Experts: CMS Move to Cut Insulin Costs Has Limits

Recently, CMS unveiled a new program to reduce Medicare beneficiaries’ out-of-pocket costs for insulin (RDB 3/12/20, p. 8). The voluntary model aims to lower the cost of a 30-day supply to “no more than $35” and reduce annual insulin costs by an average of $446 per person. Industry experts say the program, called the Part D Senior Savings Model, should save patients money but will have a limited impact on overall drug spending.

“The goal of the program is a way of putting the rebates and additional pricing incentives up front to the member level,” Brian Anderson, an actuary at Milliman Inc., tells AIS Health via email. “This is not a direct point-of-sale rebate approach, but it is a similar strategy for this therapeutic category.”

© 2022 MMIT
Peter Johnson

Peter Johnson

Peter has been a reporter for nearly a decade. Before joining AIS Health, Peter covered a wide variety of topics in his hometown of Seattle, where he continues to live. Peter’s work has appeared in publications including The Atlantic and The Stranger. Peter attended Colby College.

Related Posts

workers-prepping-infusion-drug
May 12

Major PBMs Look Ahead to 2023 for Biosimilars Boom

READ MORE
wall-street-sign
May 12

Centene Plans to Sell Magellan Rx, PANTHERx Rare for $2.8 Billion

READ MORE
pills-and-dollars
May 12

Study: With High Prices, Rebate Revenue Is Growing for PBMs

READ MORE

GAIN THERAPEUTIC AREA-SPECIFIC INTEL TO DRIVE ACCESS FOR YOUR BRAND

Sign up for publications to get unmatched business intelligence delivered to your inbox.

subscribe today