A Government Accountability Office review found generally lower initial prescription payments at insurer-owned Medicare Part D pharmacies but lacked the data to determine whether those payments remained lower after later fees and adjustments. APCI’s October Insights Snapshot, by Greg Reybold and Cathy Hanna, examines why that gap limits what policymakers can conclude about pharmacy savings.
“Gross, Not Net: Why GAO’s 30-Month Part D Audit Couldn’t Determine What Drugs Actually Cost” argues that audits must account for what pharmacies ultimately receive before drawing conclusions about savings. Read the Snapshot for APCI’s assessment and its recommendations for more comprehensive audits.