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HHS has released its final guidance for the second cycle of Medicare drug price negotiations, which will include up to 15 new drugs, in today's bite-sized hospital and health industry news from California, Maryland, and Virginia.
- California: Gilead Sciences last week announced a plan to allow six generic pharmaceutical companies in Asia and North Africa to make and sell its HIV drug lenacapavir at a lower price. Lenacapavir is a twice-yearly injection that reduced HIV infections by 96% in clinical trial participants. Under the deal, the pharmaceutical companies will be allowed to sell the drugs in 120 countries, including those in sub-Saharan Africa, which have the highest HIV rates. However, the deal leaves out many middle- and high-income countries, including Brazil, Colombia, Mexico, China, and Russia, who account for roughly 20% of new HIV infections. "It's good for those countries who are included in the license, but we will see more and more inequality of access as new technologies are available for the richest and for the poorest — those who are going to struggle are those in-between," said Othoman Mellouk, an expert in access to medicines with the health equity advocacy group ITPC Global. (Nolen, New York Times, 10/2)
- Maryland: HHS last week released the final guidance for the second cycle of Medicare drug price negotiations. In August, the Biden administration announced the negotiated prices for the 10 drugs that were part of the first cycle of negotiations. These prices will go into effect in 2026. By February 2025, CMS will announce up to 15 new drugs as part of the second cycle of price negotiations. Based on feedback from the first cycle of negotiation, the second cycle will include several additional patient-focused engagement events, including up to 15 patient-focused roundtables and one town hall meeting. CMS will also offer manufacturers earlier meetings to discuss pricing offers for their drugs. "We are continuing to implement the prescription drug law thoughtfully, prioritizing engagement with all interested parties, and ensuring the process is as transparent and inclusive as possible," said Meena Seshamani, CMS Deputy Administrator and director of the Center for Medicare. "As we approach the second cycle of negotiations, we continue to focus on ensuring people with Medicare prescription drug coverage have access to the innovative cures and therapies they need at prices they can afford." (Twenter, Becker's Hospital Review, 10/3; CMS press release, 10/3; Morse, Healthcare Finance, 10/3; Pagliarulo, Healthcare Dive, 10/3)
- Virginia: Sentara Health recently announced plans to lay off 200 employees, primarily in its insurance division, following a decline in Medicaid memberships. These layoffs affect less than 1% of the system's 34,000 employees, and 40% were in leadership roles. According to the health system, its Medicaid membership declined by 16%, or over 115,000 members, after Medicaid redeterminations. "These workforce adjustments align our staffing levels with our health plan membership," said a company spokesperson. Currently, Sentara said it is working to find other internal roles for employees affected by the layoffs. (DeSilva, Modern Healthcare, 9/30)
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