Gov’t Reduce HC Costs: Rx Decisions Say No

I have nothing against the pharmaceutical companies.  We need medications.  Development of medications costs money.  There are lots of failures to find one that works.  They deserve to make money.

That being said…they are smart and apparently the administration is inappropriately (IMHO) paying attention to what they suggest is right.

  • For Medicare PDP, the plans can no longer require the member to pay more when they choose a brand drug which is available as a generic.  WHY NOT?  It’s the same drug.  There may be a few exceptions called Narrow Therapeutic Index (NTI) drugs, but just make them exceptions.  This was a bad decision which will cost us taxpayers money.  (See prior posts – Potentially Ridiculous Decision and Uproar Over “Reference-Based”…)
  • Now, they jump on the savings that are offered for members who hit the “donut hole” and stay on the brand medication.  Why not just require MDs to give out samples?  Of course this will effect behavior and drive brand utilization.  Pharma is not stupid.  This is another decision which will cost us taxpayers money.

On the one decision where they go against pharma – drug reimportation, they make a bad decision.  Why import drugs?  Why not implement a therapeutic MAC (maximum allowable cost)?  This will definitely impact drug costs AND generic drugs (which make up almost 70% of the claims filled) are cheaper in the US.

This is the government that we want to manage the costs of our healthcare system when they can’t even make the logical decisions that anyone close the business could make.  Come on!

[IMHO = In My Humble Opinion]

Sold to Pharma

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