Here are five takeaways.
1. At present, Medicare Part D plan sponsors interact with drug companies to negotiate the price of Medicare drugs.
2. To assess what the system would look like if CMS negotiated directly with drugmakers, Dr. Fonseca highlighted the Veterans Affairs pharmacy benefits program, which already negotiates drug prices and has lower drug costs than many other providers, according to the report.
3. To contain high drug costs, the VA program does not cover the newest, most effective treatments, said Dr. Fonseca. Only three of the 25 most innovative drugs were available in the VA’s drug formulary, according to an August 2016 report by Xcenda consultants.
4. In contrast, 11 Medicare Part D plans covered all 25 innovative drugs, and a majority of Medicare plans covered 21 of the 25 drugs, said Dr. Forseca.
5. Dr. Forseca argues giving Medicare the power to negotiate drug prices would mirror the coverage limitations seen in the VA’s program and keep some of the most effective treatments out of patients’ reach. While he believes Medicare is overdue for adopting new approaches to drug coverage, Dr. Forseca believes the program should give beneficiaries more freedom to choose the coverage and services best-suited for their individual needs.
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