Part D plans increasingly place generic drugs on higher formulary tiers

The audience was reminded during a House Energy and Commerce Committee hearing on drug pricing reform, “that ways in which health plans and pharmacy benefit managers structure pharmacy benefits can have as negative an impact on beneficiaries’ out-of-pocket costs as high launch prices of new pharmaceuticals and rising list prices of existing drugs.” A recent report from Avalere, a healthcare consulting firm, found “this year Medicare Part D (outpatient) plans place generic prescription drugs on generic tiers with low patient cost-sharing only 45% of the time; nearly a 20% decrease since 2016 when 64% of generic drugs were assigned to the lowest formulary tiers.” Read the attached article for more details here…

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