Skip to main content
Monthly Archives

February 2024

On this World Cancer Day, President Biden Has Lowered Costs for Patients

Millions of Cancer Patients and Survivors Are Saving Thanks to The Inflation Reduction Act

On this World Cancer Day, millions of cancer patients and survivors feel the direct financial impacts of affordable prescription drugs and health insurance from the Inflation Reduction Act, passed by President Biden and Democrats in Congress. 

The Inflation Reduction Act has capped out-of-pocket spending on drugs to $2,000 a year for Medicare beneficiaries, prevented drug companies from raising prices faster than the rate of inflation, and given Medicare the power to negotiate for lower drug prices. The Inflation Reduction Act also lowered health insurance premiums for millions of people who buy health insurance on their own, with a historic 21.3 million signing up for coverage in 2024. 

However, MAGA Republicans and their allies are scheming to rip away this life-saving care. The GOP has introduced legislation to repeal the Inflation Reduction Act while their allies are waging a legal battle in the courts against free preventive care including cancer screenings, and big drug companies are trying to block the Medicare Drug Price Negotiation Program. 

Thanks to the Inflation Reduction Act, cancer patients can breathe a sigh of relief knowing the care they need is covered and the cost of their prescription drugs won’t cause them to have to choose between food and rent.

By The Numbers:

  • 30 percent of Medicare beneficiaries who face high prices for cancer treatments don’t fill their prescriptions.
  • Medicare has spent over $14.3 billion on the cancer treatment drug Imbruvica – an average of $128,548 per beneficiary. Medicare is now negotiating a lower price.
  • 1.4 million Medicare enrollees spend more than $2,000 on medications each year, including people who need high-cost cancer drugs. Starting in 2025, seniors will pay no more than $2,000 per year on prescription drugs.
  • Tax credits included in the Inflation Reduction Act reduced health premiums for overabout 19 million people who receive their coverage through the Marketplace. These plans cover pre-existing conditions, including cancer, enabling patients to continue to afford coverage. 

The Inflation Reduction Act Lowers Health Care Costs

Capping Out-Of-Pocket Spending On Prescription Drugs Relieves Financial Stressors. Medicare beneficiaries with serious conditions like cancer, multiple sclerosis, and rheumatoid arthritis could save thousands of dollars under the Inflation Reduction Act. In 2025, out-of-pocket costs for prescription drugs will be capped at $2,000 per year for medications covered by Medicare Part D; directly lowering costs for the more than 1.4 million enrollees who paid more than $2,000 on medication in 2020. A common drug often prescribed to Americans with cancer are brand-name oral oncolytics that can cost upwards of $10,000 a year. 30 percent of patients in need of oral oncolytics struggle to maintain treatment due to cost. A quarter of American adults have not filled a prescription, cutting pills in half, or skipped doses due to the cost of medication.

Extending Premium Subsidies Saves Lives. The Inflation Reduction Act extended enhanced premium subsidies through the end of 2025, saving the average consumer over $800 per year on premiums. As of 2024, approximately 19 million people, or over 90 percent of consumers who selected an ACA plan, received enhanced premium tax credits, making their coverage affordable and accessible. After two years of these subsidies, the Department of Health and Human Services released an analysis showing that just 8 percent of Americans lacked health insurance at the beginning of 2022 — an all-time low for the nation. Having affordable health care is imperative for Americans diagnosed with cancer and other chronic illnesses to receive necessary care, tests, and treatment. 

Improves The Lives Of Seniors And People Of Color With Chronic Conditions. Seniors with chronic illnesses, such as cancer, on Medicare are expected to benefit the most from provisions in the Inflation Reduction Act. About 60 percent of cancers occur in adults older than 65 years old. Older adults are also more likely to be diagnosed with cancer once it reaches the later stages of development. This is due to slower cell regeneration making cancer more difficult to spot in early stages of growth. People of color are also disproportionately impacted by certain cancers. Black people have the highest death rate and shortest survival rate than any other racial or ethnic group. Black men are twice as likely to die from prostate cancer and Black women over 50 are twice as likely to die from breast cancer than their white counterparts. Lower prescription drug prices for Medicare and the expansion of premium tax credits make affording care for these chronic conditions possible for older adults and people of color. 

