16 July 2019 - Medicare Part D enrolees may actually pay more for some generic drugs than they would for their brand-name counterparts because of the Part D benefit, according to findings of a new study appearing in Health Affairs.

Since 2012, beneficiaries who purchase brand-name drugs receive a manufacturer discount that goes toward their out-of-pocket (OOP) costs, which allows them to reach the catastrophic coverage phase with lower OOP spending compared with beneficiaries who purchase generic drugs and receive no such discount. The benefit was implemented by the Affordable Care Act, which attempted to close the Medicare Part D coverage gap.

“As a result of this concern, in early 2018 the Bipartisan Budget Act (BBA) modified the Part D benefit to ensure that beneficiaries would not pay more for biosimilars than for their brand-name counterparts,” wrote the researchers. “While this change corrected the misaligned incentives for biosimilars, it did not extend the protection to generic drugs.”

Read Center for Biosimilars article