HHS issues RFI for Part D '$2 drugs' on some widely-used prescriptions

 

The Model would be administered by the Center for Medicare and Medicaid Innovation (CMMI) and would “standardize cost sharing for low-cost generics through a new, easy-to-understand option for people with Medicare Part D enrolled in a participating plan and their health care providers,” CMMI says.
 

The 270 potential drugs (including various doses and formulations) listed by CMMI include anti-depressants escitalopram and bupropion; the antipsychotic lithium; blood pressure medications metoprolol, hydrochlorothiazide and amlodipine; antibiotics penicillin and amoxicillin; statins atorvastatin and simvastatin; the antifungal Fluconazole; and the blood-thinner Warfarin.

 

CMS and CMMI cite a mandate from President Biden’s Oct. 14, 2022, Executive Order on prescription drug prices, which does not specify a $2.00 initiative, and HHS Secretary Xavier Becerra’s Feb. 14, 2023, report, which calls for a “Medicare High-Value Drug List” pilot “allowing Part D Sponsors to offer a Medicare-defined standard set of approximately 150 high-value generic drugs with a maximum co-payment of $2 for a month’s supply, applying across all phases of Part D coverage up to the out-of-pocket limit.”
 

The program would be voluntary for Part D sponsors, CMS says, and “pending further development, could start as early as January 2027.”

 

The RFI is here; it lists “primary areas of interest” that include: “Drug List Development Process” and “Maximizing Plan Participation,” among others. Responses are due by Dec. 9, 2024.