Gives Medicare The Power To Negotiate Lower Drug Prices. Thanks to the Inflation Reduction Act, Medicare is currently negotiating lower prices for Medicare Part D’s 50 million beneficiaries. 10 drugs have been selected for initial price negotiations, and more drugs will be negotiated down each year. By 2030, up to 80 drugs will have lower negotiated prices. 

  • Medicare Is Currently Negotiating Lower Prices for Cancer Drug Imbruvica. One of the first ten drugs selected for negotiation is Imbruvica, a drug used to treat blood cancers. Over 20,000 Medicare Part D beneficiaries rely on Imbruvica as of 2022, with those not enrolled in the Extra Help program paying an average of $5,247 annually​​. Imbruvica costs significantly more in the U.S. than in other high-income countries. Its manufacturers charge U.S. customers around 1.5x more than customers in Switzerland, and more than 5x more to U.S. customers than to customers in Australia. 

GREED WATCH: Bristol Myers Squibb Brought In More Than $45 Billion In 2023

During their earnings report today, drug giant Bristol Myers Squibb announced it raked in $45 billion in 2023, bringing in a profit of over $8 billion and beating Wall Street expectations. The company manufactures Eliquis, a popular drug used by more than 3.5 million Medicare beneficiaries to treat blood clots that has been selected among the first 10 drugs for Medicare price negotiation under the Inflation Reduction Act. Unsurprisingly, Bristol Myers Squibb opposes the Biden administration reforms that allow Medicare to negotiate prescription drug prices. While drugmakers earn billions, Americans pay exorbitantly high prices for prescription drugs.

  • During the call, CEO Chris Boerner bragged about the company’s “good performance” in the fourth quarter and throughout 2023. 
  • Bristol Myers Squibb brought in $12.2 billion in 2023 from blockbuster blood clot drug Eliquis, and has now made over $69 billion on Eliquis since launching the drug in 2012. Eliquis costs U.S. customers 3–7x more than customers in other high-income countries. 
  • Bristol Myers Squibb announced it is rewarding its shareholders with an additional $3 billion in stock buybacks over the next several years, alongside a quarterly dividend increase of over 5 percent compared to Q4 2022.
  • While Bristol Myers Squibb raised prices on U.S. patients, it rewarded its CEO with over $20 million in compensation in 2022.
  • Bristol Myers Squibb announced agreements last month to acquire two smaller drug companies, Karuna Therapeutics and RayzeBio, and last week completed its acquisition of a third, Mirati Therapeutics.
  • Bristol Myers Squibb is suing the Biden administration to stop Medicare from negotiating lower drug prices for patients because it would endanger their massive profits. 
  • On aggregate, drug companies charge Americans prices up to four times higher than prices in other countries, forcing patients to cut pills and skip doses.
  • Over 80 percent of voters support giving Medicare the power to negotiate, making it the most popular provision in the Inflation Reduction Act. 

The Inflation Reduction Act brings down prescription drug costs for everyday Americans, especially seniors, by capping the price of insulin at $35 per month and providing free vaccines including shingles, giving Medicare the power to negotiate lower drug prices, and limiting the amount people have to pay each year for prescription drugs to $2,000 annually starting in 2025.  

Read more:

REPORT: Why Medicare Needs the Power to Negotiate for Lower Drug Costs: the Five Drugs That Tell the Story

FACT SHEET: Big Drug Companies Are in Court to Stop Medicare Negotiation and Protect Their Sky-High Profits

GREED WATCH: Merck Announces Over $60 Billion in 2023 Earnings

Merck announced it raked in $60.1 billion in 2023 – an $800 million increase over 2022 – during their earnings report today. While they make billions, Americans pay exorbitantly high prices for prescription drugs. Merck opposed the Biden administration reforms that lower prescription drug prices. 

