Replace the words Medicaid with Medicare and this would be 100% truth!
Because payers would prefer a competitive low WAC price over a rebate. This is what happened with the Biosimilars. Payers don’t want to mess with the rebates.let’s play this out. Both Az and BI need to negotiate with CMS due to IRA requirements. This means there will be an agreed upon MFP for both that will be well below the WAC price for the AG. WAC - Rebate = MFP. The Part D plans get the rebate in this equation and use these proceeds to keep premiums low, attract new clients, etc.
Here’s the million $ question. Why would a Part D plan even consider the AG based on the economics outlined above?
IRA doesn’t start until 2026. We are taking 2025.let’s play this out. Both Az and BI need to negotiate with CMS due to IRA requirements. This means there will be an agreed upon MFP for both that will be well below the WAC price for the AG. WAC - Rebate = MFP. The Part D plans get the rebate in this equation and use these proceeds to keep premiums low, attract new clients, etc.
Here’s the million $ question. Why would a Part D plan even consider the AG based on the economics outlined above?
IRA doesn’t start until 2026. We are taking 2025.
Because payers would prefer a competitive low WAC price over a rebate. This is what happened with the Biosimilars. Payers don’t want to mess with the rebates.
Unless you have payer experience, you only know what you are being told.
We don’t know the AG 2025 WAC price. No one knows!
Who the fuck is this dumbass?Because payers would prefer a competitive low WAC price over a rebate. This is what happened with the Biosimilars. Payers don’t want to mess with the rebates.
Unless you have payer experience, you only know what you are being told.
We don’t know the AG 2025 WAC price. No one knows!
Agree 100%The facts are that AZ will either work to get the AG on every Generic tier formulary for 2025 or continue to pay massive rebates and try to keep pace with Jardiance on the first brand tier formulary. They will choose one not both. Probably the AG route or why else would they have even launched it.
You in a few months looking at your termination papersWho the fuck is this dumbass?
really? That must be why Steglatro is doing so well. And Tudorza. And all the Adalimumab biosimilars.
yeah, you’re right. Payors love the lower WAC products.
any other words of wisdom?[/QUOTE
These are branded drugs with rebates. And the low WAC biosimilars did get the contracts. Why would they want the overhead to process rebates, when they can get a negotiated WAC that is lower than the rebated cost? Yes, this can happen and it is happening more and more.
Stick with samples and lunch.
Sounds great and all true for 2024!!! What happens in 2025? Do you believe AZ doesn’t have a plan? C’mon! Tell us something we don’t know.Don’t you realize the payor gets their cake and they eat it too with the branded product (high WAC and rebate)? The payor gets the rebate dollars which helps them keep premium lower for their clients…thus attracting MORE clients. They also get the lower net cost drug for the clients and they can provide their clients with lower cost guarantees…which attracts more clients.
it’s win/win for the payor.
as far as ‘overhead to process rebates’ you’re barking up the wrong tree. Rebates for payors are in the $billions from manufacturers. They happily process them. They also have complex software that helps keep their processing overhead LOW.
Sounds great and all true for 2024!!! What happens in 2025? Do you believe AZ doesn’t have a plan? C’mon! Tell us something we don’t know.
Yeh, ok!they’re already discounting it 35% off brand WAC. Branded rebates are much higher than that. Why would they also add rebates to the AG on top of the discount while also paying Prasco to manage it? Their only play is to try to get a few AG scripts here and there at the expense of branded FX to help improve the AZ net sales. That’s about it.
Yeh, ok!
they’re already discounting it 35% off brand WAC. Branded rebates are much higher than that. Why would they also add rebates to the AG on top of the discount while also paying Prasco to manage it? Their only play is to try to get a few AG scripts here and there at the expense of branded FX to help improve the AZ net sales. That’s about it.
Lies….the pill still has a big story to tell!!We’ll soon be replaced with the customer engagement specialist just like respiratory was. Customers want samples, copay cards and free food. The brand is mature with no new data to promote.
