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NKF raises concern about access to transplant drugs under Medicare Part D with new CMS proposal
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The National Kidney Foundation is questioning whether a new proposal by CMS to revamp Medicare Part D drug pricing might limit access to prescription drugs for some transplant patients.
“While we appreciate the Trump administration’s focus on reducing the cost of prescription drugs, we have significant concerns with this proposed policy,” the NKF said in a statement. “We are hopeful that CMS will hear our concerns and ensure that patient[s’] safety is the first and foremost priority.”
Under its Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses proposal, which would take effect in 2020, CMS said Medicare Advantage and Part D plans would have more tools to negotiate lower drug prices. The agency is also considering a policy that would require pharmacy rebates to be passed on to seniors to lower their drug costs at the pharmacy counter, according to the press release.
“President Trump is following through on his promise to bring tougher negotiation to Medicare and bring down drug costs for patients, without restricting patient access or choice,” HHS Secretary Alex Azar said in a press release on Nov. 26. “By bringing the latest tools from the private sector to Medicare Part D, we can save money for taxpayers and seniors, improve access to expensive drugs many seniors need and expand their choice of plans.”
However, the NKF said the proposal could remove “key protections for transplant patients that allow them to access the immunosuppressive drug regimen that best meets their individual needs and would leave the government in the position of deciding what is clinically appropriate when reviewing Part D plan formularies.”
Medicare covered the cost for more than 30,000 organ transplants in the United States this year, and the NKF acknowledged that many Medicare beneficiaries had their immunosuppressive drugs covered through Medicare Part B assistance.
“While this proposal will impact a small number of organ recipients, it puts those who do get their immunosuppressive drugs under Part D, health and lives at risk,” the NKF said. “It is also likely to result in higher spending under Medicare Parts A and B, particularly if more patients’ organs fail, fueling the need for more health care services and/or the need for a Medicare covered transplant.”
References:
www.kidney.org/news/nkf-concerned-about-proposed-changes-to-medicare-part-d