Breast Cancer, HIV Drugs May Face Tougher Part D Climate Under Protected Class Proposal
Medicare proposed rule exposes Part D protected class drugs to threat of formulary exclusion if price increases exceed a certain threshold. Here's how it might play out for cancer and HIV drugs.
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CMS proposed rule would not eliminate any protected classes but would allow plans to impose additional restrictions on drugs in those classes. Proposal also codifies step therapy for Part B drugs.
US Health and Human Service Department questions recent federal court decision striking down the government’s policy of allowing plans to broadly exclude manufacturer copay assistance from counting toward patient deductibles or out-of-pocket maximums.
Infographic: One of the more prominent arguments against the Medicare drug price negotiation program is that by limiting the number of years that products can be marketed before price caps are imposed, the scheme discourages development of additional indications.