  • While publicly Merck is claiming price negotiations will hurt the company, during the earnings call CEO Rob Davis bragged about the company’s future prospects saying, “we expect continued strong growth in 2024 driven by demand for our key products.”
  • Over the course of 2023, Merck rewarded its shareholders with around $400 million in stock buybacks, with $143 million coming in the first quarter of 2023 alone.
  • Merck is suing the Biden administration to stop Medicare from negotiating lower drug prices for patients because it would endanger their massive profits. 
  • Merck charges U.S. customers over twenty times more for Januvia than customers in other high-income countries. 
  • On aggregate, drug companies charge Americans prices up to four times higher than prices in other countries, forcing patients to cut pills and skip doses.
  • Over 80 percent of voters support giving Medicare the power to negotiate, making it the most popular provision in the Inflation Reduction Act. 

The Inflation Reduction Act brings down prescription drug costs for everyday Americans, especially seniors, by capping the price of insulin at $35 per month and providing free vaccines including shingles, giving Medicare the power to negotiate lower drug prices, and limiting the amount people have to pay each year for prescription drugs to $2,000 annually starting in 2025.  

Read more:

Medicare Negotiations for Lower Drug Prices Explained: Januvia

REPORT: Why Medicare Needs the Power to Negotiate for Lower Drug Costs: the Five Drugs That Tell the Story

FACT SHEET: Big Drug Companies Are in Court to Stop Medicare Negotiation and Protect Their Sky-High Profits

ROUND UP: “New Era in Medicare” Begins with Opening Offers in Negotiation to Lower Drug Prices

The Center for Medicare and Medicaid Services took another major step to lower the prices of prescription drugs and end the days of drug companies charging whatever they want. Kicking off the first round of negotiations made possible by provisions in the Inflation Reduction Act, Medicare made its initial offer to drugmakers. The Inflation Reduction Act’s Medicare Drug Price Negotiation Program will lower prices for some of the highest-cost prescription drugs that seniors rely on to treat conditions like cancer, diabetes, and autoimmune disorders – conditions that disproportionately impact women, communities of color, and people in rural areas. Meanwhile, every Republican voted in Congress voted against the Inflation Reduction Act and Republicans have now introduced legislation to repeal it and are fighting to protect drug company profits. Final negotiated prices will be announced in September and will take effect in 2026.

HEADLINES

The Washington Post: Today: Biden Administration Makes Opening Offers In Drug-Price Negotiation Program. “Negotiations must end by Aug. 1. If the companies and health officials agree, the new prices will take effect in 2026. The White House put serious muscle behind its announcement. The administration released a new analysis about high U.S. drug costs, shared a high-level memo, launched a new LowerDrugCosts.gov site to inform Medicare beneficiaries… Leslie Dach, the chair of Protect Our Care, a Democrat-aligned health advocacy group, called Thursday’s move “a giant step forward” in efforts to lower U.S. drug prices. “Medicare negotiation means more seniors will be able to afford the medications they need to stay alive,” he added in a statement.” [The Washington Post, 2/1/24]

The New York Times: U.S. Makes Initial Offers In Medicare Drug Price Negotiations. “The initial round of price offers is a key step in the negotiation process. Each drugmaker has until early March to accept the offer or propose a counteroffer to the government. A series of negotiation sessions could follow, with the process set to conclude by August. Health policy experts said the announcement of the initial round of offers amounted to a kind of starting gun, giving the Biden administration the chance to take an aggressive posture and test the willingness of drugmakers to acquiesce.” [The New York Times, 2/1/24]

Axios: The Challenge For Medicare Drug Negotiators: How To Value A Medicine’s Benefits. “It sets off a monthslong back-and-forth with drugmakers before final prices are revealed in September — all while the industry fiercely contests the negotiations in court… The law is explicit about factors that Medicare has to consider when coming up with that price, including how much it costs to manufacture or distribute the drug and the manufacturer’s research and development costs… A study published last year in JAMA found that of the 50 top-selling Medicare drugs in 2020, more than half were deemed by assessment organizations in Canada, France, and Germany to offer little to no therapeutic benefit over existing therapies.” [Axios, 2/1/24]

Politico: CMS Sends First Price Offers To Drugmakers. “CMS has promised to use several factors to calculate the prices, such as whether the product has a therapeutic equivalent and the overall research and development costs. But during a call with reporters Wednesday evening, Biden administration officials declined to say how much savings the initial price offers would generate. A previous estimate showed that, between June, 2022 and May, 2023, the 10 drugs cost the federal government $50.5 billion.” [Politico, 2/1/24]

