Keeping the Government at Bay: Protecting Part D from the Protected Classes and Specialty Drug Pricing

A tenuous collaboration between drug manufacturers and health insurance plans holds together Part D, the private Medicare drug benefit. That collaboration is coming under pressure on several fronts: specialty drug pricing and restrictions on health plan formulary tools for six specfic drug classes are the most threatening. Karen Ignagni, the head of the health industry trade group, says industry must resolve the problems or leave a hole for more government control.

By Cole Werble

Two fissures are threatening to break apart the business coalition that makes the private Medicare drug program viable.

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