Stakeholders back Medicare Part D out-of-pocket cap, call for additional changes to lower patient costs

The biopharmaceutical industry, patient groups, PBMs and other stakeholders have endorsed proposals to cap out-of-pocket drug costs for Medicare Part D beneficiaries in comments submitted to the House Ways and Means and Energy and Commerce Committees.

The committees asked for comments in May on draft legislation that would cap out-of-pocket (OOP) costs at the Medicare Part D catastrophic threshold, which is $5,100 in 2019. The legislation would phase-in a reduction in the government’s liability for costs in the Medicare Part D catastrophic phase from 80% to 20% over four years, with Part D plans taking over the liability...