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Pfizer Hints at Curbing Assistance In Part D Next Year In Notice Asking Patients To Enroll In M3P

 
• By Lauren Flynn Kelly

New terms for Medicare Part D beneficiaries interested in enrolling in Pfizer’s oncology patient assistance program in 2025 involve attestations that assistance is still needed after enrolling in the new M3P program and that they have not yet met the $2,000 out-of-pocket spending cap.

PAPs In Part D Unusual But Richer Benefits In 2025 Offers Manufacturers Relief • Source: Shutterstock

Medicare Advantage insurers and their distribution partners are bracing for a busy Annual Election Period, thanks in part to multiple Part D benefit changes resulting from the Inflation Reduction Act. Adding to their concerns about likely market disruption and enrollee confusion is a new drug manufacturer letter that raises operational and financial questions about the interplay between Patient Assistance Programs (PAPs) and the Medicare Payment Prescription Plan (M3P).

Key Takeaways

  • Pfizer notified Medicare Part D enrollees participating in its oncology drug patient assistance program that they to re-enroll in 2025, they must attest they have enrolled in the new M3P cost share ‘smoothing’ program and have not yet met the $2,000 out-of-pocket cap. 

In a letter dated 19 August, Pfizer informed Part D beneficiaries using its Pfizer Oncology Together program that...

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