Op-Ed: Strengthening and Protecting Part D is an Important Challenge

In an op-ed published in The Hill on October 10, Carl Schmid, deputy executive director of MAPRx member organization The AIDS Institute, wrote about the challenges and opportunities facing Medicare Part D. While highlighting the popularity of the prescription drug benefit with nearly 44 million enrolled beneficiaries, Carl also notes that out-of-pocket costs for beneficiaries continue to rise and have the potential to rise even more with the impending “out-of-pocket cliff,” which could raise costs by $1,250 in 2020 for beneficiaries reaching the catastrophic coverage phase of the benefit.

Carl writes:

As policymakers and others discuss future changes to the Medicare Part D program, I am hopeful they will pay special attention to ensuring that every beneficiary has timely, affordable access to the medications they need to live a healthy life.

Solutions should focus on improving the exceptions and appeals process, providing greater formulary oversight, implementing an out-of-pocket cap, applying rebates at the point of sale and ensuring manufacturer discounts are a component of true out-of-pocket costs.

The task of strengthening and protecting Part D is a challenging one, but if the beneficiary remains the focus, significant and lasting improvements for all are well within reach.

To read the full op-ed, click here.