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Cathy Kelly

Senior Writer

Washington, DC

Cathy has covered US regulation and reimbursement policy for the biopharma industry since 2004, starting with the establishment of the Medicare Part D program. Since then, she has written extensively about developments in all major sectors of the US insurance market (Medicare, Medicaid and commercial plans). She has covered key legislation affecting biopharma, including the Medicare Prescription Drug, Improvement, and Modernization Act which created Part D, health care reform under President Obama, and the Inflation Reduction Act which establishes a government price negotiation program in Medicare for the first time and redesigns of the Part D benefit.

She has closely followed the increasing influence of pharmacy benefit managers and their use of formulary negotiations and rebates to control pricing. Cathy also has covered developments in health technology assessments, including the growing influence of the Institute for Clinical and Economic Review, and has monitored industry progress on novel drug contracting that reflects value-based pricing.

She has worked as a health care reporter and editor while raising three daughters. Cathy lives outside DC in Bethesda, MD, with her husband Sean.

Latest From Cathy Kelly

NIH Drug Patent Licensees Would Develop ‘Access Plan’ Under Proposal; Pricing Commitments Optional

Proposed rule would not require price concessions in the interest of balancing enhanced access with protecting the ‘viability and sustainability of a product’ in the market.

Policy Research & Development

CMS Proposal To Further Reduce Medicaid 'Best Prices' Thwarted, For Now

The agency says it will collect additional information from manufacturers on methods for adding up price concessions from the supply chain before moving ahead.

Reimbursement Medicaid

Janssen’s Stelara May Be Medicare Price Negotiation Savings Star

New research is gauging how much savings CMS may see on the prices of the first 10 drugs selected for negotiation.

Reimbursement Medicare

Medicare Negotiation Second Cycle Draft Guidance Offers Options For ‘Effectuating’ Prices

The mechanics of implementing the new prices is the most significant update in the draft. The few revisions to key elements of the negotiation process in the guidance include alternative approaches to forums for collecting patient input on the selected drugs. 

Reimbursement Medicare

Medicare Negotiation Timeline For Prices To Be Implemented In 2027

The schedule for the second round of negotiations is different from the first cycle, in part because the Inflation Reduction Act allowed for extra time initially as the program launched. The first- and second-year timelines also overlap: The second negotiation cycle will begin before the first cycle prices are implemented. 

Medicare Pricing Debate

Wegovy's Medicare Part D Prospects: Four Million Lives And Counting?

Novo Nordisk is expecting a relatively modest uptake in Medicare Part D for the cardiovascular claim, but plans still will worry about stemming demand in obesity.

Reimbursement Medicare
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