EP317: Wait, the Latest Action on Drug Pricing Reform Can Be Found in the Infrastructure Bill? With Josh LaRosa, MPP, Policy Director, Wynne Health Group

In Episode 317, Stacey Richter talks with Josh LaRosa, MPP, policy director at Wynne Health Group, about how drug pricing reform quietly ended up tucked inside the federal infrastructure bill — and the three major ways the government might try to capture Medicare drug savings.

WHAT YOU'LL LEARN

✅ Why drug pricing reform showed up as a funding source in the infrastructure bill

✅ The three major approaches Congress is weighing to capture Medicare drug savings

✅ What "inflation rebates" are, and how they'd apply to both Medicare Part D and Part B drugs

✅ Why HHS negotiating drug prices directly remains such a politically charged option

✅ What might be coming from the Executive Branch, including a possible Most Favored Nation rule reboot

WHY THIS MATTERS

Drug pricing reform is being discussed as a literal funding mechanism for roads and bridges, which tells you something about how seriously Washington is weighing it right now. Between inflation rebates that could hit both Part D and the often-far-more-expensive Part B oncology drugs, and the long-simmering possibility of direct HHS price negotiation, the shape of this legislation could have a real impact on Medicare spending and, by extension, everyone whose costs are influenced by federal drug pricing policy.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

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00:00 Introduction.

02:56 Where are we on drug pricing reform in legislation?

05:06 What things have the greatest potential for consideration on drug pricing reform legislation?

06:07 How is the Part D benefit design and reform shaping up?

07:55 Who is one of the largest offenders of high federal spending?

09:15 Who is going to pay in the reform of the catastrophic pricing phase?

12:04 What are inflation rebates?

15:36 "The interesting part of the inflation rebates … is that it not only … had these inflation rebates as applying to … Medicare Part D drugs but also Medicare Part B … drugs."

16:20 How likely is this reform?

18:43 What's happening on the regulatory and administrative side of drug pricing?

24:23 When will we start to see what the White House intends to do about drug reform pricing?