Bad news Alert...
The finalized MedPAC recommendations urge Congress to do the following:
- Modify the Part D “six protected classes” policy. MedPAC recommended the removal of antidepressants and immunosuppressants from the protected status that ensures their greater availability. Such a chance would no longer require formularies to provide “all or substantially all” of the drugs in these classes, greatly limiting patients’ access to medications. Also recommended was a streamlined process for formulary changes; requirements for prescribers to provide supporting statements with more clinical rigor when applying for exceptions; and the use of new tools when managing specialty drug benefits.
- Modify the Part D low-income subsidy policy. MedPAC recommended changes to copayments for low-income Medicare beneficiaries to encourage use of generic drugs when available in selected drugs classes. It was also recommended that cost-sharing for generic medications be reduced or, in some cases, altogether eliminated. Such changes would make it more difficult for patients to access brand name drugs, which could harm patients who need access to a newer medication.