CMS will allow Medicare Advantage plans to require that patients try low-cost generics before stepping up to more expensive therapies. Late Tuesday, the CMS announced that Medicare Advantage (MA) plans can now impose step therapy on Part B drugs. Step therapy allows a plan to determine whether patients should first get a low-cost generic and then work their way up to a more costly product if the initial treatment is ineffective. MA plans already have this authority for Part D drugs, which are drugs provided at pharmacies. This latest move allows prior authorization for drugs administered in doctors’ offices. Officials at CMS said step therapy could lower drug costs by incentivizing drugmakers to have the least expensive drugs available as the first option. Last year, MA plans spent $11.9 billion on Part B drugs. (Virgil Dickson, Modern Healthcare)
