Medicare Part D: Why Change What is Already Working?

Medicare Part D: Why Change What is Already Working?

02.21.14 | By

CMS recently released a proposed rule that would significantly change Part D, the prescription drug program in Medicare, potentially jeopardizing coverage, choice, access and affordability for beneficiaries. In a Feb. 19 Pink Sheet article, PhRMA President and CEO John Castellani discussed the proposed rule, evaluated its possible impact and questioned why there is a need to “change some of the fundamental issues and practices in Part D that have been so successful.”

Part D is a rare government program that costs far less than anticipated and enjoys a high beneficiary satisfaction rate of 90 percent, making it a success story for both beneficiaries and taxpayers. In limiting plan options and interfering with a competitive, market-based program, the proposed rule could potentially lead to higher costs for seniors, as well as restrict competition and innovation, among other concerns.

Additionally, the proposed rule would eliminate critical protections for several classes of medicines, including mental health medicines, which could restrict access and significantly reduce adherence. Such negative consequences could also lead to worse health outcomes and higher overall spending. In the Pink Sheet article, Castellani makes the point that “these [classes of clinical concern] are primarily generic medications. About 83 percent of all the antidepressants that were used in 2011 were generics, so it’s not a question of saving money by driving people toward more generics.”

The proposed rule would undermine an otherwise highly successful program that has helped countless beneficiaries. If you get a chance, the Pink Sheet story is worth a read. And, as always, we welcome your thoughts and comments. 



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