The study, which examined CMS data for 250,000 Medicare rheumatoid arthritis patients, found beneficiaries often have higher out-of-pocket costs for Part D-covered rheumatoid arthritis drugs compared to arthritis drugs covered in fee-for-service Medicare under Part B.
The average annual out-of-pocket costs for Part B-covered arthritis drugs was $1,380 in 2016, versus $1,990 for Part D-covered arthritis drugs. Avalere said the numbers account for patients with supplementary coverage or low-income subsidies.
The findings come as the federal government is considering moving some biologic therapies that treat rheumatoid arthritis from Part B to Part D. Medicare currently covers these biologics under both. Drugs are covered under Part B if they are physician-administered and Part D if self-administered.
Avalere said the proposed shift could leave many Medicare rheumatoid arthritis patients with higher out-of-pocket costs unless there is more policy change to lower cost sharing under Part D.
Read more about the study here.
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