CMS projects decreased Part D premiums in 2019, for second straight year

For the second year in a row, CMS projects that Medicare Part D premiums will decrease.

The Centers for Medicare & Medicaid Services estimates that premiums will drop from $33.59 each month to $32.50 in 2019. CMS' Office of the Actuary bases its numbers on bids submitted by drug plans for next year.

CMS Administrator Seema Verma touted to the potential decreases as part of the Trump administration's efforts to reduce drug costs.

"The actions that HHS and CMS are taking to increase competition in order to drive down costs for patients are working," Verma said in a statement. "CMS will continue to strengthen the Part D program and bolster plans' negotiating power so they can get the best deal for seniors from prescription drug manufacturers."

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2019 marks the second straight year that CMS estimates a decrease in premiums following a five-year period of increases between 2013 and 2017.

The premium estimates follow shortly after CMS rolled out several changes to Part D as part of the overall drug price initiative. Some of the agency's updates to the program include:

  • cutting down the maximum price that low-income enrollees can be charged for biosimilars
  • allowing plans to substitute certain generic medications on their formularies more quickly
  • removing a requirement that Part D plans are "meaningfully different" from one another
  • clarifying the "any willing provider" requirement, which could boost the number of pharmacy options for beneficiaries

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The Trump administration has called for even bigger changes to Part D as part of its drug pricing blueprint, titled "American Patients First." The blueprint includes provisions that would move certain drugs from Medicare Part B into Part D.

Doing so, according to the administration, would allow plan administrators to better negotiate prices with drugmakers. However, some experts have warned that it could also lead to higher out-of-pocket costs for consumers.

The Community Oncology Alliance, which represents physicians in oncology, also warned that this could increase the leverage of pharmacy benefit managers, which have come under fire for how they use rebates to set prices for consumers.

Medicare open enrollment begins Oct. 15, and CMS said it should release final Part D premium numbers for 2019 in mid-to-late September.