A pair of recent analyses offer new evidence that Medicare’s protected classes policy does not drive higher costs for the program and beneficiaries, despite attacks from insurance companies who have argued they should be allowed to restrict access to these needed medications. Specifically, the two analyses -- one undertaken by Milliman and the other by BluePeak Advisors -- show that the six protected classes have similar cost patterns to non-protected drugs.
Among the highlights of the respective analyses:
These analyses are consistent with a recent study from Avalere, further refuting statements from plans and pharmacy benefit managers (PBM) that they cannot manage utilization of protected class drugs. In fact, the analyses show that drug costs have remained stable in the protected classes and generic utilization has increased – meaning plans are holding costs down as the protected class ensures that individuals with difficult-to-manage conditions are able to get the medication they need.
Write something about yourself. No need to be fancy, just an overview.