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Spreading the costs and pain in Part D

How proposed Part D changes would hit patients, manufacturers and plans

The Trump administration’s proposed changes to Medicare Part D would shift costs from the federal government to patients, manufacturers and insurers, all of which are sure to lobby against it and derail it in Congress.

On March 11, the administration unveiled its FY20 budget proposal, and in doing so laid bare its attempt to use the budget process as a vehicle for implementing the elements of its drug pricing blueprint that require legislation.

The greatest savings would come from proposed changes to how cost-sharing is accounted for in Medicare Part D and the proportion of costs shouldered by the government once patients become eligible for catastrophic coverage. The purpose of the proposed changes is to reduce the number of individuals who qualify for catastrophic coverage and to incentivize plans to favor lower cost generics.

The changes are expected to save the federal government $74.7 billion over 10 years.

But the road to get there is littered with increased costs for patients, manufacturers and health plans. A 2016 analysis

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