Trends In Coverage For Disease-Modifying Therapies For Multiple Sclerosis In Medicare Part D.
Health Aff (Millwood)
; 38(2): 303-312, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30715973
ABSTRACT
The high cost of multiple sclerosis (MS) disease-modifying therapies can negatively affect access for patients through increased payer restrictions and higher out-of-pocket spending. Our objective was to describe changes in pharmacy benefit coverage and cost-sharing amounts for MS disease-modifying therapies in the Medicare Part D program, using enrollment-weighted Prescription Drug Plan Formulary files for the period 2007-16. Among therapies available throughout the study period, the rate of prior authorization use increased from 61-66 percent of plans to 84-90 percent. The share of plans with at least one therapy available without limitations declined from 39 percent to 17 percent. The projected cumulative out-of-pocket spending for 2019 was $6,894. The therapy with the highest out-of-pocket spending was generic glatiramer acetate. Policy makers need to consider both access restrictions and a growing cost-sharing burden as potential consequences of high and rising drug prices for people with MS.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Custo Compartilhado de Seguro
/
Gastos em Saúde
/
Medicare Part D
/
Medicamentos sob Prescrição
/
Esclerose Múltipla
Limite:
Female
/
Humans
/
Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article