A proposal from the US Centers for Medicare and Medicaid Services (CMS) could have negative consequences for a wide range of drugmakers, Bloomberg reported Tuesday.

Under the proposal, insurers will be permitted to use step therapies and remove protection from certain drug classes if price hikes exceed the rate of inflation.

Amgen, Regeneron Pharmaceuticals and Roche have been cited as the companies that would be most affected by the proposal.

Meanwhile, Height analyst Andrea Harris indicated that top HIV manufacturers Gilead Sciences and GlaxoSmithKline, as well as top makers of antidepressants including Allergan, AstraZeneca, Bausch Health, Eli Lilly, Otsuka and Pfizer, could face new challenges and may be dissuaded from price increases.

"Whether this policy will be finalised is an open question; it remains to be seen if CMS can withstand withering political pressure likely to come from patient advocacy groups concerned with the potential loss of access to certain medications," commented Veda analyst Spencer Perlman.

Conversely, Leerink analyst Ana Gupte predicted that the proposal would benefit insurers such as UnitedHealth and Humana, while Ross Muken of Evercore ISI hinted that pharmacy benefit managers could gain "incremental negotiating leverage."