Posted by Michael Wonder on 29 May 2019
Specialty drug pricing and out-of-pocket spending on orally administered anti-cancer drugs in Medicare Part D, 2010 to 2019
28 May 2018 - For Medicare beneficiaries, Part D provides access to prescribed drugs.
However, access to high-priced specialty medications covered by Part D may be limited by increasing drug prices and Part D benefit designs requiring patients to pay a percentage of the drug’s price with every fill through coinsurance.
To improve affordability of drugs for patients, the Affordable Care Act has gradually reduced the required coinsurance for branded drugs in the coverage gap (ie, doughnut hole) from 100% in 2010 to 25% in 2019. However, price increases over that same period might have offset expected savings for patients needing specialty drugs, including anticancer drugs.
