Discover and read the best of Twitter Threads about #PartD

Most recents (11)

Because last week was a busy week for #insulin tweets, @KhrystaBaig and I have saved this Tweetorial for our new @JAMA_current paper for busy time. AHEM, remember? ๐Ÿ‘‡ Follow along, will you? 1/10 Image
A little background before we dive into GIFs. While #insulin isn't free, it is only $35 on some plans in #PartD as part of the @CMSinnovates #SeniorSavings Model. But who saves money under this model? 2/10โ€ฆ
The #SeniorSavings Model allows plans to cover insulin at $35 copays with every fill. But in 2021 and 2022 you had to enroll into a plan to get $35 insulin. If you didn't pick a Model participating plan, you could have paid too much! 3/10
Read 10 tweets
๐Ÿ’Š๐Ÿ’Š New Tweetorial Alert ๐Ÿ’Š๐Ÿ’Š
Please take a break from your #doomscrolling and read this thread. If you have an even longer break read the paper @NEJM:โ€ฆ 1/7
This paper is about #PartD & cancer. It is also about #pharmacoequity (shoutout @UREssien). Not the way we typically think about equity, though. This is about how screwed you are if you need cancer treatment and your treatment happens to be covered by #PartD and not #PartB. 2/7
Half of cancer drugs are covered by #PartD. Whether you get a pill versus infusion is based on your cancer type or subtype. For #breastcancer the preferred regimens for #HER2+ cancer are infused (#PartB); for HER2-, ER/PR+ cancer preferred regimens include a #PartD drug. 3/7
Read 8 tweets
New work out this evening in @NEJM @NEJMPerspec on the plan to redesign #Medicare #PartD and how much savings there might be for people enrolled in the program! This has been a moving target (I'm looking at you #BuildBackBetter)! I've got you covered! 1/7
The article is here for your reading pleasure:โ€ฆ
I calculated savings relative to the 2022 benefit for the top 15 highest spending drugs in Part D for the major bills introduced that aimed to redesign the program. None are an exact fit, but HR3 is maybe the closest given the $2000 cap. Some details are still unknown. 2/7
Read 11 tweets
This is about #PartD and #AuthorizedGenerics and how some generics aren't a very good deal for health plans, even if they provide savings to patients. With @profmikecarrier @NancyKeatingMD @AmeetSarpatwari. 1/7โ€ฆ
You might remember headlines like this one that were telling us about companies coming out with generic versions of their $$$$ brand-name drugs. We saw this for #insulin #hepatitisC and #epipen over the past few years. 2/7โ€ฆ
These are "authorized generics" which are when a brand company takes off the brand name but the drug is exactly the same. In these cases, the generic product came out way before patents were expired. 3/7
Read 8 tweets
๐Ÿ“„๐Ÿ“„New article in @JAMAHealthForum ๐Ÿ“„๐Ÿ“„

We take a deep dive into the question of how to estimate rebates and other discounts received by Medicare #PartD.

With @bnrome, #VeroniqueRaimond, #JoshGagne, @akesselheim @PORTAL_Research

Thread below.
1/ First some background.

There are 2 broad categories of discounts in Medicare #PartD: direct and indirect remuneration (#DIR) and coverage gap discounts (#CGD).
2/ #DIR includes confidential rebates that drug manufacturers pay to #PartD plans and #PBMs, often to secure favorable formulary placement. #DIR also includes discounts paid by pharmacies to plans and #PBMsโ€”e.g., to be in the planโ€™s preferred network.
Read 20 tweets
Last week my mom was diagnosed with metastatic (stage IV) breast cancer. As someone who has worked in the pharmaceutical industry, studies cancer drug prices, and is trained as a health services researcher, I have some thoughts to share about our current system. 1/10
First, #Cancer sucks. Metastatic cancer is something I hope you never have to say to or hear from someone that you love. When it is you, or your loved one, you desperately want more time. You want good quality of life, and you need for them to live. 2/10
The subtype of cancer tells you what treatment options you have in this really awful situation. If you have orally administered options or infused options, for example. Some subtypes have great targeted therapies that extend life and "are well tolerated". 3/10
Read 12 tweets
NEW in @JAMA_current: @JB_Everson, @DusetzinaS and Mark Frisse say that a new @CMSGov rule about integrating real-time Rx drug info into #Medicare #PartD plans needs a simple, incremental approach to maximize its potential.
@JAMA_current @JB_Everson @DusetzinaS @CMSGov Here's one reason why it might not work as intended.

Read the Viewpoint in @JAMA_current here:โ€ฆ Image
What might work better? Well, this idea might be worth @CMSGov time considering... Image
Read 3 tweets
NEW in @NEJM: @MelindaBBuntin explains what states can learn (but also what they won't) from Tennessee's negotiation with @CMSGov to change its #Medicaid program to a block grant.โ€ฆ
@NEJM @MelindaBBuntin @CMSGov "These efforts are distinct from block-grant bills proposed
by congressional Republicans and extensively debated in
2017, which sought to limit federal spending and shift financial risk to states in exchange for somewhat greater programmatic flexibility."
Read 5 tweets
NEW: Today in @NEJM, @DusetzinaS finds BIG differences in 3 proposals to control out-of-pocket prescription drug spending for #Medicare #PartD patients facing really high annual drug spending.โ€ฆ Image
2 proposals, one from @medpac and another from @SenFinance, have caps on out-of-pocket spending.โ€ฆ
1 other, from @HHSGov, would share #rebates with patients at the counter. That idea and doing nothing, also a possibility, donโ€™t control annual out-of-pocket spending for patients.
Read 5 tweets
Walk with @DusetzinaS on a complicated journey of how generic #prescription #drugs are costing #Medicare beneficiaries MORE than brand-name drugs in some cases.

Read the full study in @Health_Affairs here:โ€ฆ ImageImageImage
These drugs are used by older folks who have serious or rare conditions. We're talking about #cancer or #diabetes or #MS.
What the study finds is that people who pay between $20K and $80K per year for their medications pay less for brand-name drugs than generics. Weird, right?

It's due in part of how #PartD works and the economics of pharmaceuticals and, well, it's super complicated.
Read 5 tweets
We have a new study out today in @Health_Affairs on #PartD. Bear with me because the findings are a little crazy. You can find the paper here:โ€ฆ 1/10
Our big finding: If you need a lot of drugs or some very expensive drugs you would save more money out-of-pocket by using brands instead of generics. 2/10
Yeah, that's right. That doesn't make sense.
This happens because branded drug companies pay discounts in the doughnut hole that count as out-of-pocket spending. Generic drug makers donโ€™t. 3/10
Read 11 tweets

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