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AHIP Submits Comment Letter On Medicare Part B Drug Proposal

posted by Matt Eyles

on May 10, 2016

In response to CMS’ proposal on a new drug payment model in Medicare Part B, AHIP Executive Vice President Matthew Eyles recognized the agency for “shining a light on a fundamental concern about the affordability of prescription drugs for beneficiaries and taxpayers.”

As part of those efforts, AHIP urges CMS to carefully “assess the potential unintended impacts of its proposal, including the potential for cost shifting to other segments of the Medicare program as well as to Medicaid and the commercial market.”

The full comment letter is included here. Excerpts are below:

  • “…By recognizing that pharmaceutical costs are rising at unsustainable rates in Medicare Part B (and across the healthcare system) and proposing solutions, CMS is shining a light on a fundamental concern about the affordability of prescription drugs for beneficiaries and taxpayers.”
  • “…Part B payments for drugs have increased at an average annual rate of 8.6% since 2007, and total spending for drugs in the Part B program doubled from 2007 to 2015 – growing from $11 billion to $22 billion.”
  • “We strongly urge CMS to assess carefully the potential unintended impacts of its proposal, including the potential for cost shifting to other segments of the Medicare program as well as to Medicaid and the commercial market.”
  • “Both history and the experience of our members suggest that efforts to reduce pharmaceutical prices in one market segment can result in higher costs through manufacturers setting higher launch prices for new drugs and pursuing greater price increases on existing drugs.”
  • “We also encourage CMS to promote parity across the entire Medicare program and ensure that the tools made available in the fee-for-service (FFS) program are also made available to health plans that provide Medicare’s benefits to millions of beneficiaries through Medicare Advantage (MA) plans and Medicare prescription drug (Part D) plans.”

Matt Eyles is Executive Vice President, Policy and Regulatory Affairs at AHIP.