Total reimbursement for brand-name prescription drugs in Medicare Part D increased 77% between 2011 and 2015, nearly six times faster than inflation, despite a 17% decrease in the number of prescriptions, according to a report released today by the Department of Health and Human Services’ Office of Inspector General. The share of beneficiaries with at least $2,000 in annual out-of-pocket costs for brand-name drugs nearly doubled over the five-year period to 7.3%. “Generally, plan sponsors base their reimbursement amounts on the prices that manufacturers set for their drugs,” OIG said. “Therefore, increasing manufacturer prices for brand-name drugs may result in increasing costs for Medicare and its beneficiaries, especially those beneficiaries who need access to expensive maintenance drugs.”

Related News Articles

Special Bulletin
Member
Special Bulletin on CMS’s Nov. 26 proposed rule aimed at lowering drug prices for beneficiaries enrolled in Medicare Advantage and Part D programs.
Letter
The AHA urges the Health Resources and Services Administration to meet the Jan. 1 effective date it has proposed for its final rule on drug ceiling prices and…
Press Releases
Advisory
Member
On Sept. 20, the Centers for Medicare…
Special Bulletin
Member
The Centers for Medicare…
Special Bulletin
Member
On October 25, the Centers for Medicare…