The Centers for Medicare and Medicaid Services (CMS) recently announced the prices for the first 10 drugs targeted by the Medicare Drug Price Negotiation Program. The Partnership to Improve Patient Care (PIPC) shares the goal of advancing affordability of health care for all patients and people with disabilities. It is critical that individuals can both afford and access the treatments prescribed by their physicians.
CMS’ continuous engagement of patients will be essential to respond quickly to any unintended consequences for affordable and timely access to the specific treatment physicians determine to be most appropriate and effective for each individual patient. CMS asserts it will use its comprehensive formulary review process for Medicare prescription drug plans to assess any practices that may undermine access to selected drugs. We urge CMS to go further and adopt a concrete plan to monitor and respond to potential increased use of utilization management strategies and adverse formulary placements for both selected drugs and their alternative treatments, which could increase patient costs and impede physicians’ judgment about the best care for individual patients.
PIPC has long advocated for the agency to embrace current law and policies that bar the use of evidence that devalues people with disabilities and serious chronic conditions, as well as to develop predictable and meaningful methods and processes for engaging patients related to the factors that the agency must consider, including unmet need and comparative clinical effectiveness. We look forward to public disclosure and transparency of the published studies and other evidence used in CMS’ decisions as soon as possible, as well as how the agency considered input from patients and caregivers in its decision-making. In the future, we urge development of a refined process and feedback loop, with patients serving as a primary resource when determining the quality of evidence and its representativeness of the populations impacted. PIPC has provided comments and suggestions to CMS related to its use of evidence and its engagement of patients that we hope the agency will consider and adopt in the future.
PIPC has long advocated for the agency to embrace current law and policies that bar the use of evidence that devalues people with disabilities and serious chronic conditions, as well as to develop predictable and meaningful methods and processes for engaging patients related to the factors that the agency must consider, including unmet need and comparative clinical effectiveness. We look forward to public disclosure and transparency of the published studies and other evidence used in CMS’ decisions as soon as possible, as well as how the agency considered input from patients and caregivers in its decision-making. In the future, we urge development of a refined process and feedback loop, with patients serving as a primary resource when determining the quality of evidence and its representativeness of the populations impacted. PIPC has provided comments and suggestions to CMS related to its use of evidence and its engagement of patients that we hope the agency will consider and adopt in the future.
