Skip to Main Content

WASHINGTON — The government will allow some private Medicare plans to be more discerning about how they cover prescription drugs, the Trump administration announced in a memo Tuesday.

Specifically, Medicare Advantage plans — private plan alternatives to Medicare that cover about 19 million beneficiaries across the country — will be allowed to require patients who need a costly physician-administered drug, like most chemotherapy, to first use cheaper drugs and see if they work before moving to more expensive drugs.


That technique is known as “step therapy,” and other Medicare plans can already use it for drugs that patients buy in a pharmacy. So can private insurance companies.

Unlock this article by subscribing to STAT+ and enjoy your first 30 days free!