An Obama administration proposal to reduce Medicare payments for many prescription drugs has run into sharp bipartisan criticism, suggesting that it is easier to diagnose the problem of high prices than to solve it.
Patients’ advocates have joined doctors and drug companies in warning that the federal plan could jeopardize access to important medications. Every member of the Senate Finance Committee — 14 Republicans and 12 Democrats — and more than 300 House members have expressed concern.
The first phase of the new “payment model” could begin as early Aug. 1. In the second phase, which could start as soon as January 2017, Medicare would link payment to a drug’s value. The government might, for example, pay more for drugs that it deemed more effective in treating or preventing a particular condition. Or it might pay the same amount for drugs that it judged to be “therapeutically similar.” These drugs — to treat various types of cancer, rheumatoid arthritis,macular degeneration and other conditions — are typically administered in doctors’ offices or hospital clinics. They include drug products that are made from human or animal cells, as well as treatments that mobilize the body’s immune system to fight cancer and other diseases.
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