Blum Touts Drug Adherence As Part D Cost Saver

Inside Health Posted: March 21, 2013

CMS Medicare chief Jonathan Blum touted improved drug adherence as a Medicare cost saver, saying that CMS analysis shows that efforts to lower the cost of medicine for people in Medicare’s coverage gap have reinforced CMS efforts to improve the delivery of care. Blum made the comments as part of CMS’ announcement that 6 million unique seniors have now saved a total $6 billion due to the rebate program authorized under the health reform law.

Not only does the program improve the financial health to beneficiaries, it is really a key part of CMS’ strategy to improve care delivery and lower costs, Blum says.

He further noted that when the Part D coverage gap rebate program was first established, many stakeholders raised concerns that it could result in increased drug spending — since the rebates would be provided for brand-name drugs that are often more expensive. However, Blum says that there are no signs that has happened. In fact, he says, Part D costs have remained flat for years and are expected to decline in 2014.

Blum, responding to a reporter’s question, did acknowledge that much of spending growth has been driven by increased consumption of high-cost specialty drugs, and this trend is expected to continue. CMS will continue to monitor this and adopt to changes in the market-place, but it does have “strong tools to manage and respond to cost trends,” he said.

CMS provides strong incentives to Part D plans to put in place medication therapy management programs and “we are seeing growing signs that the programs do help improve compliance and lower costs,” he said.

In the 45-day notice to Part D plans issued Feb. 20, CMS had asked plans to broaden populations targeted for medication therapy management services, and specifically to promote access and adherence to anti-hypertensive drugs as part of the CMS’ Million Hearts initiative (see related story).

The same notice announced that Part D beneficiaries will have both lower deductibles and lower co-pays than in any year since the program’s inception.

Beneficiaries that fall into the Part D coverage gap in FY 2014 now receive a 52.5 percent discount on brand drugs and 28 percent discount on generics due to health law’s drug discount program. — Amy Lotven (