Panel: Emerging Evidence to Inform Medicare Prescription Drug Policy

Friday, November 8, 2019: 3:15 PM-4:45 PM
I.M Pei Tower: Majestic Level, Majestic Ballroom (Sheraton Denver Downtown)

*Names in bold indicate Presenter

Organizer:  Erin E. Trish, University of Southern California
Panel Chair:  Steven Lieberman, Brookings Institution
Discussants:  Anna Anderson-Cook, ; Arnold Ventures and Steven Lieberman, Brookings Institution

While there is widespread recognition of the value and benefit of biopharmaceutical investment and innovation, there is also considerable concern about the affordability of prescription drugs. The lack of such affordability can restrict consumer access to necessary medications and threaten the sustainability of publicly-funded programs such as Medicare. 

In this panel, we explore several topics related to prescription drug spending and affordability, including evaluating the implications of potential policy reforms in this area. The first paper evaluates the drivers of rising costs of brand-name drugs in the Medicare Part D prescription drug program. This analysis represents a particularly unique study due to the authors’ ability to incorporate data on drug-level rebates, allowing for an analysis not only of list prices but also of net prices. The second paper builds on this foundation by evaluating pricing, coverage, and out-of-pocket spending for anticancer specialty drugs in Part D, demonstrating the growing financial burden faced by patients who take these drugs. The third paper evaluates the potential effect of proposed reforms to the Part D program that may help to address these concerns, including requirements to pass-through rebates to beneficiaries at the point-of-sale and changes to the structure of the federal reinsurance program. Finally, the fourth paper focuses on another important component of Medicare drug spending – namely, that covered under the Part B benefit, including drugs administered by infusion or injection in physicians’ offices and hospital outpatient departments. The authors provide important evidence on the drivers of Part B drug spending and the potential impact of proposed reforms to the Part B program. Taken together, these papers provide important evidence regarding the drivers of growth in Medicare drug spending and the potential impact of proposed reforms targeting this spending growth.                

Given rising drug costs and the associated burden on patients and payers, it is increasingly important to understand the drivers of these costs, as well as the implications of the range of possible policy approaches to address this burden. The findings from the four papers included in this panel are highly relevant to policy debates on this topic and have the potential to inform the design of prescription drug policy going forward.

Policy Options to Address Incentives and Drug Spending in Medicare Part B
Aditi P. Sen, Kelly Anderson, Bryan Hambley and Gerard Anderson, Johns Hopkins University

Specialty Drug Pricing, Coverage, and out-of-Pocket Spending in Part D, 2010 to 2018
Stacie Dusetzina1, Haiden Huskamp2 and Nancy Keating2, (1)Vanderbilt University, (2)Harvard University

The Contribution of Changes in Drug Mix and Existing Product Price Inflation in Explaining Rising Costs of Brand-Name Drugs in Medicare Part D
Anna Anderson-Cook, Tamara Hayford, Jared Maeda, Lyle Nelson and Yash Patel, Congressional Budget Office

Medicare Part D: Time for Re-Modernization?
Erin E. Trish, University of Southern California

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