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Politico: New Study Shows Insurers Have Enough Tools to Manage Costs of Drugs in ‘Protected Classes’

11/29/2018

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​Politico’s Pulse newsletter prominently featured a study from the Partnership for Part D Access showing that Medicare Part D plans are currently equipped to control costs of critical drugs in the six protected classes. As detailed in the article, the study found that "Part D benefit designs are steering patients to cheaper drugs. More than 90 percent of prescriptions in the protected classes are for lower cost generics, even when accounting for the fact that nearly all HIV drugs are branded medicines. Use of prior authorization also is common — it’s required for nearly half the brand drugs in the protected classes and 36 percent of all protected class drugs. Plans also use formulary tier placement to try and control costs." This shows that the six protected classes safeguard access to critical drugs while not unduly constraining plans’ ability to manage their formularies.

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