PhRMA eyes push for broader use of Part D approach

Lawmakers promising to cut government healthcare programs are about to hear an alternative message from Big Pharma. The Pharmaceutical Research and Manufacturers of America trade group has a new legislative agenda calling for a Medicare Part D-esque drug benefit for other government-funded programs.

As Bloomberg reports, PhRMA documents shows that the group advocates a Part D approach to drug coverage. The program allows Medicare recipients to choose drug coverage from among a set of private insurance plans that operate according to federal rules. Prices are discounted, but not as much as the prices paid by Medicaid. Under that program, drugmakers have to pay rebates based on the lowest prices they offer all U.S. customers.

PhRMA is also considering a push for more access to prescription drugs through the state health exchanges established under President Obama's healthcare reform, the documents show. "This position is grounded in the experience demonstrating that the principal alternative, centralized government decisions about the value of medicines, is nearly always used to restrict rather than improve access to medicines and should be avoided," the documents said (as quoted by Bloomberg).

The Part D benefit specifically excludes the sort of price negotiation and controls that other governments use to push drug costs downward. It also mandates coverage for all drugs in 6 "protected classes," rather than allowing coverage to be limited to certain preferred--and often cheaper--products. As Bloomberg notes, private insurers may not be in favor of a Part D approach to drug benefits under the state exchanges, because they may be able to save more money under different rules.

- read the Bloomberg story