Posted by Michael Wonder on 14 Aug 2018
Drug pricing policy: HHS introduces step therapy in Medicare advantage
14 August 2018 - Last Tuesday, CMS took its latest action in the area of drug pricing.
CMS gave Medicare Advantage plans the ability to use step therapy, in which a patient may be required by their insurer to try a less expensive drug before moving on to a more expensive drug, for physician-administered Part B drugs.
This is one of the more significant actions the administration has taken on drug pricing to date, but there are also potential concerns about this move, and its rollout sheds light on the administration’s drug pricing strategy more generally.
The introduction of step therapy into Medicare Advantage plans has the potential to lower drug prices in those plans.
