AMCP: Proposed Part D Changes Could Undermine Program

Overdue Change in Protected Classes Overshadowed by Parts Impacting Cost and Access for Beneficiaries 

For Immediate Release

Alexandria, Va., January 30, 2014 — The Academy of Managed Care Pharmacy (AMCP) today released the following statement by CEO Edith A. Rosato, RPh, IOM commenting on CMS' recently released draft rule on proposed changes to the Medicare Part D program, as follows:
"At a time when increasing access to and affordability of health care is a national imperative, the Centers for Medicare and Medicaid Services'Medicare Part D proposed rule for 2015 would seem to be going in the opposite direction." 
"The Academy is greatly concerned that all but one of the proposed changes would roll back CMS' recent progress in reducing costs for program administration and increasing beneficiary access to affordable medications. These provisions would end preferred networks, limit access to cost-saving mail order pharmacy, and expand Part D's medication therapy management program." 
"AMCP is concerned that these changes would increase costs to the program and beneficiaries – the latter primarily by limiting their access to affordable Part D plans. For 2014 more than 75 percent of Medicare beneficiaries have chosen cost-effective Part D plans with preferred networks. Expanding access to prescription drugs at affordable prices should continue to be CMS' goal – reforms should advance access and affordability, not reverse it. Moreover, expanding Part D's MTM program, already underfunded, is unwise without providing additional resources to ensure robust benefits for patients." 
"There's a silver lining in CMS' proposed rule. We support its scaling back requirements for medications in three of the six protected classes: antidepressant, antipsychotic, and immunosuppressive medications. When Congress "protects" a class of medicine from competition, plans have almost no room to negotiate price. We commend CMS for explicitly recognizing the positive role that pharmacy and therapeutics committees play in selecting safe and effective medications for formularies; indeed, the P&T committee process seeks to optimize medication utilization while ensuring affordability and robust formularies. In these classes, we commend CMS for allowing P&T committees to do what they do best: develop robust formularies that offer patients access to appropriate and affordable medicines." 
"CMS should stay the course and scale back the number of protected classes further. However, regarding changes to preferred networks, mail-order pharmacy and MTM in Part D, we urge CMS to make a swift, but sure course correction." 
About AMCP  
The Academy of Managed Care Pharmacy is a national professional association of pharmacists and other health care practitioners who serve society by the application of sound medication management principles and strategies to improve health care for all. The Academy's nearly 7,000 members develop and provide a diversified range of clinical, educational and business management services and strategies on behalf of the more than 200 million Americans covered by a managed care pharmacy benefit. More news and information about the Academy can be found at
For more information, please contact:
Kevin Bruns | 703-683-8416 ext. 656