The change: Under the ACA, the coinsurance rate in the “donut hole” is being reduced from 100% in 2011 to 25% in 2022.
The results: No change in drug use. No change in total spending. But seniors did switch from generic to brand drugs more often.
Click her to view/download the Study
HT: Jason Shafrin
In 2018 the Centers for Medicare and Medicaid Services (CMS) suddenly removed Auryxia (ferric citrate) from the Medicare Part D drug formulary and began to require prior authorization for the few indications it would reimburse. CMS gave little information about the reversal but apparently made the decision because it views ferric citrate at a mineral product, like dietary supplements such as Vitamin C. Dietary supplements are not covered by Medicare except in a few cases.
The Lown Institute recently released its Top 10 worse examples of profiteering and dysfunction in our health care system in 2021. Lown’s so-called Shkreli Awards were named after Martin Shkreli, the “pharma bro,” whose company became infamous for price gouging. After Turing Pharmaceuticals bought the 60-year old drug Daraprim, the price rose for $13.50 a pill to $750 a…