STAT: Biden Administration Makes Opening Offers In Medicare Drug Price Negotiations. “The offers will not be made public unless a manufacturer chooses to publicly disclose information about the talks, a senior administration official said. Companies have until March 2 to either accept the government’s offer or propose a counteroffer. The Biden administration will publish the final prices by Sept. 1 of this year after the negotiation process ends. The negotiated prices won’t take effect until 2026.” [STAT, 2/1/24]

USA Today: Medicare Drug Price Negotiations Kick Off With Price Offers On These 10 Drugs. “Under President Joe Biden’s Inflation Reduction Act, another 30 drugs will be selected over the next two years for negotiated prices that will be rolled out in 2027 and 2028. HHS Secretary Xavier Becerra heralded a “new era in Medicare” with the federal heath program’s newfound authority to negotiate drug prices under Biden’s signature health and climate legislation… A senior Biden administration official said the president has said drug companies should have a fair return on their investments but noted the drug selected for negotiation have been on the market for years without generic alternatives.” [USA Today, 2/1/24]

CNN: Medicare Drug Price Negotiations Start After Biden Administration Makes Initial Offers. “CMS considered multiple factors when developing its initial offer, including the drugs’ clinical benefits and the price of alternatives, among others. The agency also held listening sessions so patients and others could provide input on the selected drugs. The discounts will range from at least 25% to 60% off the non federal average manufacturer price, depending on when the drugs were approved… In the first two years of negotiations, CMS will select only Part D drugs that are purchased at pharmacies. It will add Part B drugs, which are administered by doctors, to the mix for 2028.” [CNN, 2/1/24]

The Wall Street Journal: U.S. Medicare Drug-Price Negotiations Start Now. “Under a new U.S. law, the federal government on Thursday is sending its initial offers of how much it is willing to pay for Medicare patients’ use of an initial batch of 10 cancer, diabetes and other drugs to Johnson & Johnson, Merck and other big companies… At stake are tens of billions of dollars in spending by the Medicare program for seniors, and equally large revenues for the industry. Medicare patients taking the drugs might see savings in out-of-pocket costs, though that could vary widely by drug.” [The Wall Street Journal, 2/1/24]

President Biden is Driving Down Costs, Expanding Coverage, and Improving Care For Black Americans

In celebration of Black History Month, Protect Our Care is highlighting important steps taken under the Biden-Harris administration to reduce disparities in access to quality, comprehensive health care by expanding coverage, reducing costs, and improving care in the communities where it is most needed. President Biden and Vice President Harris are doing everything in their power to drive down health care costs and improve access to quality health care for Black Americans – from the cradle through retirement. Provisions in the Inflation Reduction Act have made health insurance and prescription drugs more affordable ensuring a greater number of Black families have access to quality health care across the nation. Additionally, they extended Medicaid coverage for new mothers to one year postpartum, securing lifesaving care for families. 

President Biden Is Expanding Coverage By Making It More Affordable Than Ever

Expanded Premium Tax Credits to Ensure 75 Percent Of Black Adults Get Health Coverage For Less Than $50 Per Month. The premium savings extended through the Inflation Reduction Act have made more than 65 percent of uninsured Black adults eligible for zero-dollar premium plans. Nearly 75 percent of uninsured Black adults can now also access plans for less than $50 a month. The Center on Budget Policy and Priorities estimates the continuation of these increased savings would cause a sharp decline in the uninsured rate across every racial group, with a projected one in three uninsured Black adults gaining coverage.

