The Trump administration made several moves Monday aimed at lowering drug costs under Medicare for seniors.
The Centers for Medicare and Medicaid Services announced final policies for Medicare health and drug plans for 2019, part of a larger effort to lower Medicare drug costs.
One of the policies would lower the maximum amount beneficiaries pay for “biosimilars,” which are similar to expensive biologic drugs.
“This policy alone is expected to generate savings for the Medicare program of $10 million in 2019,” an administration official said on a call Monday with reporters.
Other policies include boosting competition among pharmacies to increase the number of pharmacy options that enrollees have, according to a CMS statement.
Another policy seeks to eliminate procedural hurdles that prevent an insurance plan’s list of approved prescription drugs, called a drug formulary, from adding a new generic.
“There are procedural requirements that create an extra time period where these formularies can’t be updated quite as quickly,” another administration official said. “We’re making changes to make that updating happen more quickly.”
The goal is to get the cheaper drugs onto plan formularies faster, meaning patients can start to benefit sooner.
The changes aim to get a handle on soaring drug spending under Medicare because of high prices. A 2017 Medicare Trustees report found that growth in Medicare spending on prescription drugs exceeds growth in other Medicare spending areas and overall U.S. spending.
CMS also announced several policies aimed at combating the opioid epidemic. The agency said it finalized a new authority that permits sponsors in Medicare Part D, the program’s prescription drug plan, to require beneficiaries who are at risk of addiction to use only selected prescribers or pharmacies for opioid prescriptions.
