{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T23:21:24Z","timestamp":1777764084878,"version":"3.51.4"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2019,3,1]]},"DOI":"10.1001\/jamainternmed.2018.6417","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T16:41:02Z","timestamp":1547484062000},"page":"374","source":"Crossref","is-referenced-by-count":19,"title":["Analysis of Proposed Medicare Part B to Part D Shift With Associated Changes in Total Spending and Patient Cost-Sharing for Prescription Drugs"],"prefix":"10.1001","volume":"179","author":[{"given":"Thomas J.","family":"Hwang","sequence":"first","affiliation":[{"name":"Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Jain","sequence":"additional","affiliation":[{"name":"Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie C.","family":"Lauffenburger","sequence":"additional","affiliation":[{"name":"Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerstin N.","family":"Vokinger","sequence":"additional","affiliation":[{"name":"Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"},{"name":"Faculty of Medicine, University of Z\u00fcrich and University Hospital Z\u00fcrich, Z\u00fcrich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron S.","family":"Kesselheim","sequence":"additional","affiliation":[{"name":"Program on Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"issue":"8","key":"ioi180109r11","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1001\/jamainternmed.2017.1885","article-title":"Association of prescription drug price rebates in Medicare Part D with patient out-of-pocket and federal spending.","volume":"177","author":"Dusetzina","year":"2017","journal-title":"JAMA Intern Med"},{"issue":"18","key":"ioi180109r24","first-page":"1","article-title":"Growing reinsurance payments weaken competitive bidding in Medicare Part D.","volume":"8","author":"Jung","year":"2018","journal-title":"Health Serv Res"},{"key":"ioi180109r25","article-title":"The case for restructuring the medicare prescription drug benefit","author":"Frakt","journal-title":"Health Serv Res"},{"issue":"7","key":"ioi180109r31","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1001\/jama.2017.8255","article-title":"Value-based pricing and state reform of prescription drug costs.","volume":"318","author":"Hwang","year":"2017","journal-title":"JAMA"},{"key":"ioi180109r1","unstructured":"Medicare Payment Advisory Commission. Databook: health care spending and the Medicare program. June 2018. http:\/\/www.medpac.gov\/docs\/default-source\/data-book\/jun18_databookentirereport_sec.pdf. Accessed November 1, 2018."},{"key":"ioi180109r2","unstructured":"US Centers for Medicare & Medicaid Services. 2018 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. https:\/\/www.cms.gov\/Research-Statistics-Data-and-Systems\/Statistics-Trends-and-Reports\/ReportsTrustFunds\/Downloads\/TR2018.pdf. Accessed November 1, 2018."},{"key":"ioi180109r3","unstructured":"US Department of Health and Human Services. American patients first: the Trump administration blueprint to lower drug prices and reduce out-of-pocket costs. https:\/\/www.hhs.gov\/sites\/default\/files\/AmericanPatientsFirst.pdf. Published May 2018. Accessed May 18, 2018."},{"key":"ioi180109r4","unstructured":"US Department of Health and Human Services. Fixing healthcare: driving value through smart purchasing and policy. https:\/\/www.hhs.gov\/about\/leadership\/secretary\/speeches\/2018-speeches\/fixing-healthcare-driving-value-through-smart-purchasing-and-policy.html. Published May 2018. Accessed May 18, 2018."},{"key":"ioi180109r5","unstructured":"US Department of Health and Human Services. HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. Federal Register, 2018. 83 FR 22692. https:\/\/www.federalregister.gov\/documents\/2018\/05\/16\/2018-10435\/hhs-blueprint-to-lower-drug-prices-and-reduce-out-of-pocket-costs. Accessed May 18, 2018."