Medicare Part D coverage gap : discount program effects and brand-name drug price trends : report to congressional requesters.
The Patient Protection and Affordable Care Act of 2010 established the Discount Program to help Medicare Part D beneficiaries with their prescription drug costs while in the coverage gap, which occurs between the initial and catastrophic coverage periods where Medicare helps pay for drug costs. Unti...
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| Format: | Government Document eBook |
| Language: | English |
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[Washington, D.C.] :
U.S. Govt. Accountability Office,
[2012]
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| Online Access: | https://purl.fdlp.gov/GPO/gpo33386 |
| Summary: | The Patient Protection and Affordable Care Act of 2010 established the Discount Program to help Medicare Part D beneficiaries with their prescription drug costs while in the coverage gap, which occurs between the initial and catastrophic coverage periods where Medicare helps pay for drug costs. Until the Discount Program began in 2011, beneficiaries in the coverage gap paid 100 percent of drug costs. The Discount Program required manufacturers to provide a 50 percent discount on the price of brand-name drugs for beneficiaries in the gap. GAO was asked to describe (1) CMS's oversight of the Discount Program; (2) perspectives of plan sponsors, manufacturers, and PBMs on effects of the Discount Program; and (3) how prices for brand-name drugs used by beneficiaries in the coverage gap and by those who did not reach the gap changed before and after the start of the Discount Program. To describe CMS's oversight, GAO reviewed CMS documents and interviewed CMS officials. To describe perspectives on the effects of the Discount Program, GAO interviewed the 7 largest Part D plan sponsors based on enrollment data, 8 of 10 manufacturers of brand-name drugs with the highest expenditures in the gap, and 3 PBMs who contracted with sponsors GAO interviewed. To describe price changes, GAO used CMS Part D data from 2007 to 2011 to track prices for high-expenditure brand-name drugs used by those in and those who did not reach the gap. GAO compared prices for the two baskets because drugs used by those in the gap may be more susceptible to price increases since manufacturers must provide the discount for these drugs. |
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| Item Description: | Title from title screen (viewed on Dec. 31, 2012). "September 2012." QR code for online version of document included on title page. "GAO-12-914." Electronic resource. |
| Physical Description: | 1 online resource (iii, 41 pages) : color illustrations |
| Format: | Mode of access: World Wide Web. System requirements: Adobe Acrobat reader. |
| Bibliography: | Includes bibliographical references. |