Medicare to create new list of $2 prescription drugs for Part D beneficiaries

Author(s):

Richard Payerchin

Key Takeaways

Medicare's $2 Drug List Model targets affordability and access to generic drugs for common conditions, enhancing medication adherence and health outcomes.
The initiative aligns with Executive Order 14087, aiming to lower prescription drug costs for Americans.
CMS seeks public feedback on the list, which will be updated based on new drug launches and clinical evidence.
Participation in the model is voluntary, with the current list including 272 entries of generic drugs.

Public comment period opens; new model is based on current lists of large pharmacies and retailers.

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Medicare aims to create a new list of medicines available for $2 a month for people participating in Medicare Part D prescription drug coverage.

The U.S. Centers for Medicare & Medicaid Services (CMS) has published a sample list and request for information about it. The plan for the new Medicare $2 Drug List Model would allow fixed copayments of $2 for a month’s supply.

“The model would provide individuals more certainty about the out-of-pocket costs for these generic covered Part D drugs that would target common conditions, such as high cholesterol and high blood pressure,” according to the official announcement. The plan was developed to comply with President Joe Biden’s Executive Order 14087, titled “Lowering Prescription Drug Costs for Americans,” according to CMS.

“CMS is using every lever at its disposal to ensure people with Medicare have access to lower-cost prescriptions,” CMS Administrator Chiquita Brooks-LaSure said in the news release. “The Medicare $2 Drug List Model will aim to help improve access to and affordability of low-cost generic drugs for people with Medicare prescription drug coverage, and we encourage the public to provide feedback on the model.”

CMS’s Center for Medicare and Medicaid Innovation hopes the project will help patient health as well as their finances. The low-cost, clinically important generic drugs could improve medication adherence, leading to better health outcomes, according to plans.

The concept is not necessarily new, according to CMS. Beneficiaries, physicians and other health care providers already understand the concept because many large retail pharmacies and grocery chains use defined lists of prescription generic drugs at low, fixed prices. CMS’ announcement said its plan will be tailored to Medicare beneficiaries to ensure treatment options are available for $2. Sponsor participation will be voluntary.

The list will change based on new generic drug launches, clinical evidence and price trends, according to CMS.

“The initial version of the $2 Drug List represents a starting point for the drug list that would be included in the model,” said Liz Fowler, CMS Deputy Administrator and Director of the Innovation Center. “CMS intends to include many drugs that are used to treat common conditions for people with Medicare, with periodic updates to the drug list once it is finalized.”

The Medicare Innovation Center is seeking feedback on the process to create the list. Comments are due Dec. 9 and must be submitted via this CMS online portal. Here is the formal request for information. The list, news release and executive order are available here.

CMS’ published list includes 272 entries, but some of the entries are one drug but in different doses or duration of effectiveness. The list is: Buproprion Hydrochloride; Timolol; Isosorbide Mononitrate; Meforomin Hydrochloride; Metoprolol Succinate; Venlafaxine; Acyclovir; Alendronic Acid; Allopurinol; Amiodarone Hydrochloride; Amlodipine/Benazepril Hyrdrochloride; Amoxicillin; Anastrozole; Atenolol; Atorvastatin; Azithromycin; Benazepril Hydrochloride; Brimonidine; Buprenorphrine/Naloxone; Buproprion Hydrochloride; Busiprione Hydrochloride; Carbidopa; Carvedilol; Cephalexin; Chlorhexidine Gluconate; Chlorhexidone; Cilostazol; Citalopram; Clopidogrel; Divalproex Sodium; Donepezil Hydrochloride; Enalapril Maleate; Escitalopram; Finsateride; Fluconazole; Fluoxetine; Fosinopril Sodium; Furosemide; Hydralizine Hydrochloride; Hydrochlorothiazide/Irbesartan; Hydrochlorothiazide/Lisinopril; Hydrochlorothiazide/Losartan Potassium; Hydrochlorothiazide; Hydrochlorothiazide/Triamterene; Hydroxyurea; Indapamide; Irbesartan; Isoniazid; Lamotrigine; Latanoprost; Levetiracetam; Levothyroxine Sodium; Lisinopril; Lithium Carbonate; Losartan Potassium; Lovastatin; Metformin Hydrochloride; Methimazole; Metoclopramide; Metropolol Tartrate; Metronidazole; Mirtazapine; Montelukast; Mupirocin; Naltrexone Hydrochloride; Albuterol/Actuat inhalers; Nystatin; Olmesartan Medoxomil; Penicillin V Potassium; Pioglitazone; Polymyxin; Pravastatin Sodium; Prednisone; Propranolol Hydrochloride; Quinapril; Ramipril; Risperidone; Rosuvastatin; Sertraline; Simastatin; Spironolactone; Sulfamethoxazole; Sulfasalazine; Sumatriptan; Tamoxifen; Tamsulosin Hydrochloride; Terbinafine; Timolol; Tizanidine; Trazodone Hydrochloride; Valsartan; Verapamil Hydrochloride; Warfarin Sodium; Azithromycin.