The FTC Warned 24 Large Healthcare Companies That Following CMS Price Rules Is No Shield Against a Deception Case
A hospital can meet every CMS posting rule and still face an FTC deception case over the estimate a patient receives.
Pricing & Reimbursement
CMS Set December 2027 for Insurers’ Prescription Drug Price Files, a Requirement on Hold Since 2021
The drug file reaches manufacturers, and the schema due around May 2027 decides how much net price becomes public.
Australia Set a Price Lilly Refused, So Lilly Built a Channel Around the PBS
Exclusion only works as leverage when the excluded drug has no market. Mounjaro has one, and Lilly built the channel.
France Trades €100 Million in Price Relief for an Annual Review of Older Drugs
France has moved the reimbursement threat from price to presence: a competitor’s launch can now put an incumbent under review.
Latvia Squeezes Access for 123,000 Patients Out of Price Deals as 124 Drugs Wait
Latvia is buying access with manufacturers’ money, inside a reimbursement budget NVD already expects to overrun.
Pharmac Will Fund Any Medicine for Young People With Paediatric-Origin Cancers, About 15 a Year
The numbers are small, but the rule is unusual: New Zealand funds by tumour type and protocol rather than product by product.
Korea Now Reimburses BeOne’s Tevimbra First-Line in Three Cancers, Using PD-L1 Cutoffs to Set the Limits
One reimbursement decision moved a second-line PD-1 into first line across three common cancers, inside biomarker limits.
Medicare Advantage Premiums Fall 16.5% for 2027 While Part D Deductibles Rise 30%
The premium headline is real, but part of the cost has moved from the monthly bill to the point of care.
Indonesia Is Injecting $1.1 Billion Into BPJS Kesehatan as 52 Million Members Lapse on Premiums
The injection keeps hospital claims paid for two months. It does not change the arithmetic that created the gap.
IQWiG and LSE Authors Say EU Joint Clinical Assessments Could Become a Basis for US Price Talks
A debate about who sets the evidence bar, landing the same week Germany’s health ministry proposed lowering it.