The EACH/PIC Coalition submitted comments to CMS on the 15 drugs selected for the Medicare Negotiation Program for IPAY 2027. The comments provided input on evaluating therapeutic alternatives, protecting patient access to medications, and ensuring CMS addresses patient-reported obstacles to care.
The comments stated:
“Substituting or requiring patients to change drugs based on cost considerations instead of medical needs can disrupt continuity of care and result in complications and higher overall medical costs. We urge CMS to seriously consider the unique circumstances faced by these patients and work diligently to ensure that access to all treatments is protected.”
“[W]e are concerned that the Medicare Drug Price Negotiation Program (MDPNP) is not the most effective way to lower patient costs and could ultimately cause harm by creating added barriers between patients and their medically necessary treatment. … the MDPNP could create a new incentive structure for payers that could compromise patient access to the selected medications due to increased utilization management or reshuffling of formularies.”
“Although well-intentioned, MDPNP fails to address many of the underlying causes and complicated factors that result in higher prescription drug costs for patients. Therefore, we urge regulators to focus their time on identifying and addressing patient-reported obstacles to drug affordability. Failing to resolve the underlying factors that lead to higher costs for patients can result in short-term relief and uneven benefits – aiding some but potentially leaving others with higher costs and drug accessibility challenges.”