Part D Manufacturer Discounts Set To Grow In 2020 With Catastrophic 'Cliff'
With no legislative remedy in sight, the Medicare Part D out-of-pocket payment threshold will increase by $1,250 in 2020, causing many beneficiaries to linger longer in the coverage gap, where manufacturers provide 70% discounts on branded drugs.
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Government price 'negotiations' unlikely to be enacted in the near term, CEO Ricks tells investors, but reform of the Part D benefit also faces long odds, even though Lilly would support well designed changes.
Price inflation rebates are expected to generate $50bn in savings over 10 years, according to the Congressional Budget Office.
Performance of Johnson & Johnson’s blockbuster cardiovascular drug is one of the first prominent examples of how the 2019 increase in the discount from 50% to 70% is playing out in the market.