Kos Pharmaceuticals (acquired by Abbott in 2007)

Making a Case for Coverage under Part D

 
Deciphering Medicare Part D drug benefits is no easy task.  Part D confuses just about everyone it touches:  from policy makers, physicians and patients to pharma and managed care companies.

At the end of 2005, the Centers for Medicare and Medicaid Services (CMS) cleared managed-care plans to add Kos Pharmaceuticals’ Niaspan® (extended-release nicotinic acid) to their Part D formularies.  This was good news.  It meant that seniors would have access to medication that could safely, effectively raise their HDL (good) cholesterol by 14% to 32%.  

Then came the bad news.  Mistakenly classifying Niaspan as a vitamin, regulators subsequently decided to reverse themselves and drop the coverage.

Makovsky led two lobbying firms and our client’s legal advisors to victory in the battle to make Niaspan available to all Medicare beneficiaries under Part D basic—increasing sales of the medication 24%.