An article in Patient EngagementHIT covered Partnership’s recent Avalere report, noting that existing utilization management strategies such as formulary tiers and copayment already serve as significant barriers to Medicare Part D drugs. The article notes that the recent proposed rule addressing the 'six protected classes' policy could result in payers implementing more step therapy or prior authorization within the protected classes — a step that could complicate patient access to treatment for those drugs. The piece also points to the data point in the Avalere analysis showing that Part D plans are already using tools within the program to push patients toward lower-cost alternatives. “This new study provides overwhelming evidence that Medicare’s protected classes policy strikes an appropriate balance between allowing plans to utilize medication management techniques and preserving a safety net for patients who absolutely need a particular medication,” said Partnership Executive Director Chuck Ingoglia. “Even with these protections in place, patients must overcome layers of restrictive barriers that plans put in place to access needed medications.”
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