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1. News
MEDICARE ANNOUNCES FIRST 10 DRUGS FOR PRICE NEGOTIATION: IS YOUR PRESCRIPTION ON
THE LIST?
* Updated: Aug. 29, 2023, 2:01 p.m.|
* Published: Aug. 29, 2023, 9:09 a.m.
FILE - Pharmaceuticals are seen in North Andover, Mass., June 15, 2018. Workers
and families with private health insurance would reap savings on prescription
drugs from a little-noticed provision in President Joe Biden's sweeping social
agenda bill. Drug companies would have to pay rebates to Medicare if they
increase prices above the rate of inflation. Business groups are paying close
attention, and the issue has divided them in a fierce lobbying battle. (AP
Photo/Elise Amendola, File)AP
By
* Sabrina Eaton, cleveland.com
WASHINGTON, D. C. - Drugs for diabetes, arthritis, heart failure and blood
cancer are among the first 10 medications for which Medicare will negotiate
prices to lower health care costs for its beneficiaries.
A statement from President Joe Biden said the drugs selected for price
negotiation are among the most common and costly prescriptions for seniors on
Medicare Part D. He said the drug price negotiations were made legal by the
Inflation Reduction Act, a measure championed by Democrats that Biden has turned
into a centerpiece of his re-election campaign.
“For far too long, Americans have paid more for prescription drugs than any
major economy,” said Biden. “And while the pharmaceutical industry makes record
profits, millions of Americans are forced to choose between paying for
medications they need to live or paying for food, rent, and other basic
necessities. Those days are ending.”
Negotiations for the first group of selected drugs will begin in 2023, with
negotiated prices going into effect in 2026. The initial drugs whose prices will
be negotiated are:
· Eliquis, used by 3.7 million Medicare enrollees, including 155,000 Ohioans, to
prevent and treat blood clots. The average Part D covered prescription drug
costs per enrollee for this drug is $4,448 per year.
· Jardiance, used by 1.6 million Medicare enrollees, including 47,000 Ohioans,
to treat diabetes and heart failure. The average Part D covered prescription
drug costs per enrollee for this drug is $4,487 per year.
· Xarelto, used by 1.3 million Medicare enrollees, including 57,000 Ohioans, to
prevent and treat blood clots and reduce risks for patients with coronary or
peripheral artery disease. The average Part D covered prescription drug costs
per enrollee for this drug is $4,511 per year.
· Januvia, used by 869,000 Medicare enrollees, including 39,000 Ohioans, to
treat diabetes. The average Part D covered prescription drug costs per enrollee
for this drug is $4,703 per year.
· Farxiga, used by 799,000 Medicare enrollees, including 27,000 Ohioans, to
treat diabetes, heart failure and chronic kidney disease. The average Part D
covered prescription drug costs per enrollee for this drug is $4,091 per year.
* Entresto, used by 587,000 Medicare enrollees, including 21,000 Ohioans, to
treat heart failure. The average Part D covered prescription drug costs per
enrollee for this drug is $4,915 per year.
· Enbrel, used by 48,000 Medicare enrollees, including 1,000 Ohioans, to treat
rheumatoid arthritis, psoriasis and psoriatic arthritis. The average Part D
covered prescription drug costs per enrollee for this drug is $58,148 per year.
· Imbruvica, used by 20,000 Medicare enrollees, including 1,000 Ohioans, to
treat blood cancers. The average Part D covered prescription drug costs per
enrollee for this drug is $133,178 per year.
· Stelara, used by 22,000 Medicare enrollees, including 1,000 Ohioans, to treat
psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis. The average
Part D covered prescription drug costs per enrollee for this drug $119,951 per
year.
· Fiasp; Fiasp FlexTouch; Fiasp PenFill;NovoLog; NovoLog FlexPen; NovoLog
PenFil, used by 777,000 Medicare enrollees, including 33,000 Ohioans, to treat
diabetes. The average Part D covered prescription drug costs per enrollee for
this drug is $3,316 per year.
