Spending Challenges for Prescription Drugs: Part B and Part D - - PowerPoint PPT Presentation

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Spending Challenges for Prescription Drugs: Part B and Part D - - PowerPoint PPT Presentation

Spending Challenges for Prescription Drugs: Part B and Part D Reform Stacie B. Dusetzina, PhD Associate Professor of Health Policy Ingram Associate Professor of Cancer Research Prescription Drugs and Spending Trends Recent Proposals for


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Spending Challenges for Prescription Drugs: Part B and Part D Reform

Stacie B. Dusetzina, PhD

Associate Professor of Health Policy Ingram Associate Professor of Cancer Research

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Prescription Drugs and Spending Trends

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Recent Proposals for Part B

  • International Pricing Index
  • Step-Therapy for Medicare Advantage
  • Relocate Drugs from Part B to Part D

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Recent Proposals for Part D

  • Reclassify rebates as kickbacks / pass-through rebates at the point-of-

sale

  • Remove protected class status for drugs (dropped from final rule)
  • Adding an out-of-pocket spending cap on Part D*

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$0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000 Harvoni Full Cost: $94,916 Zepatier Full Cost: $54,841 Out-of-Pocket Spending

If Rebates are Large, Patients Could Benefit

Dusetzina SB, Conti RM, Yu NL, Bach PB. Association of Prescription Drug Price Rebates in Medicare Part D With Patient Out-of-Pocket and Federal Spending. JAMA Intern Med. 2017;177(8):1185–1188.

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  • Reference Pricing
  • Price Setting that Aligns with Value
  • Shift Incentives in Part D for Negotiating
  • Regulation?

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What Might Work?

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Questions?

@DusetzinaS

s.dusetzina@Vanderbilt.edu