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Medicare Part D Proposed Rule To Lower Prices Targets PBMs, Benefits Manufacturers

 
• By Cathy Kelly

Proposal reflects a concern that plans and pharmacy benefit managers are inappropriately benefitting from price concessions (in this case from pharmacies) while beneficiaries are not, a theme the pharma industry has been pushing for some time.

A Surprise Gift From CMS? • Source: Alamy

The Centers for Medicare and Medicaid Services is proposing to lower drug prices for beneficiaries in the Medicare Part D program without tapping manufacturer revenues and in fact, could end up boosting them.

Effective beginning in 2023, CMS would require Part D plans and pharmacy benefit managers to pass through pharmacy price concessions...

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