Becker's Healthcare March 8, 2024
Medicare Part D plans have ramped up restrictions on prescription drugs since 2011, a study published in the March edition of Health Affairs found.
In 2011, Part D plans excluded 20.4% of compounds from formularies and subjected 11.5% to prior authorization or step therapy. In 2020, plans excluded 30.4% of compounds and placed 14% under prior authorization or step therapy.
Standalone prescription drug plans excluded more drugs from their formularies than Medicare Advantage plans, the study found. In 2020, standalone part D plans excluded 48.1% of brand-name compounds from formularies, while MA-Part D plans excluded...
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