A Patient-Centered Approach to Medicare Drug Reform

Dr. A Mark Fendrick, V-BID Center Director



The Trump administration has recently proposed a number of sweeping changes to the Medicare program to curb taxpayer spending on prescription drugs. These include price setting, revamping how doctors and hospitals acquire drugs, and changing how physicians are reimbursed for medicines.

The changes apply to “Part B,” the component of Medicare that covers medicines administered in a health-care facility, like gene therapies and advanced treatments for cancer, arthritis, and multiple sclerosis. Today, physicians purchase these medications directly.

Each of the suggested reforms are blunt instruments that focus exclusively on drug prices without fully accounting for clinical value. These changes may reduce short-term expenditures, but will likely restrict access to the lifesaving medications that many seniors rely on. These policies also miss the critical clinical point that in certain patient scenarios, lower-cost drugs are ineffective, potentially harmful, and economically wasteful, while in others, the more precise use of higher cost medications can lead to healthier patients and better financial outcomes…

Full Op-Ed from RealClear Policy


Read more about value-based insurance design in Medicare:

Medicare Advantage 1-Pager     Medicare Advantage White Paper     Medicare Advantage Infographic

Medicare Advantage Summary     V-BID Medicare Advantage Brief     History of V-BID in Medicare Timeline