Five things to know:
1. Under the model, individuals enrolled in participating Medicare Part D plans would pay no more than $2 for a month’s supply of each drug included on the list. The model aims to standardize low out-of-pocket costs for certain generics used to treat common conditions such as hypertension or high cholesterol.
2. Through the model, CMS will test whether this approach can improve medication adherence, health outcomes, and patient and prescriber satisfaction, the agency said.
3. CMS published a sample list of more than 250 proposed medications for the model and is seeking public comment through Dec. 9.
4. Part D sponsors’ participation would be voluntary, with the model potentially starting as soon as 2027, CMS said.
5. The model is one of three proposed by HHS in response to an executive order President Biden signed in October 2022, which asked the agency to develop and test new payment and delivery models to lower prescription drug costs. The other two are the Cell and Gene Therapy Access Model and the Accelerating Clinical Evidence Model. Learn more about these models here.
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