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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

Keytruda, Opdivo May Be Only Part B Drugs Chosen For Medicare Negotiation In First Applicable Year

In general, more Part D drugs will be eligible than Part B drugs in the early years of the program because Part D drugs have higher levels of spending and so will dominate the list of candidates. A new report sizes up the drugs that would qualify for Medicare Price negotiation in 2026-2028.

Reimbursement Medicare

Medicare Rx Negotiation Horizon: The Key Dates Ahead Of 2026 Rollout Of The Pricing Program

Medicare Policy

Game On: Medicare Will Parry Manufacturer Efforts To Sidestep Price Negotiation, Guidance Says

CMS will need to continue to be ‘savvy’ to strategies brand manufacturers already employ to shape the landscape for generic and biosimilar competition, policy expert says.

Reimbursement Policy

House QALY Bill Overreach Threatens Medicare Price Negotiation Program, Democrats Warn

Concern about disrupting the implementation of the negotiation program could presage a tough road for the legislation in the Democrat-controlled Senate.

Health Technology Assessment Medicare

PBM Transparency Act Advances In Senate And It’s A Far Cry From The Rebate Rule

Bill aims to lower patient costs in part by engaging the US Federal Trade Commission to shed light on pharmacy benefit manager transactions with health plans, manufacturers and pharmacies.

Reimbursement Policy

Medicare Seeks Input On Dispute Resolution, Civil Penalties For Rx Pricing Program

Calculating a ‘fair price’ for new versions of already negotiated moiety is also one of several that CMS is requesting input on in its recently released initial guidance on the negotiation program.

Reimbursement Policy
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