER's President and CEO Sarah Emond about access to GLP-1 obesity medications:


"Drug companies are happy with the money they’re making, and health plans are wary of locking in a subscription contract when prices could drop in the future, according to an April white paper from the Institute for Clinical and Economic Review, a Boston-based nonprofit that evaluates health care prices...


'There are so many things about to change that might get us toward more affordable access, that there are, I think, some reasons to be optimistic,' said Sarah Emond, president and CEO at the Institute for Clinical and Economic Review."

Pharmaceutical News

 MUST READS


CDC advisory panel, selected by RFK Jr., recommends thimerosal be dropped from flu vaccines

STAT


Insurers, Physicians, Health Departments Join Former HHSers In Push For ACIP Alternative

Inside Health Policy

ACIP recommended on Thursday that Americans should not receive flu vaccines containing the preservative thimerosal. The votes reflected new members’ concerns about safety issues tied to the preservative, despite numerous studies conducted over the past quarter-century that have found no such issues. 


In practical terms, the move by the Advisory Committee on Immunization Practices will have little, if any, impact on Americans, as only a small percentage of the flu vaccine that comes to the U.S. market contains thimerosal. About 4% of flu doses here come in multi-dose vials, which contain thimerosal to lower the risk that a vial might become contaminated in the process of withdrawing successive doses. But in broader terms, it serves as a win for Kennedy, a longtime vaccine critic who has shown his anti-vaccine base that he will use his position to deliver on the concerns of that community. 


Separately -- the Vaccine Integrity Project (VIP), an organization made up of vaccine experts including former HHS officials, has enlisted broad stakeholder support as it ramps up efforts to create an alternative ecosystem for vaccine recommendations, clinical guidelines and even administration. The group is now working with physicians’ organizations, insurers and state health departments, among others, coming as the insurer lobby AHIP and leading physician lobbies separately signal they will maintain a commitment to vaccine access regardless of ACIP’s actions.

CDC nominee Susan Monarez sidesteps questions about disagreements with RFK in Senate hearing

The Associated Press

Susan Monarez, President Donald Trump’s pick to lead the U.S. Centers for Disease Control and Prevention, told senators Wednesday that she values vaccines, public health interventions and rigorous scientific evidence, but largely sidestepped questions about widespread cuts to the agency, elimination of programs, and any disagreements with Health Secretary Robert F. Kennedy Jr.'s actions to date.

Price Inflation Rebates: Biden Policies Add Teeth To Trump’s Pharma Tariff Threat

Pink Sheet

Price inflation penalties in Medicare and Medicaid would make passing along tariff costs to consumers tougher. The situation may have prompted Eli Lilly to be one of the first companies to announce plans to add manufacturing capabilities in the US as a way to avoid tariffs.


Tariffs and the most-favored nation (MFN) policy are at cross purposes when it comes to US prices, said international tax expert Haroom Cheema, a principal at the Timpani Global consulting firm who also spent more than 11 years at Merck. “They work in opposite directions,” he said. “Tariffs make drugs more expensive in the US, everything else being equal, and the MFN sort of forces them to be cheaper, everything else being equal.”

Medicare drug spending will slow due to IRA price negotiations, CMS economists predict 

Endpoints News

Medicare spending on prescription drugs is expected to grow at a slower rate between 2028 and 2033 as a result of drug pricing provisions in the Inflation Reduction Act, a report by members of CMS’ Office of the Actuary said. In their latest report projecting national healthcare expenditures, the authors said the average annual growth rate of Medicare prescription drug spending is expected to be 4.3% between 2028 and 2033.


While 2024 figures are not yet final, the authors projected that the growth rate for Medicare prescription drug spending last year was 14.7%. The 2025 growth rate for Medicare retail prescription drug spending is expected to “decelerate sharply” to 6%, impacted in part by the elevated spending in 2024 and “IRA provisions that remove the coverage gap discount and introduce a new manufacturer discount program,” according to the authors.

Insurers pledge to smooth out the prior authorization process

Fierce Healthcare

Insurers, large and small, from across the country have announced a series of commitments they're making to reform one of the biggest pain points in the patient journey: prior authorization.

 

Key steps include committing to reducing the number of services that are subject to prior auth, with "demonstrated" progress by Jan. 1, 2026. The plans are also working to roll out common and transparent solutions that promote electronic prior auth submissions, with a framework up and running for plans and providers by Jan. 1, 2027.

OTHER HEADLINES

Key Upcoming Dates
  • 7/15: Multiple Sclerosis -- Final Evidence Report  
  • 7/17: Spinal Muscular Atrophy -- Evidence Report
  • 7/23: Non-Cystic Fibrosis Bronchiectasis -- Draft Evidence Report

Learn more about ICER’s ongoing and recently completed reports:

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