Six policy solutions to help patients afford their insulin
By Holly Campbell | April 9, 2019
Dramatic improvements in how we treat diabetes have transformed the lives of patients, but too many struggle to afford their insulin and other medicines at the pharmacy counter. Due to...
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PhRMA comments on OIG proposed rule to reform the rebate system
By Holly Campbell | April 8, 2019
Today, PhRMA submitted comments on the Department of Health & Human Services (HHS) Office of Inspector General (OIG) proposed rule, “Removal of Safe Harbor Protection for Rebates Involving...
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If the six protected classes policy is weakened, the Medicare Part D exception and appeals process will not provide sufficient protections for patients facing access challenges
By Tom Wilbur | March 29, 2019
One of the most important and successful parts of Medicare Part D is the six protected classes policy which covers patients whose conditions – such as HIV, cancer, and epilepsy, among others – are...
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Rebate rule would help ensure seniors with diabetes don’t pay more for their medicine than their insurer
By Holly Campbell | March 25, 2019
Misaligned incentives in Medicare Part D are increasing costs for seniors with diabetes. While insurers negotiate larger and larger rebates with biopharmaceutical companies each year, seniors...
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Bipartisan lawmakers urge Administration to rethink proposed changes to six protected classes policy
By Tom Wilbur | March 22, 2019
At the end of 2018, the Centers for Medicare & Medicaid Services (CMS) introduced a dangerous proposed rule that would weaken the Medicare Part D six protected classes policy. The six protected...
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OptumRX: Sharing rebates with patients is “worth it”
By Holly Campbell | March 18, 2019
PhRMA has long advocated for sharing the $166 billion in rebates and discounts given by biopharmaceutical companies to the government, insurers, and pharmacy benefit managers (PBMs) with patients...
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Changes to the six protected class policy are the wrong prescription for Medicare and HIV patients
By Tom Wilbur | March 15, 2019
For over 10 years, one of the cornerstones of the Medicare Part D program has been to ensure the sickest and most vulnerable patients have access to the clinically critical medicines they rely on....
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New “Prescription for Medicare” campaign focuses on impacts of wrong and right solutions for Medicare
By Juliet Johnson | March 6, 2019
Today, we are launching the “Prescription for Medicare” campaign which focuses on ensuring that changes made to Medicare are the right prescription for seniors. There’s a lot of talk in Washington...
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Repealing Part D noninterference clause threatens access and choice for America’s seniors
By Tom Wilbur | March 5, 2019
For more than a decade, Medicare Part D has successfully provided seniors access to comprehensive prescription drug coverage with low and stable premiums, while negotiation within its unique...
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New study shows why insurers should share rebates with Medicare Part D beneficiaries on a mandatory basis
By Holly Campbell | February 14, 2019
New research by three Milliman actuaries explores the dynamics underlying the relationship between Medicare Part D plan premiums and sharing rebates directly with beneficiaries at the pharmacy...
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