President Biden Is Addressing the Maternal Mortality Crisis By Giving New Moms Health Care One Year Postpartum

Medicaid Expansion One Year Postpartum Saves The Lives Of Black Mothers. Medicaid is vital for ensuring access to quality, affordable care, especially for women of color who experience higher rates of preventable maternal mortality and morbidity than white women. While the passage of the Affordable Care Act brought uninsurance among mothers down by more than 42 percent, the maternal mortality rate in America has doubled over the last three decades, and the COVID-19 pandemic significantly worsened the crisis. Over 80 percent of pregnancy-related deaths are preventable, and over half occur between 7 days and 12 months after pregnancy. Recognizing the urgency of the maternal health crisis, the Biden-Harris Administration, with Democrats in Congress, offered states incentives to expand Medicaid coverage for a full year postpartum – first, on a temporary basis through the American Rescue Plan and then permanently in the Consolidated Appropriations Act of 2022. Moreover, President Biden has proposed in his 2023 budget to make 12 months of postpartum coverage mandatory for all Medicaid programs. 

HHS Awarded More Than $103 Million For A New Maternal Mental Health and Substance Use Disorder Task Force And A National Public Education Campaign On Postpartum Depression. This past fall, the Biden-Harris Administration announced new actions and funding to fight the maternal health crisis. More than $103 million has been awarded to create a maternal mental health and coexisting substance use disorder task force to improve federal data collection and health equity, and implement best practices for prevention, screening, diagnosis, intervention, treatment, community practices, communication, and community engagement. The focus of the task force will be to ensure mental health equity and promote trauma-informed practices. The funding is also going towards a national public education campaign, called Talking Postpartum Depression, which will increase awareness of postpartum depression symptoms, share reliable resources, and demonstrate the many ways to access care. 

  • HHS Awarded Nearly $90 Million To Expand Maternal Health Resources and Services Administration (HRSA) Programs. The HRSA programs that have been awarded additional funding from HHS focus on expanding and diversifying the perinatal workforce, increasing access to maternal health services in underserved and rural communities, investing in maternal mental health research, and supporting patients and families postpartum by training additional OB/GYNs, midwives, and maternal health care providers.

CMS Launched ‘Birthing Friendly’ Designation On Comparing Care Tool.  The Biden-Harris administration and CMS launched the ‘birthing friendly’ designation on CMS’s online Care Compare tool. This designation allows patients to search for a hospital that participates in a perinatal quality improvement collaborative program and that implements evidence-based care to improve maternal health. More than 24 health plans agreed to use this designation on their consumer-facing websites, reaching more than 150 million people.

President Biden Is Lowering Drug Prices For Seniors On Medicare

The $35 Insulin Cap Will Save Black Individuals Who Need Insulin $1,500 Per Year. According to the Department of Health and Human Services, diabetes is the most common chronic illness in the United States, with Black adults being almost 60 percent more likely to be diagnosed with diabetes. With insulin manufacturers raising retail prices by over 600 percent in the last 20 years, the ability to simply afford the required medication needed to survive has become a major barrier to health equity and financial security. Under the Inflation Reduction Act though, insulin prices have now been capped at $35 a month. This will save each Black senior who uses Medicare up to $1,500 annually.

Medicare Part D And Medicaid Recipients Can Receive Vaccinations For Free. Medicare is better than ever and seniors can get their shingles shots and all other vaccines recommended by the CDC’s Advisory Committee on Immunization Practices, such as COVID-19, RSV, and the flu, for free. White Americans are nearly twice as likely to have received the shingles vaccine than Black Americans and this is not the only area where vaccination programs highlight a consistent racial disparity. Much of these inequities can be traced back to cost and lack of access to this vital form of preventive health care. The Inflation Reduction Act aims to begin tackling this vast issue by making more vaccines available to Medicare Part D recipients with no cost-sharing. Free vaccines for more Black seniors means reducing hospitalizations, fewer complications in other health problems, and a more sustainable and equitable health system. The Inflation Reduction Act also required state Medicaid and CHIP programs to cover vaccines recommended by the CDC’s Advisory Committee on Immunization Practices for no out-of-pocket costs. This allowed an estimated 4 million adults to gain access to shingles vaccines that didn’t previously have access before. Accessible vaccinations will particularly help low-income families on Medicaid, many of whom are people of color and people with disabilities, to help prevent illness and related work absences. 

Extra Help Program Expanded To Help 3 Million Afford Health Care. The Biden administration announced investments in helping up to 3 million eligible seniors and people with disabilities enroll in the Extra Help program in 2023 to benefit from the program’s lower cost premiums, deductibles, and copayments. The Inflation Reduction Act expanded the program, starting in January 2024. 

