Administration To ‘Unleash’ Medicare Advantage Plans’ Bargaining Power On Some Drug Prices
As a negotiation tool, Medicare Advantage plans will now be able to require patients getting drugs in a doctor's office or the hospital to try lower-cost medicines before moving up to more expensive ones in a process called step therapy. Insurers already had this option in Part D drug plans -- which cover prescriptions such as those purchased by beneficiaries at pharmacies. But the option is now being expanded.
Reuters:
U.S. To Boost Drug Price Negotiation In Medicare Advantage Health Plans
The Trump administration said on Tuesday it would give Medicare Advantage health plans for the elderly new tools to negotiate for lower prescription drug prices. The Centers for Medicare and Medicaid Services (CMS) said Medicare Advantage plans will be allowed to require that patients first try certain lower-cost drugs before moving to a more expensive alternative if the first treatment is not effective. (Erman and Gershberg, 8/7)
The Hill:
Trump Administration Gives Insurers Power To Lower Medicare Drug Prices
The policy aims to allow Medicare Advantage plans access to the same tools as private insurers to try to lower the costs of treatments delivered in a physician office or hospital under Medicare Part B. The change will impact more than 20 million people enrolled in Medicare Advantage plans. In 2017, Medicare Advantage plans spent $11.9 billion on Medicare Part B drugs, according to the Centers for Medicare and Medicaid Services (CMS). (Weixel, 8/7)
Stat:
Private Medicare Plans Will Be Able To Use A New Tool To Lower Drug Costs
The administration framed the announcement as a step toward lowering drug prices, saying in a press release that it will enable Medicare Advantage plans “to drive down prices for some of the most expensive drugs seniors use.” “President Trump promised better Medicare negotiation and lower drug prices for the American people. Today, we are taking an important step in delivering on that promise,” health secretary Alex Azar said. But the new policy is a far cry from President Trump’s campaign promise to let Medicare negotiate prices — a far more ambitious and controversial proposal that he and his top health officials have since abandoned. (Swetlitz, 8/7)
Reuters:
Trump Says Will Make Announcement Next Week On Reducing Drug Prices
U.S. President Donald Trump said on Tuesday that his administration would make an announcement next week on reducing drug prices, but he did not offer specifics. Speaking at a dinner with business leaders at his New Jersey club, Trump said, "We are announcing something next week which is going to get them down really substantially." Trump has made lowering the cost of prescription drugs an issue for his administration. (Oliphant, 8/7)