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Many VA Enrollees Supplement Their VA Drug Coverage With Part D or Private Insurance

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Nearly 7.9 million veterans were enrolled in the VA health care system in 2011; nearly 1.5 million were also enrolled in Medicare Part D, and 2 million had private drug insurance....

Part D Standard Benefit in 2010

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From 2006 to 2010, prior to implementation of the Affordable Care Act, Part D’s standard coverage included a deductible, an initial benefit, a “coverage gap” and then catastrophic coverage for those with the highest spending on medicines. Beginning in 2011, beneficiaries receive a 50% discount on...

Competition in Part D Promotes Access and Helps Control Costs

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Part D has several mechanisms that promote access and control costs....

The US Prescription Drug Lifecycle Promotes Innovation and Affordability

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Incredible advances by innovator pharmaceutical companies, resulting from pioneering scientific work and large-scale investments, eventually lead to lower cost generics that bring long-term value to consumers....

Non-Drug Medical Spending Declined Significantly After Part D

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Implementation of Part D was associated with a $1,200 decrease in annual non-drug medical spending among enrollees with prior limited or no drug coverage, resulting in an overall savings of $13.4 billion in 2007, the first full year of the Part D program....

Beneficiary Satisfaction With Part D

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Patients are satisfied with their Medicare Part D coverage....

Control Over Pharmacy Benefit in Medicaid Varies

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In many states, Managed Care Organizations (MCOs) cover and set Medicaid pharmacy benefits for some or all beneficiaries, while in others, state government administers benefits directly or determines the drug list that plans must use....

BIO/PhRMA Principles on Responsible Sharing of Truthful and Non-Misleading Information about Medicines with Health Care Professionals and Payers

PhRMA  |  Codes & Guidelines

These Principles are intended to form the basis for defining new and clear regulatory standards governing responsible, truthful and non-misleading communications to inform health care professionals about the safe and effective use of medicines.

In Part B, Beneficiaries Save Through Price Negotiations Between Manufacturers and Providers

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Discounts and rebates negotiated by doctors, hospitals, health systems, and other purchasers are factored into the Medicare Part B payment rate and can lead to lower costs to the Medicare program and beneficiaries. ...

Improving Adherence Could Yield Additional Savings

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Improving adherence to congestive heart failure medicines could yield federal savings of $22.4 billion over 10 years. ...

PhRMA urges CMS to share the savings with seniors

PhRMA  |  Blog Post

Yesterday, PhRMA submitted comments in response to the Centers for Medicare & Medicaid Services (CMS) Request for Information (RFI) on sharing a portion of manufacturer rebates directly with beneficiaries at the point of sale.

PhRMA Statement on Report President Commissions’ Final Report with Opioid Recommendations

PhRMA  |  Press Release

“PhRMA is working with the National Institutes of Health (NIH) and National Institute on Drug Abuse (NIDA) to establish a public-private partnership that will advance the development of non-addictive pain treatment options, as well as new treatments for addiction and overdose.

Federal Spending on Health Care

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Over the next decade, total sales of brand medicines are projected to be 9% of federal spending in Medicare, Medicaid, VA, and TRICARE....

Satisfaction With Part D Is High Among the Most Vulnerable Beneficiaries

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Dual eligibles and beneficiaries with limited incomes exhibit the highest satisfaction rate with their drug coverage....

Increased Use of Medicines Reduces Other Medicaid Costs

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Increased use of medicines among Medicaid patients decreases other Medicaid costs....

Part D Expanded Coverage and Improved Treatment Adherence for Seniors

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As a result of Part D, 90% of Medicare beneficiaries have comprehensive drug coverage, and previously uninsured patients with heart failure are more likely to be adherent to their heart treatment regimens. ...

As Is Common With Commercial Insurance, Medicare Covers Medicines Under Two Benefits

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Medicare’s retail pharmacy benefit is called Part D, and Medicare’s medical benefit is called Part B....

Retail Pharmacies Extend the Reach of the 340B Program, But Do Not Always Help Patients

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When 340B discounts are extended to retail pharmacies, the hospital and pharmacy profit while the patient may see no direct benefit from the 340B discount....

Coverage Gap Phaseout, to Date, Has Improved Medication Adherence for Diabetes

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Research shows that the phaseout of the coverage gap is making medicines more affordable in the gap and has resulted in patients adhering better to prescribed therapies....

Increasing Prescription Drug Cost Sharing for Medicaid Patients May Lead to Higher Total Medicaid Costs

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For patients with very low incomes, even small increases in cost sharing can reduce access to needed care, which can lead to poor outcomes and increased program costs....

Medicaid Rebates Apply to More People Under ACA

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Beginning in 2014, the Medicaid expansion allowed states to expand Medicaid to more adults, further increasing the number of people whose prescriptions are eligible for rebates....

Future Impact: Need for New Treatments for Alzheimer’s Disease

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The development of a new treatment that delays the onset of Alzheimer’s could reduce Medicare and Medicaid spending on patients by $218 billion annually by 2050.  ...

Sources of Outpatient Drug Coverage for Seniors and the Disabled

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Medicare Part D plans covered about 35.7 million beneficiaries in 2013....

Beneficiaries Save Through Plan Competition and Manufacturer Negotiations

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Part D plans negotiate discounts with manufacturers. These savings are used to help reduce premiums, deductibles, and cost sharing....

VA Formulary Excludes Medicines Commonly Prescribed by Community Physicians

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In a 2003 VA pilot program allowing veterans to use non-VA physicians, 42% of prescriptions written by community physicians were not available on the VA formulary....

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