Trump Plan to Lower Drug Prices Could Increase Costs for Some Patients

“President Trump has called on us to merge Medicare Part B into Part D, where negotiation has been so successful on so many drugs,” said Alex M. Azar II, the secretary of health and human services.

Dr. Steven B. Miller, the chief medical officer of Express Scripts, one of the nation’s largest pharmacy benefit managers, said he was confident that his company could save money for beneficiaries and the government if it could manage drugs now covered by Part B of Medicare.

“Part D has been under budget every year, and member satisfaction is extraordinarily high,” Dr. Miller said. “It’s a very successful program. That’s why people are excited about moving drugs into Part D.”

Doctors, however, have doubts that shifting drugs from Part B to Part D of Medicare would bring the promised savings.

“If I were a policymaker, I might think it was a good idea,” said Dr. Jeffery C. Ward, an oncologist at the Swedish Cancer Institute in Edmonds, Wash. “But as a physician, I’m convinced that it could be a disaster if done wrong. I’m not convinced that switching those drugs will save the government any money. I don’t think the Part D plans can dicker a better price than the average sales price” now used as a basis for payment in Part B.

Andrea J. Zlatkus, the practice manager for a group of rheumatologists in West Chester, Pa., was also skeptical. “The prices of Part D drugs have increased over the years at a much faster rate than the prices of Part B drugs that we use for treatment of our patients,” she said.

Cancer drugs are one of six “protected classes” of drugs in Part D of Medicare. Prescription drug insurance plans must cover “all or substantially all” of these drugs.

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