},{"key":"ioi180109r6","unstructured":"US Centers for Medicare & Medicaid Services. CMS Drug Spending: Medicare Part B. https:\/\/www.cms.gov\/Research-Statistics-Data-and-Systems\/Statistics-Trends-and-Reports\/Information-on-Prescription-Drugs\/index.html. Published May 2018. Accessed May 18, 2018."},{"key":"ioi180109r7","unstructured":"US Centers for Medicare & Medicaid Services. Medicare Prescription Drug Benefit Manual: Chapter 6: Part D Drugs and Formulary Requirements. https:\/\/www.cms.gov\/Medicare\/Prescription-Drug-Coverage\/PrescriptionDrugCovContra\/Downloads\/Part-D-Benefits-Manual-Chapter-6.pdf. Accessed May 18, 2018."},{"key":"ioi180109r8","unstructured":"US Department of Health and Human Services. Secretary Azar: remarks on drug pricing blueprint. November 1, 2018. https:\/\/www.hhs.gov\/about\/leadership\/secretary\/speeches\/2018-speeches\/remarks-on-drug-pricing-blueprint.html. Accessed May 18, 2018."},{"key":"ioi180109r9","unstructured":"US Food and Drug Administration. Drugs@FDA: FDA Approved Drug Products. https:\/\/www.accessdata.fda.gov\/scripts\/cder\/daf\/. Accessed November 1, 2018."},{"key":"ioi180109r10","unstructured":"US Centers for Medicare & Medicaid Services. 2018 ASP Drug Pricing Files: April 2018 Update. https:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Part-B-Drugs\/McrPartBDrugAvgSalesPrice\/2018ASPFiles.html. Published April 2018. Accessed November 1, 2018."},{"key":"ioi180109r12","unstructured":"US Centers for Medicare & Medicaid Services. Medicare Coverage Gap Discount Program Beginning in 2011: Revised Part D Sponsor Guidance and Responses to Summary Public Comments on the Draft Guidance. https:\/\/www.cms.gov\/Medicare\/Prescription-Drug-Coverage\/PrescriptionDrugCovContra\/Downloads\/2011CoverageGapDiscount_Revised-Guidance-052110.pdf. Published May 21, 2010. Accessed November 1, 2018."},{"key":"ioi180109r13","unstructured":"JohnsonNJ, MillsCM, KridgenM. Millman; America\u2019s Health Insurance Plans. Milliman. Prescription Drug Rebates and Part D Drug Costs: Analysis of historical Medicare Part D drug prices and manufacturer rebates. Published July 16, 2018. https:\/\/www.ahip.org\/wp-content\/uploads\/2018\/07\/AHIP-Part-D-Rebates-20180716.pdf. Accessed November 1, 2018."},{"key":"ioi180109r14","unstructured":"US Centers for Medicare & Medicaid Services. Advance Notice of Methodological Changes for Calendar Year (CY) 2006 Medicare Advantage (MA) Payment Rates. https:\/\/www.cms.gov\/Medicare\/Health-Plans\/MedicareAdvtgSpecRateStats\/Announcements-and-Documents-Items\/2006Advance.html. Published February 18, 2005. Accessed November 1, 2018."},{"key":"ioi180109r15","unstructured":"US Centers for Medicare & Medicaid Services. Medicare Part D: Direct and Indirect Remuneration (DIR). https:\/\/www.cms.gov\/newsroom\/fact-sheets\/medicare-part-d-direct-and-indirect-remuneration-dir. Published January 19, 2017. Accessed November 1, 2018."},{"key":"ioi180109r16","unstructured":"SSR Health LLC. US Prescription Brand Net Pricing Data. https:\/\/www.ssrhealth.com\/. Accessed November 1, 2018."},{"key":"ioi180109r17","unstructured":"US Centers for Medicare & Medicaid Services. Announcement of Calendar Year (CY) 2018 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter and Request for Information. https:\/\/www.cms.gov\/Medicare\/Health-Plans\/MedicareAdvtgSpecRateStats\/Downloads\/Announcement2018.pdf. Published April 2017. Accessed November 1, 2018."},{"key":"ioi180109r18","unstructured":"The Commonwealth Fund. Medicare Beneficiaries' High Out-of-Pocket Costs: Cost Burdens by Income and Health Status. https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2017\/may\/medicare-beneficiaries-high-out-pocket-costs-cost-burdens-income. Published May 12, 2017. Accessed November 1, 2018."},{"key":"ioi180109r19","unstructured":"US Centers for Medicare & Medicaid Services. 