CMS Unveils Preliminary List of 101 Generic Drugs for Medicare $2 Out-of-Pocket Plan

Preliminary Drug List:
The Centers for Medicare & Medicaid Services (CMS) has released a preliminary list of 101 generic drugs for the Medicare $2 Drug List Model, aiming to cap out-of-pocket costs at $2 per month for select medications.

Model Purpose:
The model aims to improve medication adherence, health outcomes, and satisfaction among Medicare Part D beneficiaries by standardizing cost-sharing for low-cost generics.

Common Conditions:
The drugs on the list target common conditions such as high cholesterol, high blood pressure, diabetes, and other chronic diseases.

Development Process:
The Innovation Center developed the list using various data sources and a clinically driven process, incorporating feedback from external technical expert panels.

Voluntary Participation:
Participation in the model is voluntary for Part D sponsors and could start as early as January 2027, pending further development.

Potential Impact:
Research suggests that this model could modestly lower out-of-pocket spending for many Medicare beneficiaries, with 38.3% potentially saving money with a $2 per month limit on these drugs.

Public Comment Period:
The CMS is seeking input through a Request for Information (RFI) until December 9, 2024, to further develop the model.