Donut Hole Politics: Patient Assistance Under Part D
This article was originally published in RPM Report
Big pharma wants to help pick up the costs for patients reaching the coverage gap under Medicare's drug benefit. Medicare's watchdogs at the Inspector General's office are skeptical, but the pharma companies are being persistent.
You may also be interested in...
The Obama Administration OKs the use of co-pay cards for brand prescription drugs in the ACA-created insurance exchanges. One prominent Republican intends to investigate the decision. But insurers and PBMs can decide whether or not to accept them—a fact being lost in the debate.
A Kaiser Family Foundation report on the impact of the Medicare Part D donut hole reads like an artifact of history. But it helps quantify the benefit to brand name industry from closing the donut hole in the context of health care reform.
The pharmaceutical industry's 50% donut hole discount worked out exactly as planned in the context of shaping the health care reform debate. The implementation of the new program is a different story. The program created by CMS doesn't look anything like industry would have hoped-but manufacturers have no choice but to play by CMS' rules, and try to make it work for them anyway.