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Medicare Part D Redesign: Pfizer’s Catastrophic Phase Discounts Will Total $1.5bn In 2025

 
• By Cathy Kelly

The new discount obligation will more than offset the increased sales expected to be driven by the redesign's $2,000 cap on beneficiary spending. The forecast is the first public discussion of the Part D redesign's impact on an individual company.

The Part D redesign can boost and undercut manufacturer sales. (Shutterstock)
Key Takeaways
  • Pfizer expects the new 20% discount in the catastrophic phase of the Medicare Part D benefit will lower its 2025 revenue $1.5bn.
  • The hit will be offset to a relatively limited extent by increased sales expected from the $2,000 annual out-of-pocket spending limit for beneficiaries that also will be added to Part D next year.
  • Pfizer’s forecast demonstrates the “push and pull” of the two policies under the Part D redesign and that product mix will determine the net impact on individual companies.

Pfizer became the first firm to publicly discuss the impact of the mandatory 20% price concessions required in the upcoming catastrophic phase of the Medicare...

That will be offset to a relatively limited extent by the $2,000 cap on beneficiary out-of-pocket spending that also will be added to Part D in 2025. The cap, which...

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