$2,000 Annual Cap For Out-Of-Pocket Spending On Prescription Drugs, Will Save Black Families Over $1,200 Per Year. Black Medicare beneficiaries are nearly twice as likely than white Medicare beneficiaries to stop taking a prescription due to cost. From 2016 to 2021 alone, costs for specialty prescription drugs increased by 43 percent while other drug prices increased by rates of over 500 percent. The Inflation Reduction Act addresses these outrageous skyrocketing prices by requiring that manufacturers whose drug prices increase faster than that of inflation will have to pay Medicare a rebate. This will not only save the government billions of dollars, but it will drastically reduce out-of-pocket costs for Medicare beneficiaries. The Inflation Reduction Act will also implement by 2025 a $2,000 annual cap for out-of-pocket spending on prescription drugs, saving Black families on average $1,216 every year.

Negotiating Lower Drug Prices Will Make Drugs That Are Disproportionately Needed By Historically Marginalized Communities More Affordable And Accessible. The ten drugs selected by Medicare for lower negotiated prices treat several conditions that disproportionately impact people of color. Five of the ten drugs are taken by a disproportionate number of Black, Latino, Asian, and/or American Indian/Alaska Native Medicare enrollees relative to the Medicare population as a whole, including:

  • Entresto is taken by a higher percentage of Black enrollees than their proportion of the Medicare population. 
  • Farxiga is taken by a higher percentage of Black enrollees, Latino enrollees, and Asian American enrollees than their proportion of the Medicare population.
  • Fiasp/NovoLog is taken by a higher percentage of Black enrollees, Latino enrollees, and American Indian/Alaskan Native enrollees than their proportion of the Medicare population.
  • Januvia is taken by a higher percentage of Black enrollees, Latino enrollees, and Asian American enrollees than their proportion of the Medicare population. 
  • Jardiance is taken by a higher percentage of Black enrollees, Latino enrollees, Asian American enrollees, and American Indian/Alaskan Native enrollees than their proportion of the Medicare population.

Biden Administration Kicks Off Medicare Drug Negotiations, Lowering Prices By At Least 25%

MAGA Republicans Want Drug Companies to Continue Ripping Off Americans, Who Pay Up to Four Times More for the Same Drugs as People in Other Countries

Washington D.C. — The Center for Medicare and Medicaid services took another major step to lower the prices of prescription drugs and end the monopoly that drug companies have to set prices. Because of President Biden’s Inflation Reduction Act, Medicare now has the power to negotiate lower prices for prescription drugs. Until now, drug companies have charged Americans two to three times more than people in other countries, but these steps will lower prices by at least 25 percent. 

The Inflation Reduction Act’s Medicare Drug Price Negotiation Program will lower prices for some of the highest-cost prescription drugs that seniors rely on to treat conditions like cancer, diabetes, and autoimmune disorders – conditions that disproportionately impact women, communities of color, and people in rural areas. Read our profiles on the ten selected drugs here.

Since the enactment of the Inflation Reduction Act, big drug companies have spent millions of dollars lobbying and filed meritless lawsuits to block the Negotiation Program from lowering drug prices. Medicare negotiation will save seniors and taxpayers tens of billions of dollars, and it’s the most popular provision of the Inflation Reduction Act. However, every Republican voted in Congress voted against the Inflation Reduction Act and Republicans have now introduced legislation to repeal it and are fighting to protect drug company profits.

In response, Protect Our Care Chair Leslie Dach issued the following statement:

Today is a giant step forward in lowering drug prices for millions of Americans. Medicare negotiation means more seniors will be able to afford the medications they need to stay alive. Americans are being ripped off by high drug prices, forcing patients to cut pills and skip doses to make ends meet. 

“While President Biden is fighting to lower costs, big drug companies and their Republican allies want to stop negotiations entirely — even as drug companies continue to increase their prices and announce massive profits. The big drug companies are filing bogus lawsuits in hand-picked courts, and Republicans are trying to repeal negotiations in Congress, but President Biden and Democrats are working tirelessly to make prescription drugs affordable for seniors and families across the nation.”

Learn more at LowerDrugPrices.org