An “unintended consequence” of the Affordable Care Act may mean that Medicare Part D beneficiaries will pay more for biosimilars than for costlier brand-name biologics, according to a new analysis released last week.
The reason is that the law requires drug makers to provide 50 percent discounts for brand-name biologics when beneficiaries reach the so-called donut hole, or coverage gap in which there is a temporary limit on what Medicare Part D will pay for drugs. However, the law does not require companies to provide discounts for biosimilars, which are lower-cost and nearly identical versions.
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