WASHINGTON — The Trump administration wants to give private Medicare plans the flexibility to exclude from their formularies certain drugs, including some like antidepressants and AIDS medications, in hopes the increased negotiating power will help the plans bring down drug costs for patients and for the Medicare program itself.
It was the first in a series of changes that the Trump administration put forth in a new regulation late on Monday, all of which largely nibble around the edges of the underlying problem of high drug prices. Each of the polices are nonetheless likely to inflame drug companies and allied patient advocates who have said similar policy proposals could limit patient access to medicines.
Under current law, private Medicare drug plans are required to cover “all or substantially all” drugs in six classes: 1) antidepressants; 2) antipsychotics; 3) anticonvulsants; 4) immunosuppressants for treatment of transplant rejection; 5) antiretrovirals; and 6) antineoplastics. The original intent was to make sure insurers did not deny vulnerable patients access to potentially lifesaving drugs.
About the Author Reprints
