The Trump administration has proposed that insurance plans providing drug coverage to Medicare beneficiaries will no longer be forced to cover six hitherto “protected” drug classes. The classes—which include drugs for psychiatric conditions, cancer and immune diseases—are among the priciest of all drugs and account for as much as 33 percent of total outpatient drug spending under Part D of Medicare.
Under the proposal, Medicare plans could “exclude from their formularies protected class drugs with price increases that are greater than inflation, as well as certain new drug formulations that are not a significant innovation over the original product,” says Seema Verma, the administrator of the Centers for Medicare and Medicaid Services.
