Medicare Part D Redesign Will Sharpen Policy Focus On Protected Classes

Manufacturers worry that the redesign will prompt tighter controls in the protected classes, while some research indicates plans are already using all the tools at their disposal to manage some key classes, such as cancer drugs, suggesting they may need to be able to do more.

eyeglasses
With Costs Growing, Particularly For Cancer Drugs, The Focus On Protected Class Won't Go Away • Source: Shutterstock

Upcoming changes in the Medicare Part D benefit that involve increasing the risk borne by insurers in the catastrophic phase may boost pressure on plans to control costs in the six protected classes and manufacturers are worried about what that might lead to.

Key Takeaways
  • Manufacturers are worried that the incentives to better manage costs imposed on Part D plans by the Inflation Reduction Act might lead to stricter management of the protected classes.

Under the Inflation Reduction Act, Part D plan obligations for drug costs will increase from 15% to 60% in 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 Market Access

More from Pink Sheet

COVID-19 mRNA Vaccine Labels Now Quantify Myocarditis Risk, But ACIP Wants Other Changes

 
• By 

New members of the CDC’s Advisory Committee on Immunization Practices suggested concerns beyond myocarditis, questioning whether test-negative observational studies are giving an incorrect picture of effectiveness.

Medicare’s Combo Products Negotiation Plan Conflicts With US FDA Standards, Firms Argue

 
• By 

The plan could curtail a period of pricing flexibility for newer subcutaneous versions of important oncology drugs.

EU Pharma Overhaul May Reshape Aspects Of Drug Promotion And HCP Partnerships

 

Lawyers explain how changes to rules around drug advertising and promotional activities under the EU pharma reform package could impact companies operating in the bloc, with one legal expert advising companies to “monitor developments closely.”