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HEADLINES: Medicare Negotiations to Lower Prescription Drug Costs Across the Country

By September 8, 2023No Comments

The Biden administration announced the first round of high-cost drugs whose prices will be lowered as Medicare begins to negotiate with drug companies. The new program created by the Inflation Reduction Act will lower costs for some of the highest-priced prescription drugs on the market used to treat conditions like cancer, diabetes, and autoimmune disorders – conditions that disproportionately impact women, communities of color, and people in rural areas.

President Biden and Democrats in Congress stood up to big drug companies and won a decades-long battle to lower the cost of prescription drugs for millions of Americans  . Negotiating lower prices is overwhelmingly popular across the country, yet big drug companies are suing the federal government to protect their massive profits by halting the program, and Republicans are attempting to repeal the Inflation Reduction Act entirely. Read more about the first 10 drugs here.

ALABAMA

Alabama Political Reporter: How Alabamians Will Be Affected by the Medicare Drug Price Negotiation Program. “According to Protect Our Care, a non-profit organization dedicated to affordable health care, approximately 166,000 Alabamians will see lower drug prices as a result of the negotiations…Founder and president of Protect Our Care, Leslie Dach, released a statement discussing the importance of the price negotiations. ‘Americans deserve financial security and some peace of mind when they go to sleep at night,”  But, too many are forced to choose between being able to afford their medicines or paying for food or housing. Prescription medicines cannot work if people cannot afford to take them, and high drug prices are keeping too many Americans from the health care they need. Patients should not be paying out-of-control prices for medicines they need when all it’s doing is increasing drug company profits and footing the bill for outrageous CEO salaries. President Biden and Democrats in Congress stood up to big drug companies and won a decades-long battle to lower the cost of prescription drugs by giving Medicare the power to negotiate lower prices. The Biden administration is laser-focused on making medications affordable for families and ending the era of drug companies’ unchecked power and greed.’” [Alabama Political Reporter, 9/8/23]

ARIZONA

ABC15 Arizona: Valley Seniors Hope Negotiating Prescription Drug Prices Will Help Save Money. “‘The number one reason why seniors skip or ration their medications is because they cannot afford it. So, this will save millions of Arizonans a lot of money on their prescription drug costs,’ said Dana Kennedy, State Director for AARP. Medications to treat heart disease, diabetes, and Crohn’s disease are among the most expensive prescriptions in Medicare Part D.” (ABC15, 9/4/23)

ARKANSAS 

KARK Little Rock: Biden Administration Names 10 Drugs for Price Negotiation. “The drugs on the list announced Tuesday accounted for $3.4 billion in out-of-pocket costs for Medicare patients last year. The Medicare program paid more than $50 billion for the drugs between June 1, 2022, and May 31, according to the Centers for Medicare and Medicaid Services, or CMS. The announcement Tuesday is another significant step toward taming drug pricing under the Inflation Reduction Act, which was signed by Biden last year. The law also calls for a $2,000 annual cap on how much people with Medicare have to pay out of pocket for drugs starting in 2025. In addition, the law already caps out-of-pocket costs for insulin at $35 a month for Medicare patients.” [KARK Little Rock, 8/29/23]

CALIFORNIA

Noozhawk Santa Barbara: 5 Things to Know About the New Medicare Price Negotiation Rule. “Until now the drug industry has successfully fought off price negotiations with Washington, although in most of the rest of the world governments set prices for medicines. While the first 10 drugs selected for negotiations are used by a minority of patients — 9 million — CMS plans by 2029 to have negotiated prices for 50 drugs on the market. Biden administration officials say reining in drug prices is key to slowing the skyrocketing costs of U.S. health care. The drugs selected by CMS range from specialized, hyper-expensive drugs like the cancer pill Imbruvica (used by about 26,000 patients in 2021 at an annual price of $121,000 per patient) to extremely common medications such as Eliquis (a blood thinner for which Medicare paid about $4,000 each for 3.1 million patients). Medicare price negotiations will equip private health plans to drive a harder bargain. David Mitchell, president of the advocacy group Patients for Affordable Drugs, predicted that disclosure of negotiated Medicare prices ‘will embolden and arm private sector negotiators to seek that lower price for those they cover.’” [Noozhawk Santa Barbara, 5/2/23]

COLORADO

KOAA News5 Colorado: More Than 100,000 Coloradans Could See Price Cuts in Ten Medicare Prescriptions. “More than 100,000 Coloradans could see cuts to their costly medications. Ten are up for negotiation, which includes treatment to life-threatening conditions like cancer, heart failure, and diabetes.” (KOAA, 9/5/23)

