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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

Copay Accumulators Get A Reprieve: Commercial Plans’ Use Will Not Be Restricted By CMS – Yet

US Health and Human Service Department questions recent federal court decision striking down the government’s policy of allowing plans to broadly exclude manufacturer copay assistance from counting toward patient deductibles or out-of-pocket maximums.

Reimbursement Policy

Will Medicare Price Negotiation Stop Post-Approval R&D?

Infographic: One of the more prominent arguments against the Medicare drug price negotiation program is that by limiting the number of years that products can be marketed before price caps are imposed, the scheme discourages development of additional indications.

Outlook 2024 Pricing Strategies

Medicare Price Setting And The Value Of Post-Approval R&D Spending

Will scrutiny by the Centers for Medicare and Medicaid Services eventually lead to shifts in investment away from improving older drugs toward developing new products? 

Market Access Policy

Medicare Part D Coverage For Humira Biosimilars Has Inspector General’s Attention

Office of Inspector General analysis could add momentum to reforms of the rebating system.

Reimbursement Biosimilars

Medicare Part D Coverage For Humira Biosimilars Has Inspector General’s Attention

Office of Inspector General analysis could add momentum to reforms of the rebating system.

Reimbursement Biosimilars

‘Essential’ Drug Coverage Including Obesity Treatments Make Sense For ACA Plans, CMS Says

But the Centers for Medicare and Medicaid Services wants to see data first on how promoting coverage of the new obesity drugs would impact uptake, plan costs and beneficiary premiums.

Reimbursement Metabolic Disorders
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