Consumers Could Be On Hook For More Health Costs Under Trump Proposal To Incentivize Generic Drugs
The proposal would allow insurers to only credit the cost of a generic drug -- if one exists -- toward the annual limit for cost-sharing. So if a consumer filled a prescription with a $25 brandname drug, but there was a generic on the market that cost $5, the consumer might get credit for only $5 in out-of-pocket spending. In other news, CMS announced a voluntary program geared toward letting Medicare put more pressure on drugmakers to drive down prices.
The New York Times:
Trump Proposals Could Increase Health Costs For Consumers
Consumers who use expensive brand-name prescription drugs when cheaper alternatives are available could face higher costs under a new policy being proposed by the Trump administration. The proposal, to be published this week in the Federal Register, would apply to health insurance plans sold under the Affordable Care Act. Health plans have annual limits on consumers’ out-of-pocket costs. Under the proposal, insurers would not have to count the full amount of a consumer’s co-payment for a brand-name drug toward the annual limit on cost-sharing. Insurers would have to count only the smaller amount that would be charged for a generic version of the drug. (Pear, 1/21)
Stat:
Medicare Experiment Could Pressure Insurers To Save On Prescription Drugs
The federal government is giving health insurance companies that run Medicare prescription drug plans new tools it hopes will save money for patients. The Centers for Medicare and Medicaid Services announced a voluntary program Friday that will allow Medicare Part D plans, which share the cost of prescription drug insurance with the federal government, to keep more of the savings they negotiate — with the caveat that if they don’t save enough money, they have to pay the government back for it. (Swetlitz, 1/18)
The Star Tribune:
In Pursuit Of Better Health Care For Less Money, Minnesota Hospitals Show Uneven Results
A federal experiment meant to reward hospitals for saving money on Medicare patients ended with two of the three Twin Cities participants dropping out when they instead both lost millions providing that care. The uneven outcome showed that Minnesota has a long way to go to achieve the promise of better health care for less money. Three Twin Cities hospital and clinic systems participated in the federal Next Generation Accountable Care Organization program, known as Next Gen — the latest of many efforts to make the nation’s health care system more accountable. (Olson, 1/18)
And on Capitol Hill —
The Hill:
Grassley To Test GOP On Lowering Drug Prices
Sen. Chuck Grassley (R-Iowa) is giving Republicans an early test on their commitment to lowering drug prices.Legislation sponsored by the Senate Finance Committee chairman and Democratic Sen. Amy Klobuchar (Minn.) would allow people to buy prescription drugs from approved pharmacies in Canada. (Weixel and Hellmann, 1/21)