2018 Resource and Cost-Sharing Limits for Low-Income Subsidy (LIS). https:\/\/www.medicaid.gov\/state-resource-center\/state-operations-and-technical-assistance\/downloads\/sota-update-20171213.pdf. Published November 2017. Accessed November 1, 2018."},{"key":"ioi180109r20","unstructured":"America\u2019s Health Insurance Plans (AHIP). State of Medigap 2018. https:\/\/www.ahip.org\/wp-content\/uploads\/2018\/06\/State_of_Medigap18_FINAL.pdf. Accessed November 1, 2018."},{"key":"ioi180109r21","unstructured":"National Association of Insurance Commissioners. 2016 Medicare Supplement Insurance Experience Reports. https:\/\/www.naic.org\/prod_serv_alpha_listing.htm#medsupp_loss. Published September 12, 2017. Accessed November 1, 2018."},{"key":"ioi180109r22","unstructured":"US Centers for Medicare and Medicaid Services. Medicare Program; International Pricing Index Model for Medicare Part B Drugs. CMS-5528-ANPRM. https:\/\/www.federalregister.gov\/documents\/2018\/10\/30\/2018-23688\/medicare-program-international-pricing-index-model-for-medicare-part-b-drugs. Published October 30, 2018. Accessed November 1, 2018."},{"key":"ioi180109r23","unstructured":"Office of Inspector General. High-price drugs are increasing federal payments for Medicare Part D catastrophic coverage. OIG, 2017. https:\/\/oig.hhs.gov\/oei\/reports\/oei-02-16-00270.pdf. Accessed November 1, 2018."},{"key":"ioi180109r26","unstructured":"US Centers for Medicare & Medicaid Services. Prior Authorization and Step Therapy for Part B Drugs in Medicare Advantage. https:\/\/www.cms.gov\/Medicare\/Health-Plans\/HealthPlansGenInfo\/Downloads\/MA_Step_Therapy_HPMS_Memo_8_7_2018.pdf. Published August 7, 2018. Accessed November 1, 2018."},{"key":"ioi180109r27","unstructured":"US Department of Health and Human Services. Trump Administration gives Medicare new tools to negotiate lower drug prices for patients. https:\/\/www.hhs.gov\/about\/news\/2018\/08\/07\/trump-administration-gives-medicare-new-tools-to-negotiate-lower-drug-prices-for-patients.html. Published August 7, 2018. Accessed November 1, 2018."},{"key":"ioi180109r28","unstructured":"RoehrigC; Altarum. The impact of prescription drug rebates on health plans and consumers. Published April 2018. https:\/\/altarum.org\/sites\/default\/files\/Altarum-Prescription-Drug-Rebate-Report_April-2018.pdf. Accessed November 1, 2018."},{"key":"ioi180109r29","unstructured":"Congressional Budget Office. Proposals Affecting Medicare\u2014CBO\u2019s Estimate of the President\u2019s Fiscal Year 2019 Budget. https:\/\/www.cbo.gov\/publication\/53906. Published June 5, 2018. Accessed November 1, 2018."},{"key":"ioi180109r30","unstructured":"White House Office of Management and Budget. An American Budget\u2014President\u2019s Budget FY 2019. https:\/\/www.whitehouse.gov\/wp-content\/uploads\/2018\/02\/budget-fy2019.pdf. Accessed November 1, 2018."},{"key":"ioi180109r32","unstructured":"Medicare Payment Advisory Commission. June 2016 Report to the Congress: Medicine and the Health Care Delivery System. http:\/\/www.medpac.gov\/docs\/default-source\/reports\/chapter-6-improving-medicare-part-d-june-2016-report-.pdf. Published June 15, 2016. Accessed November 1, 2018."}],"container-title":["JAMA Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/\/jamainternalmedicine\/article-pdf\/179\/3\/374\/17346475\/jamainternal_hwang_2019_oi_180109.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T16:08:30Z","timestamp":1551715710000},"score":1,"resource":{"primary":{"URL":"http:\/\/archinte.jamanetwork.com\/article.aspx?doi=10.1001\/jamainternmed.2018.6417"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,1]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,3,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamainternmed.2018.6417","relation":{},"ISSN":["2168-6106"],"issn-type":[{"value":"2168-6106","type":"print"}],"subject":[],"published":{"date-parts":[[2019,3,1]]}}}