A new report from the Kaiser Family Foundation provides an overview of Part D in 2014 and explores major trends in the program since 2006.
The Drug Enforcement Agency released a new rule reclassifying hydrocodone combination products as Schedule II drugs. Previously, only pure hydrocodone drugs were considered Schedule II, while hydrocodone combination products were classified as Schedule III because it was believed that mixing hydrocodone with non-narcotic painkillers such as acetaminophen would reduce their potential for abuse. The policy change will take effect in 45 days, and will place stricter rules on how doctors can prescribe hydrocodone combination products.
Despite some technical difficulties, CMS still plans to release detailed information about payments to doctors from drug and medical device companies. Doctors were originally given until August 27th to review the payment data and make corrections before the launch date. However, the Open Payments system went offline from August 3rd to 15th when some users could see information regarding other doctors. As a result, CMS extended the deadline to review and dispute payment data to September 8th.
The release of this information, per the Physician Payments Sunshine Act, is widely anticipated by watchdog groups and will likely increase consumer scrutiny of promotional payments. A March 2014 ProPublica article (see previous blog post) already identified dramatic decreases in payments made to doctors by large pharmaceutical companies, possibly in anticipation of the this data release. Medical groups, including the American Medical Association, have asked CMS to postpone releasing the payments data to given doctors enough time to dispute incorrect information. However, it appears that CMS intends to keep the September 30th launch date for the online payment database.
An analysis of National Average Drug Acquisition Cost (NADAC) data found that half of all retail generic drugs became more expensive over the past 12 months. Of the nearly 2,400 generic drugs analyzed, almost 10 percent experienced price increases over 100 percent. Some of these dramatic increases can be attributed to shortages, which can be caused by events such as manufacturers exiting the market, supply disruptions, and FDA intervention. Conversely, only 16 percent of the generic drugs analyzed experienced price declines greater than 10 percent.
Recently, CMS projected that the average Part D basic plan premium for 2015 will increase by approximately $1 to a total of about $32 per month.
This modest increase continues the trend of slow growth in Part D plan premiums. Between 2011 and 2014, the average basic plan premium remained steady at $30 to $31, despite concerns that closing the coverage gap would result in premium hikes. Similarly, there were concerns that 2015 premiums would increase due to the anticipated costs of covering of expensive specialty drugs, notably hepatitis C treatments (see previous blog post).