Drug rationing coming to Part D

A major policy goal of the Inflation Reduction Act was to reduce CMS’s drug expenditure in the catastrophic phase of Part D, but the way in which the act accomplished this — burdening health plans with a much greater share of drug costs — will almost certainly lead plans to clamp down on drug utilization.

Part D helps Medicare beneficiaries pay for self-administered prescription drugs by splitting the cost of those drugs between Medicare, manufacturers, plans and patients. Beneficiaries pay a monthly premium, which is supplemented by Medicare based on bids submitted by the plans. The benefit is divided into three phases — a deductible, an initial coverage period, and a catastrophic phase — each with different cost-sharing. ...