New study finds insurers and PBMs increasing access restrictions in Medicare Part D

17 April 2024

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Medicare beneficiaries in the USA are facing greater access restrictions on their lifesaving medicines, according to a study by the Schaeffer Center at the University of Southern California recently published in Health Affairs, which was highlighted on a web posting by trade group Pharmaceutical Research and Manufacturers of America (PhRMA).

Looking at the Medicare Part D prescription drug benefit program, researchers found that health plans and pharmacy benefit managers (PBMs) are imposing more utilization management restrictions on prescription medicines or excluding the medicines from their formularies altogether.

Key findings:

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