AMCP Nexus 2023, held recently in Orlando, Florida, hosted a forum for healthcare stakeholders to discuss the looming Medicare price negotiation program and its impact on strategic planning for primary manufacturers. Our Genesis Research Group experts were there to hear how manufacturers are preparing for negotiations.
Adam Weston, Director of US & Global Access and Pricing Strategy at Genesis Research Group, said: “The level of uncertainty that remains at this stage highlights the need for manufacturers to be prepared when entering these negotiations. It also shows that manufacturers of competitor products should double down on short-term scenario planning to manage the spill-over impacts of price negotiation and not just plan for longer-term risks for their products.”
With the mounting responsibilities of primary manufacturers to interpret and respond to Medicare drug negotiation offers and participate in negotiation meetings, here are five top-of-mind questions for the industry:
- CMS will conduct listening sessions with patients and other stakeholder groups in Fall 2023.
How can manufacturers best support these discussions to ensure all voices are heard, and patient choice is valued? - Manufacturers of affected products will receive CMS’s first offer on February 1st, 2024 and will have the opportunity to submit a counteroffer by March 2nd.
How can manufacturers streamline evidence to support value-based pricing underpinning the counteroffer? - Manufacturers will receive their final offer from CMS on July 15th before the maximum fair prices (MFPs) are published on September 1st, and CMS’s justifications for the prices are published in March 2025.
What is the best external communication strategy to articulate value? - Payers are preparing to use the MFP as a “lever” for negotiation for other books of business and in competitive contract negotiation within the classes, creating a further spill-over effect for manufacturers of competitor products.
How can manufacturers prepare for these scenarios starting now? - State policy allows for more experimentation and potential spill-over effects on Medicaid plans.
How should manufacturers plan for continued future uncertainties over various stakeholders?
Manufacturers are clearly preparing for Medicare drug negotiations and strategizing best practices to demonstrate and communicate product value. Which questions remain for your organization?
Genesis Research Group is working with clients to answer these questions and develop both near and long-term strategies to anticipate and prepare for successful price negotiations. Our team brings expertise and deep industry knowledge to support strategy and value communication services to meet manufacturers’ evolving needs. Robust evidence strategies and a knowledge management platform can support the evidence required to demonstrate humanistic and economic value to patients, physicians, and the healthcare system.
To ask Adam and his team about the price negotiations and how we can help you respond to the challenges they raise, contact solutions@genesisrg.com.
