Under the Bipartisan Budget Act (BBA) of 2018, the closure of the donut hole for brand medications was accelerated from 2020 to 2019. This acceleration was accomplished by decreasing the member cost-sharing from the ACA established amount of 30% to 25%. In addition, the BBA increased the manufacturers liability from 50% to 70%, resulting in a plan liability of 5% (down from 25% in the ACA). Oliver Wyman's healthcare actuaries recently analyzed the financial impact of shifting 7% of the manufacturer costs for brand drugs in the donut hole to health plans (plan liability going from 5% to 12% and manufacturer liability going from 70% to 63%). The following report summarizes our analysis and findings.
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OUR EXPERTISE
Industries
- Aviation, Aerospace & Defense
- Distribution & Wholesale
- Energy
- Surface Transportation
- Travel & Leisure
- Business Services
- Automotive
- Communications, Media, And Technology
- Education
- Energy And Natural Resources
- Financial Services
- Health And Life Sciences
- Industrial Products
- Private Equity And Principal Investors
- Public Sector And Policy
- Retail And Consumer Goods
- Transportation
- Velocity Podcast
capabilities
- Business & Organization Transformation
- Corporate Finance & Restructuring
- Oliver Wyman Labs
- Sustainability Center
- Actuarial
- Climate And Sustainability
- Digital
- Lippincott: Brand and Innovation
- Oliver Wyman Engineers
- Operations
- Organizational Effectiveness
- Payments
- Pricing, Sales, And Marketing
- Risk Management
- Strategy
- Turnaround And Restructuring
- People And Organizational Performance
- Performance Transformation