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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PhRMA comments to administration on Medicare Part D proposed rule
By Juliet Johnson | January 25, 2019
Today, the Pharmaceutical Research and Manufacturers of America (PhRMA) submitted comments in response to the CMS proposed rule, “Modernizing Part D and Medicare Advantage to Lower Drug Prices and...
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