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AAM applauds CMS for requiring health plans to place generic drugs on tiers

The organization publicly commends the administration’s efforts to standardize plan choice by requiring generic drugs be placed on generic tiers and brand-name drugs on brand-name tiers.
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The Association for Accessible Medicines is commending the Centers for Medicare & Medicaid Services for several of the recommended provisions outlined in the proposed Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2024.

In particular, AAM publicly commends the administration’s efforts to standardize plan choice by requiring generic drugs be placed on generic tiers and brand-name drugs on brand-name tiers.

[Read more: AAM reacts to Avalere study on generic drug costs]

The organization stated that because new, lower-cost generics and biosimilars also face coverage challenges as a result of the perverse incentives of brand drug rebates, it further recommends that CMS and HHS take steps to ensure timely patient access to new generic and biosimilar medicines by standardizing an option for a generic and biosimilar specialty tier.

“In spite of the lower prices of generics and biosimilars, plan design too often does not optimize their use. And when this occurs, patients are forced to pay more than necessary,” said David Gaugh, interim CEO at AAM. “We look forward to working with the CMS to ensure that patients have access to and realize the full value of lower cost generic and biosimilar medicines.”

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