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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

Medicare Wastage Rebate Exceptions For Small Volume Products, Cell/Gene Therapy Urged

Packaging for such products reflects ‘unique circumstances’ that should exempt them from the rebates on discarded drugs otherwise required by the policy, stakeholders tell CMS at a ‘town hall’ forum.

Reimbursement Pricing Debate

Pharma Gets 340B Appeals Court Victory But More Decisions Are Pending; Will Congress Step In?

Third Circuit is first of three federal appeals courts to issue a decision in multiple lawsuits over drug companies’ 340B contract pharmacy restrictions, which have led to conflicting lower court rulings on whether such restrictions are unlawful.

Pricing Debate Policy

US Medicare Price Negotiation: Gaming FDA Approval Dates Could Delay Drug Selection

The early February date for publishing the list of products eligible for price negotiations could dictate approval strategies for drugs with potential for big sales in Medicare going forward.

Reimbursement Pricing Strategies

Medicare Part D Redesign Could Expand Rebate-Driven Formulary Exclusions In Program

Increased application of utilization management controls expected as plans face higher costs under the redesign. However, the formulary advantages available to drugs in the protected classes may lead developers to sharpen their focus on those categories.

Reimbursement Policy

Leqembi Label Recommends Alzheimer’s Patient Registry: A Nod To Medicare Evidence Demands?

FDA-approved language recommending ongoing patient monitoring through a registry is unusual but not unprecedented to address potential safety concerns.

Reimbursement Policy

Medicare Coverage For Leqembi: Timeline For Reconsideration Of Restrictions

After getting a formal request for Medicare to reconsider coverage for Eisai’s new drug and other mAbs, CMS must decide by mid February whether to undertake the process. The formal timeline for reconsideration runs six to 12 months; past reviews have taken around nine months.

Reimbursement Medicare
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