US Medicare Insulin Demo Could Expand To Other Drugs

The US Medicare program’s Part D voluntary demonstration project focused on insulin costs is nearing launch with Trump administration fanfare and numerous insurers participating. But there is anticipation already that the approach might eventually expand to other drugs as well, and potentially other treatment areas.

Focused on insulin and insulin/drug combos, the demonstration project aims to cap copays at $35 for patients in different stages of Part D coverage: paying the deductible, initial coverage, and being in the coverage gap. The project focuses on benefit redesign administered by Part D plans for savings, rather than targeting list prices or proposing direct government negotiation or other types of proposals strongly opposed by biopharma. (Also see "Medicare Plan For Lowering Insulin Costs Takes Aim At Benefit Design Instead Of List Prices" - Pink Sheet, 12 March, 2020.) When the project was unveiled in March, Novo Nordisk AS said that manufacturers and plans must be equal and active participants