PhRMA Pushes Back on CMS Plan to Increase Medicare Part D, Advantage Negotiating Power

February 1, 2019

PhRMA picked holes in a proposed Centers for Medicare & Medicaid Services rule increasing Medicare Advantage and Part D plans’ power to negotiate drug prices.

In November, CMS issued the proposal aimed at expanding the number of ways Medicare Advantage and Part D plans can negotiate lower drug prices. It would revamp part D plans to allow them more negotiation room for groups of medicines used to treat the same condition.

PhRMA said it “strongly opposes” the proposed changes to the protected-classes policy, claiming it would be unlikely to result in significant savings and would be inconsistent with Medicare Part D’s non-discrimination protections. Plan sponsors already have the ability to manage access to most of the protected drugs, and the current level of formulary flexibility already keeps price growth under control, the trade group said.

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