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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

Lilly’s ‘High Quality’ Donanemab Data Supports Unrestricted Medicare Coverage, Firm Says

As FDA decision on Alzheimer’s product approaches, new paper outlines Lilly’s arguments for unfettered Medicare coverage for donanemab once it is approved.

Reimbursement Policy

340B Audit ‘Protections’ Needed Prior To Dispute Resolution Final Rule, Lilly Tells OMB

Lilly wants White House Office of Management and Budget to delay final rule until there are regulatory controls against duplicate and diverted discounts. OMB has also held three meetings over past few months with organizations representing 340B providers.

Reimbursement Pricing Strategies

PhRMA’s Lawsuit Against Medicare Trips Over ‘Administrative Remedy’ Standard; Will Others?

West Texas District Court dismisses lawsuit against Medicare price negotiation program on jurisdictional grounds without considering the merits of the case. PhRMA is weighing next steps.

Reimbursement Policy

Letting Paxlovid Go: HHS Seeking To Buffer Drug’s Sticker Shock In ‘Cold’ Commercial World

HHS Secretary Becerra challenges the commercial price Pfizer chose for its COVID-19 therapeutic as the government transitions from being the primary US customer for the drug.

Reimbursement Policy

PBM Legislation And The Meaning Of ‘Meaningful’ Reform

CEOs of J&J, Bristol Myers Squibb and Merck comment on the status of legislative policies reforming pharmacy benefit manager practices and the likelihood they will lower out-of-pocket costs for patients at a recent Senate hearing.

Reimbursement Pricing Debate

Senate CEO Hearing On Drug Prices Could (Almost) Have Taken Place Five Years Ago

Discussion around the landmark developments in pricing reform established by the Inflation Reduction Act of 2022 were largely absent from the hearing involving Johnson & Johnson’s Joaquin Duato, Merck’s Robert Davis and Bristol Myers Squibb’s Chris Boerner.

Reimbursement Pricing Debate
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