Forbes March 12, 2020
Joshua Cohen

Lately, prescription drug prices have preoccupied President Trump, Congress, Democratic presidential candidates, policymakers, and academics.

The discussions have been mostly talk and very little action. Sure, a number of price transparency laws have been passed at the state and federal levels. But, most have no teeth. They reveal list prices, which are already publicly available.

For the purposes of driving down patient out-of-pocket costs, and also improving accountability, it may be more expeditious to subject the formulary decision-making process to more scrutiny, especially regarding Medicare Part D plans.

Formularies matter. They facilitate and restrict access to medically necessary (prescribed) medications. As such, they determine what’s covered and at what price to the patient (co-insurance). And, patient out-of-pocket costs are what’s...

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Topics: CMS, Govt Agencies, Insurance, Medicare Advantage, Patient / Consumer, Payer, Pharma, Provider
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