How Medicare could get better prices on prescription drugs.
Congress may reform drug pricing policies under Medicare Part D as part of a larger health reform effort. Currently, the "noninterference" provision prevents the government from negotiating drug prices on behalf of Medicare Part D prescription drug plans. Commonly considered reform proposals borrow ideas from Medicaid, either through returning dual eligibles to Medicaid drug pricing or by imposing mandatory rebates across the Part D population. We examine a menu of other options, including value-based pricing; expansion of generic and therapeutically equivalent substitution; increased formulary diversity; importation; and limited antitrust waivers. These latter options may reduce federal spending without direct government price negotiations.
Outterson
Kevin
K
Boston University School of Law, Massachusetts, USA. mko@bu.edu
Kesselheim
Aaron S
AS
D017046:Cost Savings; D016527:Drug Costs; D018166:Health Care Reform; D006801:Humans; D054524:Medicare Part D; D055553:Prescription Drugs / Q000191:economics*; D011907:Rate Setting and Review / Q000379:methods*; D014481:United States
D055553:Prescription Drugs