Generics Coverage In Medicare Part D Plans Worsens In 2021

Generic prescription drugs are only placed on generic tiers 45% of the time in 2021, a significant decrease from the 64% seen in 2016, according to the latest AAM-sponsored study by Avalere Health. AAM is urging policymakers to initiate Medicare Part D reforms.

brand name v/s generic drugs
The AAM has criticized Medicare for the worsening of generic drug coverage in Medicare Part D • Source: Shutterstock

“It is vital that policymakers reform Medicare to ensure that seniors receive the full value of low-cost generics and the full value of their Part D benefit,” said Dan Leonard, president and CEO of the US Association for Accessible Medicines, as he pointed out that the latest AAM-sponsored study by researcher Avalere Health has highlighted the continued worsening of generic drug coverage in Medicare Part D.

The 2021 Avalere study found that Medicare Part D plans place generic prescription drugs on generic tiers 45% of the...

Read the full article – start your free trial today!

Join thousands of industry professionals who rely on Pink Sheet for daily insights

  • Start your 7-day free trial
  • Explore trusted news, analysis, and insights
  • Access comprehensive global coverage
  • Enjoy instant access – no credit card required

More from Medicare

US Pricing Reform: New Products Offer ‘On Ramp’ To Implementation, Lilly’s Ricks Says

 
• By 

Eli Lilly's CEO argued that pricing reforms aimed at existing drugs would be “hard to sustain or justify,” while other companies suggested a growing interest in direct-to-consumer sales programs.

Pharma Cooperating With Trump On Direct Sale To Consumers, Pfizer CEO Says

 

Pfizer is in active discussions with Trump on MFN pricing and collaborating with peers on direct sales as an approach to lower drug prices, CEO Albert Bourla said.

Cuban: Drugmakers Are More Afraid of PBMs Than Trump

 
• By 

The billionaire investor said during a recent conference that brand drug manufacturers want to work with his Cost Plus Drug Co., but are afraid the PBMs will retaliate.

Most Favored Nation Pricing: Trump Ups Pressure On Voluntary Action, Clarifies Demands

 

The new 60-day deadline for striking a deal with the drug industry underscores the challenges the Administration may be having in developing non-voluntary policies to achieve MFN pricing in the US.

More from Government Payers

Most Favored Nation Pricing: Trump Ups Pressure On Voluntary Action, Clarifies Demands

 

The new 60-day deadline for striking a deal with the drug industry underscores the challenges the Administration may be having in developing non-voluntary policies to achieve MFN pricing in the US.

340B Rebate Model Gets HRSA Endorsement; Pilot Program Limited To Medicare Negotiated Drugs

 
• By 

Pilot is harbinger of greater transparency in the 340B program. But rebates may only be denied by manufacturers for overlap with Medicare negotiated prices, not for issues like diversion that have driven recent lawsuits.

UK Approves Biogen’s Qalsody After England Revises Reimbursement Approach

 

Biogen has U-turned on its original decision not to file Qalsody for marketing approval in the UK for treating certain patients with amyotrophic lateral sclerosis. The move appears to have been triggered by a change in the reimbursement pathway agreed for the product.