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Specialty drugs often offer medical advances, but high out-of-pockets costs may impede access. This is particularly true with Medicare Part D, as CMS allows plans to place drugs costing ≥$600/month on “specialty tiers” and virtually all plans using tiered benefit structures have created such tiers.
Medicare Part D beneficiaries who do not qualify for low-income subsidies (LIS) face high and variable cost sharing for specialty drugs during the calendar year. We examined the magnitude of Part D cost sharing and out-of-pocket (OOP) cost patterns among non-LIS specialty drug users.
As a journalist, you can create a free Muck Rack account to customize your profile, list your contact preferences, and upload a portfolio of your best work.