NASP Applauds CMS for Proposing Changes to Medicare Part D

WASHINGTON, D.C. (November 17, 2017) – Late last night, Medicare officials requested comments on how to use discounts and rebates to reduce prescription medication costs for sick seniors. The proposed rule requests public comment on ways to share rebates and discounts negotiated by manufacturers, pharmacists and insurers. The Executive Director of the National Association of Specialty Pharmacy (NASP), Sheila Arquette, released the following statement:
 
“The National Association of Specialty Pharmacy applauds CMS for proposing changes to the Medicare Part D program that will re-focus the benefits of the Medicare Part D program on the beneficiaries the program was designed to protect and away from the first-tier entities contracted to administer the program. We look forward to partnering with the agency to finalize provisions that will improve the quality of care for Medicare beneficiaries while reducing their costs at the point of sale and ensuring their access to life saving medications and patient care support services from the pharmacy of their choosing.”
 
Insurers and big pharmacy benefit managers (PBMs) administer Medicare’s Part D drug program, negotiating behind-the-scenes fees and discounts hidden from the public. NASP urges CMS to address Direct and Indirect Remuneration (DIR) fees, Any Willing Pharmacy Provisions that are neither reasonable nor relevant, and the absence of Medicare Part D minimum network adequacy standards for specialty pharmacies.
 
According to a recent analysis by the Kaiser Family Foundation, 1 million Medicare beneficiaries had out-of-pocket drug spending above the Part D catastrophic threshold in 2015. These 1 million enrollees spent an average of over $3,000 per person out-of-pocket on prescriptions, $1,215 of which was above the catastrophic threshold. Unfortunately, the number with such high spending has risen sharply in recent years. Additionally, IMS Health data shows drug spending continues to shift from traditional to specialty medicines, with specialty share of net spending increasing from 23.6% in 2007 to 42.9% in 2016. 
 
National Association for Specialty Pharmacy (NASP) | NASP represents over 50 healthcare industry leaders, working on behalf of retail and specialty pharmacies, drug distributors and hospital systems on legislative and regulatory efforts for the association, which has 250 member pharmacies. To spotlight the increasingly negative consequences of DIR fees, NASP launched StopDIRfees.com with information and testimonials on how big PBMs impose DIR fees to rig the Medicare system. The site also features an online petition and contact information for constituents to call or write elected officials, urging them to stop DIR fees. NASP was founded in 2012 and is the only national trade association that represents specialty pharmacy, serving as the leading educational resource and national advocate for specialty pharmacy healthcare professionals and patients alike. In addition to providing medications to severely ill patients, specialty pharmacy also features support programs and services to ensure patients maximize the benefit from their medication, therapies and services, working to ease the treatment burden for patients, families and caregivers as they work to manage these tough conditions. 


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