Is there a simple fix for the Part D discount program?

The government has a responsibility to minimize healthcare costs for both Medicare patients and taxpayers, according to a new poll.

The Biosimilars Council, a division of the Association for Accessible Medicines (AAM), released a national poll that showed support for congressional action to lower out-of-pocket costs for patients and reduce federal spending for the Medicare Part D prescription drug benefit that covers most of America’s seniors.

The poll sought to gauge the public’s general awareness and understanding of biosimilars and the Coverage Gap Discount Program (CGDP).

According to the poll, there is an overwhelming belief by seniors and taxpayers that the government has a responsibility to lower healthcare costs for patients (nearly nine in 10 seniors) and bring down costs overall for taxpayers (nearly eight in 10). 

Simmon

“Americans are concerned about the cost of prescription drugs,” says Christine Simmon, senior vice president of policy and strategic alliances for the AAM and executive director of The Biosimilars Council. “There is a clear knowledge gap among Medicare Part D beneficiaries on how the CGDP works and it impact on patient’s taking biosimilars. Nine out of 10 seniors were unaware the CGDP prohibits drug manufacturers from providing any discount on biosimilars, creating an incentive for the use of higher-cost branded biologics.”

When informed about the CGDP prohibition on biosimilar discounts and the $1 billion in saving that fixing it would create, both taxpayers and seniors overwhelmingly supported congressional action to fix the program and create a level playing field for biologics and biosimilars, according to the poll. 

As of today, the FDA has approved seven biosimilars for the treatment of a variety of serious illnesses, and there or more than 60 additional currently in development. With the entry of biosimilar medicines, experts estimate that increased use of biosimilars could save the healthcare system as much as $250 billion over a 10-year period.

“The reality is that biosimilars are often much cheaper than branded biologics, and there is an opportunity to create meaningful savings for government payers, plan administrators, and patients by removing barriers to these FDA-approved, safe, effective and affordable versions of more costly brand biologics,” Simmons says.

“Whether you’re a policymakers or healthcare executive, increasing patient access to life-saving medications should be a priority,” she says. “Fixing the Part D’s CGDP is just common sense and good public policy. It will reduce both patient out-of-pocket costs and Part D program spending-saving taxpayers money.”

The poll also revealed that out of registered voters and senior Medicare recipients, a majority prefer generic drugs over brand-name drugs. Out of registered voters and senior Medicare recipients, nearly seven in 10 noted they worried that the cost of prescription drugs will negatively impact their life in their senior years.

Three recommendations for healthcare execs

Simmon offers three recommendations for healthcare executives based on the study:

• Whenever possible, provide beneficiaries with clear and complete information and educational resources so they can fully understand their coverage.

• Support legislation putting biosimilars on a level playing field as branded biologics, which encourages innovation while delivering savings to government payers, plan administrators, and patients.

• Where applicable, promote increased awareness and understanding of the unique benefits of biosimilar medications that offer an FDA-approved, safe, effective and affordable alternative to more-costly brand biologics.