Rodwin Marc A
School of Law, Suffolk University, Boston, United States.
J Law Med Ethics. 2025 Apr 21;53(1):1-11. doi: 10.1017/jme.2025.59.
The Inflation Reduction Act (IRA) creates a new process to cap Medicare Part D branded drug prices. It prohibits Medicare from paying more than a specified discount from average private market prices and requires that CMS negotiate with manufacturers to agree on a maximum fair price that Medicare will pay that is lower than the specified discount. This article analyzes the cause of high drug prices and how negotiations to set the maximum fair price might unfold. It compares Medicare's new pricing process to the way drug prices are set in Medicaid, the Veterans Administration, U.S. private insurers, and European nations. It analyzes how negotiations to set the maximum fair price might unfold in light of negotiation theory and the practices to negotiate prices employed in Europe. It draws inferences from the initial published data on the first round of negotiated prices.
《降低通胀法案》(IRA)创建了一个限制医疗保险D部分品牌药价格的新流程。它禁止医疗保险支付超过平均私人市场价格特定折扣的费用,并要求医疗保险和医疗补助服务中心(CMS)与制造商协商,商定医疗保险将支付的低于特定折扣的最高公平价格。本文分析了药品价格高昂的原因以及设定最高公平价格的谈判可能如何展开。它将医疗保险的新定价流程与医疗补助计划、退伍军人管理局、美国私人保险公司以及欧洲国家设定药品价格的方式进行了比较。它根据谈判理论以及欧洲采用的药品价格谈判做法,分析了设定最高公平价格的谈判可能如何展开。它从首轮谈判价格的初步公布数据中得出推论。