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Part D Redesign Pushes 2025 Bid Amounts Up As CMS Demo Aims To ‘Stabilize’ PDPs

 
• By Cathy Kelly

It is not yet clear how much premiums may increase in standalone enhanced Medicare Part D plans for 2025 because the demonstration is designed to blunt the financial pressures imposed by the Inflation Reduction Act’s benefit redesign.

The Medicare Part D Program is Heading Into A Major Transition Period. • Source: Shutterstock

Medicare Part D plan bids for 2025 more than doubled on average from 2024, primarily reflecting a shift in government payments that are part of the Inflation Reduction Act’s benefit redesign, which will be fully in effect next year, the Centers for Medicare and Medicaid Services announced 29 July.

Key Takeaways

  • The 2025 Medicare Part D bid announcement offers an early indication of how the benefit redesign will impact coverage and drug access.

  • The biggest driver of the average bid increase is the shift in Medicare’s reimbursement to plans moving from a back-end reconciliation to a front-end subsidy

The national average monthly bid amount is an enrollment-weighted average of annual Part D plan bids for basic benefits, with weights based on the number of enrollees in each plan

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Medicare Negotiation Does Not Violate Due Process, Appeals Court Rules, Other Suits At Risk

 
• By Cathy Kelly

Decision in AstraZeneca’s lawsuit against the Health and Human Services Department is a precedent-setting victory for the government and a blow to manufacturer efforts to block the price negotiation program.

Most Favored Nation Pricing Policy Floated In Medicaid, Coming Back To Medicare?

 
• By Cathy Kelly

President Trump's ongoing interest in the policy, which would ensure the US government pays no more for prescription drugs than the lowest price available in comparable countries, continues to gain attention.

Brazil’s Drug Pricing Shake Up Calls For More Robust Evidence From Companies

 
• By Francesca Bruce

Brazil’s drug pricing authorities are planning to introduce, among other things, a new drug category for biosimilars to ensure the pricing procedures for such medicines are reflected in the official pricing framework.

Brazil To Upgrade Pricing Framework To Keep Up With Market Developments

 
• By Francesca Bruce

Brazil plans to clarify its medicine pricing framework, for example by outlining the procedures for setting medicine prices and bring it up to date with recent developments in the sector.

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Recent and Upcoming FDA Advisory Committee Meetings

 
• By Sue Sutter

Recent and upcoming US FDA advisory committee meetings and a summary of the topics covered.

UK Health Data Research Service Looks ‘Encouraging’ For Industry, But Implementation Details Will Be Key

 
• By Anabel Costa-Ferreira

Marcus Vass and Vladimir Murovec of international law firm Osborne Clarke tell the Pink Sheet what the government's planned HDRS might mean for industry, and how it compares with the European Health Data Space.

EU Health Data Space May Speed Up R&D Through Access To Multi-Omics & Clinical Record Data

 
• By Eliza Slawther

The European Health Data Space framework will allow companies to accelerate R&D processes and identify new molecular targets faster by facilitating centralized access to certain types of high-quality data, Finland’s Orion Pharma says.