GEORGIA

11 Alive Georgia: Patients Excitedly Welcome Price Negotiation for Expensive Drugs. “The Biden Administration revealed the first 10 prescription drugs Medicare will negotiate under the Inflation Reduction Act meaning patients could soon pay less to get life-saving care. Diane Loupe, 66, of Decatur, takes Xarelto. She ended up with the prescription after thinking that she just had bad varicose veins. The luxury of life comes with a hefty price. Loupe said her prescription went from $10 a month to $85 a month. She has Medicare, but without insurance, pharmacies say blood thinners like hers can cost way more. 11Alive talked to a few local pharmacies. Most of the medications on the list can cost over $600. Several pharmacies say they don’t even keep them in stock because they’re so expensive. However, White House Press Secretary Karine Jean-Pierre said that’s about to change. ‘These 10 drugs, in last year, in 2022 cost Americans $3.4 billion, about $6,000 out-of-pocket expenses – just for one drug,’ Jean-Pierre said.” [11 Alive Georgia, 8/29/23]

HAWAII

Hawaii Tribune-Herald: Biden’s Medicare Drug Pricing Plan is Good Medicine for Americans. “The VA takes care of veterans, Medicaid (whose costs are shared with states and localities) is coverage for the poor and Medicare is health insurance for seniors and people with disabilities. The VA and Medicaid can, and do, negotiate with suppliers on drug prices, just like they negotiate payment levels for other health services. Yet Medicare, which sets the reimbursement rates for doctors and hospitals, is barred by federal law from negotiating on drugs. That’s the doing of the well-heeled pharmaceutical lobby. It took a long time, but the change finally came last year with President Joe Biden’s… Inflation Reduction Act. The law, signed a year ago this month, permitted Uncle Sam (meaning Secretary of Health and Human Services Xavier Becerra) to haggle over the prices of medications. Biden has now announced the first 10 drugs. The negotiations, by the Centers for Medicare &Medicaid Services, will take years and the lower prices for consumers will begin in 2026. There will be another 50 drugs over the next four years up for negotiations and after that, 20 a year. And Big Pharma is fighting all the way, already in court to stop it. One of the drugs on the list, Imbruvica, for blood cancer, runs $17,000 a month, or $204,000 a year. Whatever the reason [for the price], it can be addressed during the talks now permitted between Medicare and the supplier, a joint product of AbbVie and Johnson & Johnson.” [Hawaii Tribune-Herald, 9/2/23]

ILLINOIS

Chicago Tribune (Commentary): Big Pharma is Wrong, Medicare Price Negotiation Won’t Hinder Innovation. “Big Pharma is pulling out all the stops to avoid lowering drug prices for seniors. Their legal strategy is tantamount to ‘throwing the kitchen sink at the government,’ as one expert described it, with various lawsuits arguing violations to the First, Fifth, and Eighth amendments. The pharmaceutical industry has argued that negotiating Medicare prices with the federal government will force them to pull back on developing groundbreaking new treatments. The argument relies on a central falsehood: that the government does not subsidize investments in pharmaceutical innovation. But evidence shows that public sector investments in basic and applied biomedical research — primarily from the National Institutes of Health — contribute substantively to the emergence of new drugs and drug-related patents. Amazingly, given the pervasiveness of the industry’s argument, a recent study found that NIH funding contributed to nearly all (99.4%) of FDA-approved drugs from 2010 to 2019, and the magnitude of NIH investment in new drugs is comparable with that of the industry. These findings clearly suggest that the public deserves a more equitable return on its investment relative to the pharmaceutical industry’s investment.” [Chicago Tribune (Commentary), 9/3/23]

WGEM Quincy Illinois: Medicare Will Now Be Able to Negotiate Prices for 10 Drugs. “Some seniors have had to make tough choices between their medication and other necessities. Under a new policy announced last week, Medicare will negotiate the price of ten of the most costly prescription drugs on the market with manufacturers. Rob Ritchey, the Administrative Director of Pharmacy with Blessing said drug prices are based on how much money the government pays for the medication. He said last year the government spent $50 billion on prescription drugs. Mary Crawford, the West Central Illinois Area Agency on Aging Grant and Program Manager said seniors commonly use the drugs on the list, and those drugs really eat away at their budgets. She said its an important first step to have Medicare play a role in negotiating drug prices. She said for seniors who need assistance, programs to help them pay for their medication exist. Crawford said the current steps the federal government has taken; such as capping the price of insulin and will soon expand the extra help benefits which will reduce what people pay for premiums, deductibles, and co-pays. She says steps like these make her hopeful for other actions down the road.” [WGEM Quincy Illinois, 9/5/23]