White House officials said the ten drugs selected are among those with highest
total spending in Medicare Part D, accounting for roughly $50 billion between
June 1, 2022 and May 31, 2023.
Biden’s statement said that when implemented, prices on the negotiated drugs
will decrease for up to 9 million seniors who currently pay up to $6,497 in
out-of-pocket costs per year for the prescriptions. It said the nonpartisan
Congressional Budget Office estimates this will save taxpayers $160 billion by
reducing how much Medicare pays for drugs through negotiation and inflation
rebates.
Over the next 4 years, Medicare will negotiate prices for up to 60 drugs covered
under Medicare Part D and Part B, and up to an additional 20 drugs every year
after that.
Biden noted that pharmaceutical companies who oppose the legislation have filed
8 lawsuits against his administration, but said he won’t “back down.”
“There is no reason why Americans should be forced to pay more than any
developed nation for life-saving prescriptions just to pad Big Pharma’s
pockets,” Biden continued. “For many Americans, the cost of one drug is the
difference between life and death, dignity and dependence, hope and fear. That
is why we will continue the fight to lower healthcare costs – and we will not
stop until we finish the job.”
The Department of Health and Human Services noted that people with Medicare are
already saving an average of $70 in out-of-pocket costs on vaccines like
shingles and Tdap because the Inflation Reduction Act made recommended vaccines
free for beneficiaries starting this past January. The legislation also capped
insulin costs at $35 per month for nearly 4 million seniors and others on
Medicare.
A group of Republican committee chairs in the U.S. House of Representatives
released a statement that said the price negotiation program will “impose
price-controls set by Washington bureaucrats” and described it as “an
unworkable, legally dubious scheme that will lead to higher prices for new drugs
coming to market, stifle the development of new cures, and destroy jobs.”
“While the President gleefully celebrates announcing the first ten drugs forced
into his socialist price setting scheme, Americans are already seeing fewer
potentially lifesaving cures and treatments,” said House Energy and Commerce
Committee Chair Cathy McMorris Rodgers of Washington.
U.S. Sen. Sherrod Brown, a Cleveland Democrat who led efforts to let Medicare
negotiate directly with pharmaceutical companies, applauded release of the drug
list.
“Big Pharma fought us every step of the way, but today we’re finally taking a
major step forward in lowering prescription drug costs for Ohioans and making
sure that older Ohioans can both afford their lifesaving medications and keep
more of their hard-earned money for retirement,” said a statement from Brown.
U.S. Rep. Emilia Sykes, an Akron Democrat, released a statement that said
letting Medicare negotiate the prices of these 10 prescription drugs will result
in lower health care costs for the approximately 95,440 Medicare beneficiaries
her congressional district.
“Allowing Medicare to negotiate prescription drug prices cracks down on
corporate greed and ensures seniors aren’t forced to choose between putting food
on the table or buying life-saving drugs,” Sykes’ statement said. “Equitable
access to life-saving medications is critical to improving our healthcare
systems.”
A statement from Max Richtman, President and CEO of the National Committee to
Preserve Social Security and Medicare, said his group fought for around 20 years
for Medicare to be empowered to negotiate drug prices with manufacturers. He
noted that the Inflation Reduction Act also put a $2,000 out-of-pocket cap for
patients’ Medicare Part D drug costs and penalties for drug-makers who hike
prices above the rate of inflation.
“This is a sea change in the government’s ability to lower prescription drug
prices for older Americans, who all too often are compelled to ration
medications or forgo filling prescriptions because of soaring costs.,” said
Richtman. “The next step is to enlarge the number and type of medications
subject to negotiation, to deliver maximum relief to seniors on fixed incomes.
No one should have to choose between groceries, rent, or essential medications
--- especially our nation’s senior citizens.”
Sabrina Eaton writes about the federal government and politics in Washington,
D.C., for cleveland.com and The Plain Dealer.
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