by Kim Lyons, Pennsylvania Capital-Star
August 17, 2024
The Centers of Medicare and Medicaid Services announced this week it had completed negotiations with drug companies to reduce prices on 10 widely used prescription drugs, and. Pennsylvanians are lauding the news.
(Getty Images)
“This is a big deal, and it is generating lower costs all across the board,” Mike Crossey, president of nonprofit advocacy organization Pennsylvania Alliance for Retired Americans said Friday. “This is real money going back into patients’ pockets and taking some of the stress off of their shoulders.”
The prescription drug negotiations are a result of the 2022 Inflation Reduction Act, a massive spending package that contained measures to reduce prescription drug prices among other initiatives.
“Kamala and I both get it. We know it’s about your dignity,” President Joe Biden said at an event Thursday in Maryland with Vice President Kamala Harris. “It’s about your peace of mind. It’s about taking care of your family. It’s about giving folks just a little more breathing room.”
About 9 million enrollees in Medicare’s Part D prescription drug coverage program spent $3.4 billion out of pocket in 2022 on the 10 drugs selected for negotiation, according to a report released in August 2023 by the U.S. Department of Health and Human Services.
The ten drugs are Eliquis, Enbrel, Entresto, Farxiga, Imbruvica, Januvia, Jardiance, multiple Fiasp and NovoLog insulin products, Stelara, and Xarelto.
According to the Centers for Medicare and Medicaid Services, the lowest price reduction was 38% on blood cancer drug Imbruvica. The rest of the drugs on the list will all see price reductions above 50%, with diabetes drug Januvia reduced by 79%.
The lower prices are scheduled to take effect in 2026 and will save the government an estimated $6 billion, according to the White House. They will also save patients about $1.5 billion in out-of-pocket expenses.
Biden, Harris talk Medicare prescription drug savings in Maryland
“Under Donald Trump’s America, Big Pharma executives got rich while seniors faced an impossible choice: buy groceries or the meds they need, make rent or pay for insulin. These are impossible choices that no one in America should have to make,” said state Rep. Jessica Benham (D-Allegheny).
Benham’s legislation to rein in pharmacy middlemen known as pharmacy benefit managers (PBMs), was signed into law by Gov. Josh Shapiro in July. PBMs are hired by insurance companies to administer the prescription drug side of health plans and negotiate drug prices with manufacturers. “I can’t wait to have vice president Kamala Harris as a partner in this work come January 2025,” Benham said Friday.
U.S. Sen Bob Casey (D-Pa.) called the Centers for Medicare and Medicaid Services announcement “a huge relief” for people who rely on the often life-saving medications.
“For far too long, prescription drug costs have hung like a bag of rocks tied around the necks of millions of Americans, weighing them down every single day,” Casey said in a statement, which “shows just how significant the savings will be as Medicare plans to engage in price negotiations on more and more drugs in the coming years.”
The Inflation Reduction Act also made common adult vaccines, including shingles and TDAP, free for certain Medicare enrollees. Monthly insulin costs for Medicare enrollees were also reduced to $35 for Part D beneficiaries as part of the IRA, and beginning in 2025, annual out-of-pocket prescription drug costs will be capped at $2,000.
Casey introduced a bill in July that would cap out-of-pocket drug costs for people on commercial health insurance plans as well, expanding the provision in the IRA that put a limit on cost-sharing for prescription drugs for Medicare recipients.
The Capping Prescription Costs Act would cap individual cost-sharing for prescription drugs to $2,000 annually and cap family cost-sharing for prescription drugs to $4,000 annually. The caps would apply to both group health plans and Affordable Care Act marketplace health plans.
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