Medicare Part D Protected-Class Policy Is Associated With Lower Drug Rebates.
Medicare Part D does not allow plans to exclude drugs in six protected classes from their formularies, which may limit plans' ability to negotiate rebates and lead to higher spending. We estimated the association between protected-class status, US-level estimated rebates, and formulary coverage duri...
| Publicado en: | Health Affairs Vol. 43; no. 10; pp. 1420 - 1428 |
|---|---|
| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Health Affairs Publishing, LLC
Oct2024
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190601356&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190601356 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02782715 HAF jtl: Health Affairs issn: 02782715 maglogo: N pubinfo: dt: Oct2024 vid: 43 iid: 10 pid: 1453 pub: Health Affairs Publishing, LLC place: Washington, District of Columbia artinfo: ui: 190601356 10.1377/hlthaff.2024.00273 190601356 ppf: 1420 ppct: 8 formats: tig: atl: Medicare Part D Protected-Class Policy Is Associated With Lower Drug Rebates. aug: au: Kakani, Pragya Kyle, Michael Anne Chandra, Amitabh Maini, Luca affil: Cornell University, New York, New York sug: subj: Medicare United States Insurance, Pharmaceutical Services United States Drugs, Prescription Economics Health Care Costs Negotiation Human United States United States Centers for Medicare and Medicaid Services United States Food and Drug Administration Comparative Studies Cross Sectional Studies Marketing Confidence Intervals Descriptive Statistics Funding Source ab: Medicare Part D does not allow plans to exclude drugs in six protected classes from their formularies, which may limit plans' ability to negotiate rebates and lead to higher spending. We estimated the association between protected-class status, US-level estimated rebates, and formulary coverage during the period 2011-19. We found that protected classes indeed had significantly lower exclusion rates in Medicare Part D during this period relative to nonprotected classes, and this difference was larger than the corresponding difference in commercial plans. USlevel average rebates grew 22.5 percentage points less in protected than in nonprotected classes during 2011-19, a period when formulary exclusions increased. Relative to nonprotected classes, US-level average rebates in protected classes were especially low among drugs with high Medicare market share. These results suggest that Medicare Part D protected-class policy may reduce rebates. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|