According to the GAO report, Senate Finance Committee Chairman Max Baucus (D-Mont.) and Reps. Henry Waxman (D-Calif.), Sandy Levin (D-Mich.) and John Dingell (D-Mich.) had concerns that manufacturers participating in the program “would raise prices for brand-name drugs used by beneficiaries in the coverage gap more rapidly than for other drugs to offset the 50% discount that manufacturers are required to give these drugs.”
The federal audit's findings showed that prices for brand-name drugs used by Medicare Part D beneficiaries in the doughnut hole increased at a similar rate to those used by beneficiaries who did not reach the coverage gap. Before the program was implemented, the median price for the basket of 77 brand-name drugs used by beneficiaries in the doughnut hole rose by about 36.2% from January 2007 through December 2010, and by about 35.2% for those beneficiaries who did not reach the gap.
During the first year of the Patient Protection and Affordable Care Act's drug discount program (December 2010 through December 2011), the median prices for the two baskets of drugs increased equally at a rate of about 13%.
GAO auditors also found that most drug plan sponsors and pharmacy benefit managers reported that the drug discount program did not affect Medicare Part D plan formularies, plan benefit designs and drug utilization management practices. And they noted that the CMS checks prescription drug data to ensure that plan sponsors provide accurate discounts to beneficiaries.
“President Obama's healthcare reform law improved Medicare by immediately providing seniors with 50% discounts in the part D drug donut hole, saving five million seniors more than $4 billion to date,” Waxman, ranking member on the House Energy and Commerce Committee, said in a news release. “Today's GAO report confirms that the program is working exactly as intended and is helping to cut seniors' drug costs. That's why I'll continue to fight Republican efforts to overturn the law.”
