CMS reports that Medicare Part D rebates to insurers not passed onto government, beneficiaries

CMS reported this week that despite pharmacies and drug companies paying higher rebates to insurers over time, the savings are infrequently passed on to government health programs and beneficiaries.  The growth in rebates from drug makers to insurers has far outpaced the growth in Medicare Part D drug costs since 2010, the CMS report shows. This has helped private insurers in Part D keep costs down, but it is not translating to lower costs for consumers. In some cases, it has resulted in more drug costs being shifted to the government.

The full report can be found here.

The Opioid Epidemic and Medicare Beneficiaries

CMS recently outlined it’s strategy for combating the opioid epidemic that is impacting a large numbers of Medicare and Medicaid beneficiaries and their families.  CMS identified the following areas as priorities to reduce opioid overuse and misuse in Medicare and Medicaid:

• Implement more effective person-centered and population-based strategies to reduce the risk of opioid use disorders, overdoses, inappropriate prescribing, and drug diversion
• Expand naloxone use, distribution, and access
• Expand screening, diagnosis, and treatment of opioid use disorders, with an emphasis on increasing access to medication-assisted treatment
• Increase the use of evidence-based practices for acute and chronic pain management

The success of CMS’ strategy relies on successful coordination and cooperation between Medicare and Medicaid beneficiaries, their families and caregivers, health care providers, health insurance plans, and states.  Acumen’s work on the Overutilization Monitoring System (OMS) is described as one example of the work CMS already does with health insurance plans to improve how opioids are prescribed by providers and used by beneficiaries.

 

https://blog.cms.gov/2017/01/05/addressing-the-opioid-epidemic/#_ftn13

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-11-03.html