Medicare’s Stealth Price Hike: Seniors Are Paying More for Generics Even Though the Drug Prices Have Fallen

Via the Los Angeles Times:

The prices of generic drugs haven’t risen since 2011—in fact, in many cases have fallen—but out out-of-pocket costs for those drugs for seniors on Medicare have nearly doubled That’s the finding in a new analysis by the healthcare consulting firm Avalere Health, which studied the trends in co-pay charges for enrollees in Medicare Part D, the prescription drug benefit. The benefit is administered by private insurance companies. The insurers have great latitude to establish out-of-pocket co-pays and structure their formularies—the roster of drugs they cover—as long as they meet broad rules set down by the Centers for Medicare and Medicaid Services. What the insurers have been up to, according to Avalere, is moving many generic drugs into co-pay tiers that require patients to pay larger portions of the drugs’ cost. By shifting more costs onto patients this way, the insurers can keep Part D premiums stable. That’s important to them, since they know that patients generally choose their Part D plans based on premiums. It’s a classic bait-and-switch, because only once they start filling prescriptions do the patients realize what their real costs are. The trend can deliver a real jolt to patients. Avalere says that total out-of-pocket costs for the same basket of generic drugs increased by $6.2 billion, or 93%, from 2011 through 2015. In that period, average generics prices increased only 1%, and the volume of generics purchased rose by only 22%. The difference was almost entirely the result of higher co-pays charged per prescription by the insurers.

Source/more: Los Angeles Times
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