How protected classes in Medicare Part D influence U.S. drug sales, utilisation, and price

Health Economics

13 February 2020 - When the Medicare Part D prescription drug benefit was implemented in 2006, six drug classes were designated “protected classes.” 

Because responsibility for obtaining favourable drug prices depends on private insurers' abilities to negotiate with pharmaceutical manufacturers using the threat of formulary exclusion, the protected class designation could undermine the insurers' ability to control spending and utilisation of drugs in these six classes.

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Michael Wonder

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Michael Wonder