Copay Coupons May Skew Medicare Part B Reimbursement, GAO Says
Executive Summary
Manufacturer-generated average sales price reports used by CMS to set Part B drug reimbursement doesn’t reflect net price after coupons.
You may also be interested in...
Diabetes, Blood-Thinners Dominate Copay Support, But Assistance May Not Be Well Targeted To Need
New comprehensive study of drug coupons offered by manufacturers, pharmacies, pharmacy benefit managers and state programs, and who uses the discounts, takes a more holistic look at patient assistance programs than previous work. Researchers raise concerns that the offsets don’t seem well targeted at people with high financial or clinical need.
Part B Demo Comments Overwhelmingly Negative, Uniform In Content
More than 90% of comments submitted on proposed Medicare payment experiment for Part B drugs were negative, and most were submitted by patients and health care providers.
Lecanemab Data On Benefit In Alzheimer’s Might Satisfy FDA – But What About Medicare?
Centers for Medicare and Medicaid Services’ standard for determining whether drugs produce a clinically meaningful improvement in cognition that would allow for broader Medicare coverage is unclear. But Eisai/Biogen’s lecanemab is likely to serve as a first test.