Medicare Part D Reform Sparks Concern Regarding Role of Insurance Companies

Life Sciences & Healthcare Regulatory partner Catherine Brandon was recently quoted in a POLITICO Pro article—which also appeared in POLITICO’s “Prescription Pulse” newsletter—discussing the Biden Administration’s Medicare drug price negotiation program, which aims to lower prescription drug costs under the Medicare. The negotiation program is part of a broader set of Medicare reforms passed under the Inflation Reduction Act last year. That law also made significant changes to the Medicare Part D benefit design that will go into effect in 2025 and which requires, among other things, that insurers pay for a higher percentage of brand-name drugs after Medicare recipients reach their out-of-pocket spending limit.

Because insurers will face higher costs as a result of the Part D reform, Brandon told POLITICO that plans “are going to want to try to manage the financial implications of [the reform] probably by trying to seek additional rebates from manufacturers.” She added that drugs subject to the Biden Administration’s negotiation plan “may not be in the same position to offer rebates than non-selected drugs.”

» Read the full POLITICO Pro article (subscription required).

» Read the POLITICO “Prescription Pulse” article (newsletter; subscription required).