SHIBA News Flash -- Feb. 9, 2024

SHIBA News Flash
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Rx drug Paxlovid to appear on Medicare Plan Finder

The Centers for Medicare & Medicaid Services (CMS) announced that starting Monday, Feb. 12, 2024, the prescription drug Paxlovid will be available to add as a drug when comparing plan drug costs on the Medicare Plan Finder. Additionally, the following footnote will be applied to Paxlovid when it appears on the Drug Coverage section of the Medicare Plan Finder plan details webpage:

“This Medicare drug plan may offer Paxlovid for $0 through a patient assistance program. Contact the plan to find out if it’s participating in the program. What if the plan doesn’t participate?

When a user clicks on the “What if the plan doesn’t participate?” link, the following text will appear:

“You can still get Paxlovid for free, but you'll need to enroll in Pfizer's patient assistance program. If you get Paxlovid without enrolling in the program, you'll have to pay some of the costs.”

When clicking on the “patient assistance program” link, the user will be directed to the Paxlovid website.  

Medicare makes improvements to the Plan Finder

Medicare made improvements the Medicare Plan Finder late last week based on user feedback.

Pain point: Users who wanted to identify which drugs were not covered struggled to find that information within the Plan Details page.

Aside from showing the full price of a drug, the plan details page used a footnote to communicate that a drug wasn't covered. However, some users missed this footnote.

Solution: 

1. Added a “View drug coverage” jump link that takes users immediately to the "Yearly drug costs by pharmacy" section under "Drug Coverage."

2. Added a “Not Covered” label to identify non-covered drugs to the "Yearly drug costs by pharmacy" listing.

3. Added the same "Not covered" label to the drugs listed under individual pharmacies.