Medicare Patients With MS Face Higher Out-of-Pocket Rx Costs

Projected cumulative out-of-pocket spending for disease-modifying therapies for 2019 was $6,894

seniors paying bills

THURSDAY, Feb. 14, 2019 (HealthDay News) -- Medicare patients with multiple sclerosis (MS) face increasing out-of-pocket costs for disease-modifying therapies, according to a study published in the February issue of Health Affairs.

Daniel M. Hartung, Pharm.D., M.P.H., from Oregon State University/Oregon Health and Science University in Portland, and colleagues used enrollment-weighted Prescription Drug Plan Formulary files (2007 to 2016) to assess changes in pharmacy benefit coverage and cost-sharing amounts for MS disease-modifying therapies in the Medicare Part D program.

The researchers found that the rate of prior authorization use increased from 61 to 66 percent of plans to 84 to 90 percent. There was a decline from 39 to 17 percent in the share of plans with at least one therapy available without limitations. For 2019, the projected cumulative out-of-pocket spending was $6,894. Generic glatiramer acetate was the therapy with the highest out-of-pocket spending.

"Policy makers need to consider both access restrictions and a growing cost-sharing burden as potential consequences of high and rising drug prices for people with MS," the authors write.

Abstract/Full Text (subscription or payment may be required)

Physician’s Briefing Staff

Physician’s Briefing Staff

Published on February 14, 2019

Read this Next
About UsOur ProductsCustom SolutionsHow it’s SoldOur ResultsDeliveryContact UsBlogPrivacy PolicyFAQ