Medicare Part D Redesign: New Discounts Will Not Apply To Drugs With ‘Negotiated’ Prices

06 Sep 2022

However, Part D drugs subject to government price setting under the Inflation Reduction Act will still face pharmacy benefit manager demands for additional rebates in return for preferential formulary status.

Law Concedes Some Protection From Too Many Discount Requirements • Source: Shutterstock

Drugs whose prices have been reduced by the Medicare negotiation process established by the Inflation Reduction Act will not be subject to additional new discounts required in Part D as part of the law’s overhaul of the benefit design.

Under the negotiation process, older single-source drugs and biologics without generic or biosimilar competition will face minimum discounts of 25%,...