Our Take: CMS releases list of 43 Part B drugs flagged for quarterly rebates in IRA program
The manufacturers of 43 Part B prescription drugs and biological products may be required to pay rebates to Medicare because they increased prices on the drugs faster than the rate of inflation during the first quarter.
The rebates are required under the Medicare Prescription Drug Inflation Rebate Program, which is part of the Inflation Reduction Act signed into law last August.
As a result of the rebates, and depending on their coverage, some people enrolled in traditional Medicare or Medicare Advantage plans may pay a lower coinsurance amount for these drugs between July 1 and Sept. 30. Their coinsurance costs could be anywhere from $1 to $449 lower per average dose in comparison with what they would have paid before the IRA was passed, CMS stated.
“The Medicare Prescription Drug Inflation Rebate Program is a critical way to address long-term price increases by drug companies, and CMS is continuing our work to make prescription drugs more affordable for people with Medicare,” CMS Administrator Chiquita Brooks-LaSure said in a press release.
Although 27 drugs were on CMS’ first quarterly list of Part B rebatable drugs published in March, that list was later trimmed to 20 drugs. The list reflected drugs with price increases that outpaced inflation during the final quarter of last year.
Eighteen of those first 20 drugs remained on the new list, and another 25 were added.
While Pfizer had the most drugs (five) on the first list, seven of the 25 newly added drugs are manufactured by Amgen.
According to CMS, the agency’s normal procedure is to publish the Medicare Part B Quarterly Sales Pricing files, which now include the coinsurance adjustments for the rebatable drugs, several weeks ahead of the quarter in which they will go into effect. This gives the public a chance to review the files and report potential discrepancies, according to CMS.
That is why seven drugs were later removed from the first list of rebatable drugs, and CMS noted that the most recent list may also change if updated data becomes available.
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