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United States of America (USA) Drug Pricing and Reimbursement Landscape - Thematic Research

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United States of America (USA) Drug Pricing and Reimbursement Landscape - Thematic Research

Summary

The US was already grappling with spiraling healthcare expenditure, lack of affordable care, astronomical drug prices, and a high number of uninsured individuals before the devastating COVID-19 pandemic hit, leaving the healthcare system decimated. Later in the year, the US presidential election added another layer of complexity and division, with the candidates battling over many healthcare issues.

Scope

- This report reviews some of the most important events that occurred in the drug pricing and reimbursement landscape in the US in 2020. This includes initiatives by the Trump Administration, including executive orders related to drug pricing, the Medicare Part D Senior Savings Model for insulin, and the expansion of telehealth services beyond the pandemic.
- It also assesses the impact of the COVID-19 pandemic on health insurance coverage and premium rates, and looks at the key battlegrounds during the US Election.
- As the US now has a new President with different healthcare agendas and priorities, as well as the power to overturn many of the Trump Administrations policies, considerations for the 2021 drug pricing and reimbursement landscape have also been included.

Reasons to Buy

- Get an overview of Trump Administration drug pricing policies, including the Medicare Part D Senior Savings Model for insulin. See the status of executive orders issued by the Administration in 2020, including any ongoing lawsuits.
- Understand how the COVID-19 pandemic impacted insurance coverage, insurance rates, and access to telemedicine in the US in 2020.
- Understand the key healthcare battlegrounds during the US Presidential Election in 2020.
- Get an assessment of the potential impact of the Trump Administration drug pricing policies in 2021 and beyond.
- See how President Biden can shape the US drug pricing and reimbursement landscape in the US, particularly in areas such as the Affordable Care Act.

TABLE OF CONTENTS

Executive Summary
US Drug Pricing Landscape 2020
Trump Administration Drug Pricing Policies
Medicare Part D Senior Savings Model for Insulin
Lowering Drug Prices by Putting America First
Access to Affordable Life-Saving Medications
Lowering Prices for Patients by Eliminating Kickbacks to Middlemen
Increasing Drug Importation to Lower Prices for American Patients
Drug Pricing and Gouging Continued Across the Industry in 2020
Drug Pricing Influencer
COVID-19
Impact of COVID-19 on Insurance Coverage
Loss of Employer-Sponsored Insurance Coverage During the Pandemic
Expansion of the Affordable Care Act to Lower the Number of Uninsured Individuals
Impact of COVID-19 on Insurance Premiums
Increased Access to Telemedicine During the Pandemic
Telemedicine Before the COVID-19 Pandemic
Changes to Telemedicine Reimbursement Policies During the COVID-19 Pandemic
Increased Use of Telemedicine Due to COVID-19
Access to Telemedicine in the US After COVID-19
Impact of the 2020 US Presidential Election
The Affordable Care Act
Drug Pricing Policy
Considerations for 2021
Drug Pricing and Reimbursement Constraints Expected to Impede Industry Growth in 2021
The Trump Administrations Reforms Will Have Minimal Impact on the Drug Pricing Landscape in 2021
Strengthening the ACA Will Be Important in Reducing the High Number of Uninsured Individuals in the US
The Impact of COVID-19 on Insurance Premiums Will Not Be Fully Known Until Later in 2021
The Future of US Telehealth Looks Promising Under the Biden Administration
Appendix
Abbreviations
Related Reports
Bibliography
About the Authors
About GlobalData
Contact Us

List Of Tables

Table 1: International Drug Price Ratios for the Top 15 Medicare Part B Drugs, by 2018 Spend
Table 2: Average Impact of MFN Model on Reimbursements Rates for Oncology Practices
Table 3: Top 10 Oncology Drugs Impacted by the MFN Model
Table 4: Examples of 2021 Premium Rate Changes for Leading Health Insurers
Table 5: New Services Added to the Medicare Telehealth List

List Of Figures

Figure 1: The US Spends Twice As Much on Healthcare As Comparable Countries
Figure 2: Timeline of the Trump Administrations Drug Pricing Proposals 20182020
Figure 3: Beneficiaries Could Save Over 65% On Annual Out-of-Pockets Costs for Insulin
Figure 4: Top US Influencer Trends and Post Related to Drug Pricing in 2020
Figure 5: Number of Uninsured and Uninsured Rate Among the Nonelderly Population in the US (20082020)
Figure 6: Use of Telehealth Was Increasing Before the Pandemic, but Use Was Low Overall
Figure 7: Timeline of Key Regulatory and Policy Changes Related to Telemedicine in the US
Figure 8: Most Important Healthcare Issues for the US Election and Views on Party Nominee Approach
Figure 9: US Presidential Election Campaign Messages for the ACA
Figure 10: US Presidential Election Campaign Messages for Drug Pricing
Figure 11: Drug Pricing and Reimbursement Constraints Expected to Have the Greatest Impact in 2021

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