Pricing Tactics Slow Uptake of Generic Drugs by Medicare Plans - (Bloomberg via NewsPoints Desk)

  • A study from the Access for Affordable Medicines (AAM) lobbying group has found that Medicare prescription plans are much slower to cover new generic drugs than private plans, reported Bloomberg.

  • The research shows that 22% of generic drugs are covered by Medicare plans in their first year on the market, compared with 46% of new generic drugs covered by commercial drug plans.

  • Even after three years on the market, only around half of new generics will have been added to the lists of medications covered by Medicare prescription plans, on average, the report said.

  • A separate AAM study in September said seniors could be paying as much as $4 billion a year out of pocket as a result of the lag in getting generic options onto drug plans. The lag may be partly due to a recent Medicare policy shift that placed generic drugs in direct competition with branded therapies that often come with rebates for pharmacy-benefit managers, according to the news source.

  • US senators recently introduced an amendment to a bipartisan drug-pricing bill that would require Medicare health plans to place generic drugs on designated generic tiers to limit what patients spend out-of-pocket on prescriptions.

  • Lawmakers have also urged Health and Human Services Secretary Alex Azar and Seema Verma, administrator of the Center for Medicare & Medicaid Services, to change formulary policy for 2020.

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