Capping out-of pocket costs for some generic drugs, increasing access to specialty drugs are among models’ goals
The Centers for Medicare & Medicaid Services (CMS) is testing three new payment models aimed at lowering the cost of prescription drugs and ensuring that more patients have access to them.
In a February 14 announcement, CMS said the new models have been developed in response to President Biden’s “Lowering Prescription Drug Costs for Americans” Executive Order. The order complements the provisions of the 2022 Inflation Reduction Act designed to lower the cost of prescription drugs. The models being tested are:
“HHS [the U.S. Department of Health and Human Services, which oversees CMS] is using every tool available to us to lower health care costs and increase access to high-quality, affordable health care,” said Secretary Xavier Becerra said in the announcement. “But as President Biden has made clear, we must build on the new prescription drug law with further action, which is why HHS is implementing these new projects to bring down prescription drug costs.”
The testing process will take place through the CMS Innovation Center. Liz Fowler, PhD, JD, CMS deputy administrator and director of the Innovation Center said, “These selected models will test strategies to make it easier for Medicare patients to afford and access needed prescriptions at $2 or less, help expand access to cutting-edge cell and gene therapies for people with Medicaid, and help ensure drugs already on the market are safe and effective.”