The cost of prescription drugs in the US is very high. In fact, a 2021 research report compiled by the RAND Corporation stated that drug costs in the US are 256% higher than in 32 comparable countries.
Fortunately, Medicare beneficiaries may soon have more affordable access to popular-but-expensive drugs as a result of the Inflation Reduction Act of 2022. On August 29, 2023, the US Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced that, for the first time, Medicare will begin negotiating prices for certain drugs directly with participating drug providers. Could companies. The deals, which are due to take place in 2023 and 2024, are expected to lower the prices of a range of life-saving drugs for Medicare beneficiaries. The new drug prices will eventually take effect in 2026.
According to HHS and CMS, the first 10 drugs for price negotiation include:
- Eliquis (for treating and preventing blood clots)
- Jardines (for diabetes and heart failure)
- Xarelto (for treating and preventing blood clots)
- Januvia (for diabetes)
- Farxiga (for diabetes, heart failure, and kidney disease)
- Entresto (for heart failure)
- Enbrel (for rheumatoid arthritis, psoriasis, and psoriatic arthritis)
- Imbruvica (for blood cancer)
- Stelara (for psoriasis, Crohn’s disease, and ulcerative colitis)
- Fiasp, Fiasp FlexTouch, Fiasp Penfill, Novolog, Novolog FlexPen and Novolog Penfill (for diabetes)
According to HHS, from June 2022 to May 2023, Medicare beneficiaries paid $3.4 billion out of pocket for these 10 drugs, which are now subject to price negotiation. During that same time frame, more than 8.2 million people enrolled in Medicare Part D coverage relied on these drugs to treat a range of conditions, many of which are life-threatening.
Medicare Drug Price Negotiation Program: What’s Next?
CMS says meetings with drug companies will begin in late 2023 to establish a “maximum fair price” for each drug. Each company will get no more than three meetings before the talks end on August 1, 2024. According to HHS, the newly established prices will be published no earlier than September 1, 2024, and will be effective January 1, 2026.
In the meantime, CMS is hosting a series of virtual “patient-centered listening sessions” with participating pharmaceutical companies that are open to the general public and are scheduled to take place between October 30 and November 15. CMS notes that the purpose of these sessions is to obtain input from caregivers, Medicare beneficiaries and others who may be able to provide relevant information related to prescription drugs. The schedule of these sessions is subject to change.
Price negotiations for these 10 drugs are just the beginning, according to HHS. CMS plans to select an additional 15 high-cost drugs covered by Medicare Part D for price negotiation for 2027 and another 15 drugs for price negotiation for 2028. In addition to these three rounds, CMS promises to negotiate better prices on an additional 20 drugs for each. next year.
While there are no quick and easy solutions to the high costs of health care in the US, the Medicare Drug Price Negotiation Program promises some relief for older adults who are struggling to afford the drugs they depend on. Are.