PhRMA Urges Caution In Implementing Part D “Trial-Size” Prescriptions
The Pharmaceutical Research and Manufacturers of America, as well as pharmacy and PBM groups, recommend that CMS test its proposed policy to institute trial-size prescriptions before implementing it on a widespread basis to Medicare Part D.
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CMS mandates that Part D plans offer prescriptions filled for less than a 30-day period at a daily cost-sharing rate, with a few stated exceptions, but delays implementation until the 2014 plan year.
The biopharmaceutical industry is fighting a CMS proposal that would impact the size of manufacturer discounts on drugs provided in the Medicare Part D coverage gap in an emerging type of Part D coverage for retirees – employer-sponsored group waiver plans, known as EGWPs.
CMS Takes Second Shot At Mandating “Trial Size” Prescriptions For Part D; Estimates Savings At $2.5 Billion By 2018
CMS once again has proposed mandating that Medicare Part D prescription drug plan sponsors offer a “trial size” of first-fill prescriptions for medications treating chronic conditions and, in a step further than the previous effort, mandated that the cost-sharing be prorated based on the daily cost of the drug.