Part D Redesign: MedPAC Finalizes Recommendations To Congress But COVID-19 Will Get In The Way
Plan includes new 30% manufacturer discount in the US Medicare Part D catastrophic phase, which manufacturers will oppose as too high. But it also caps beneficiary cost sharing, a long-sought industry goal.
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Association for Accessible Medicines makes a case for lowering prices in Part D through benefit design reforms enabling quicker and better access to first generics.
A decision made more than 15 years ago by CMS to require drug insurance plans to cover all drugs for six specific diseases has proven impervious to change. But will the protected classes remain if Part D is reformed more broadly?
There won’t be a lot of legislative action in Congress in the weeks following passage of the $1.9tn American Rescue Plan. But the coming months are a critical time for the drug industry to try to set the terms for how it is treated in the next major bill later this year, and the stakes could not be higher.