As the Trump administration begins the push to move Medicare Part B drugs into Part D, consumers could be hit with higher bills as a result.
New research from Avalere Health finds that Medicare out-of-pocket costs vary significantly depending on the program. In 2016, the average cost to patients for Part D covered cancer therapies was $3,200, compared to $2,400 under Part B, a 33% difference.
Richard Kane, a senior director at the consulting firm, told FierceHealthcare that the main driver between the cost difference is common use of supplemental coverage under Part B, which is limited under Part D.
“Any proposal or policy for shifting drugs to Part D needs to account for these differences," he added.
The added coverage can make a huge difference in what consumers pay. The 25% of Part D beneficiaries without supplemental coverage paid, on average, $9,700 out of pocket for cancer therapies.
The White House's blueprint to lower drug prices includes moving more Medicare drugs into Part D, giving plan sponsors more power to negotiate with manufacturers. Trump's plan would also allow plans to adjust their formularies to address a price increase for a sole source generic drug.
Kane warned that any proposed shifts in high-cost drug therapies from Part B to Part D should be studied carefully, as costs would not be uniform for all patients.
The administration's drug pricing initiative is still in its early stages, and Kane said the White House has opportunities to work out the kinks.
"The White House has talked about possibly doing this as a demonstration program, which would shine a light on who's affected by these suggested shifts in coverage," he added.