Medicare Part D Plans Can Start Negotiating Indication-Based Pricing This Fall

Policy exempts indications covered by protected classes policy, including cancer treatments.

Letter D

The Centers for Medicare and Medicaid Services will allow Medicare Part D plans to negotiate indication-specific pricing for prescription drugs beginning with the 2020 benefit year as a way to lower costs.

Sponsors and manufacturers are expected to begin negotiations in the fall for formulary placement in 2020, so the policy could...

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