The US health department has proposed three new models to help lower the cost of drugs, promote accessibility and improve quality of care for those enrolled in voluntary government health insurance plans.
The models selected for the Centers for Medicare & Medicaid Services (CMS) to test include encouraging the Medicare Part D plans, which cover the cost of most prescriptions, to offer a monthly $2 fixed co-payment for commonly used generic drugs for chronic conditions, such as high blood pressure.
The second model allows state Medicaid agencies to pay for cell and gene therapies, which can cost upwards of $1m, by assigning the CMS to coordinate and administer multi-state agreements with manufacturers for certain cell and gene therapies.
The third model will see the CMS develop payment methods for drugs approved under the accelerated approval programme to encourage timely confirmatory trial completion and improve access to post-market safety and efficacy data.
CMS deputy administrator and director of the CMS Innovation Center, Liz Fowler, said the models would “test strategies to make it easier for Medicare patients to afford and access needed prescriptions at $2 or less, help expand access to cutting-edge cell and gene therapies for people with Medicaid, and help ensure drugs already on the market are safe and effective”.
Tackling the high costs of prescription drugs and increasing access to novel therapies has been a key focus of the Biden-Harris administration.
As part of the Inflation Reduction Act of 2022, for the first time Medicare will be able to negotiate lower prescription drug prices for beneficiaries, and starting this year, drug companies that raise their prices faster than inflation will have to pay Medicare a rebate.
Xavier Becerra, Secretary of the Department of Health and Human Services (HHS), said: “We are [going] full steam ahead in delivering the cost savings from the President’s Inflation Reduction Act of 2022, and people on Medicare are already feeling the benefits.
“But as President Biden has made clear, we must build on the new prescription drug law with further action, which is why HHS is implementing these new projects to bring down prescription drug costs.”
In addition to selecting the three models for testing, Becerra also identified additional areas for research with the potential to lower prescription drug costs.
Source : PM Live