IOWA

Iowa Public Radio: Understanding the Historic Plan for Medicare Drug Price Negotiations. “The Biden Administration announced that ten prescription drugs have been selected for Medicare price negotiations for the first time. The power to negotiate the prices comes from the Inflation Reduction Act, passed last year.” [Iowa Public Radio, 9/8/23]

KGAN Iowa: Biden’s Inflation Reduction Act to Lower Prices of Key Drugs for Iowans: A Relief for Millions. “President Biden announced the first 10 drugs to have lower prices under the Inflation Reduction Act’s Medicare Drug Price Negotiation Program. The new program requires big drug companies to negotiate lower pricing for the high-cost drugs used for treating conditions like cancer, diabetes, and heart disease. Lower Pricing will help millions across the country and Iowa.” [KGAN Iowa, 9/7/23]

The Gazette: Over 36,000 Iowans Will Be Affected by Price Negotiation Rule. “Roughly 36,000 Iowans on Medicare pay an average of $650 each year to take the blood thinner Eliquis, according to federal data, but that copay could fall in future years under a new federal law being celebrated by President Joe Biden’s administration and Iowa Democrats. The measure, part of the so-called Inflation Reduction Act, allows the federal government to negotiate prices with prescription drugmakers. This week, the Biden administration highlighted potential cost savings for the first 10 drugs whose prices the administration plans to negotiate in the coming years. However, any lower prices won’t take effect for three years, and the path forward could be further complicated by litigation from drugmakers and heavy criticism from Republicans. In addition to the 36,000 Iowans on Medicare who paid an average of $650 in 2022 on Eliquis, 15,000 paid an average of roughly $640 for another blood thinner, Xarelto, according to federal data. And 12,000 paid roughly $470 for the diabetes treatment medication Jardiance. Iowa’s average out-of-pocket costs for those three most commonly used drugs are among the highest in the country, according to the federal data. In 2022, Iowa had the fifth-highest average annual out-of-pocket cost for Eliquis, Xarelto and Jardiance. In a statement, Iowa Democratic Party Chair Rita Hart called on Republican presidential candidates who have been campaigning in Iowa to make clear their position on the legislation and the measure that allows the federal government to negotiate Medicare drug prices.” [The Gazette, 8/31/23]

LOUISIANA

The Times Picayune NOLA: How Medicare Price Negotiation Will Help Louisiana Medicare Enrollees. “It was the biggest news of the week — or at least the news with the most fanfare — and its success could mean that many of the roughly 883,000 Louisiana seniors on Medicare would no longer have to choose between buying medication or food, says AARP Louisiana. The White House announced Tuesday that the Centers for Medicare & Medicaid Services would commence negotiating lower prices with the major drug manufacturers, often known as Big Pharma, for 10 drugs frequently prescribed to seniors. CMS got authority to negotiate prices for the first time under the Inflation Reduction Act, passed last August. CMS calculates at least 151,000 Louisiana seniors on Medicare take one or more of the 10 initial drugs on the list. Mean annual out-of-pocket expenses cost those seniors between $93 for Novolog and $4,500 for Imbruvica. About 55,000 Louisiana Medicare enrollees have been prescribed the heavily advertised Eliquis to treat blood clots and have to personally pay an average of $372 after Medicare pays its portion. For those who take Jardiance for diabetes, that’s another $237 out of pocket. U.S. Rep. Troy Carter of New Orleans, the only Democrat Louisiana voters have sent to the House, said: ‘This will lower prescription drug costs for seniors in Louisiana and around the country.’” [The Times Picayune NOLA, 9/1/23]

MAINE

The Press Herald Maine: Biden’s Big Deal on Drug Prices. “President Biden announced the first price negotiations over 10 super-expensive Medicare drugs last week through the Inflation Reduction Act as if it were a big deal. It is. In fact, it’s the first time since the program’s creation under Lyndon Johnson in 1965 that Democrats have struck a major blow toward reducing the program’s costs for taxpayers. The drugs on the Biden administration’s list cost, on average, three times what other nations pay: 300% more. That explodes the drug company argument that such prices are necessary to avoid stifling innovation. Why should Americans, alone, pay through the nose so Germany, France and Sweden can get steep discounts on the very same pills? [Price negotiation is] a start, and if it becomes a trend, it could finally mark a new direction is the dismal course of the American health care system, which becomes more corporatized and bureaucratized, more remote from the people it’s supposed to serve with each passing year.” [The Press Herald Maine, 9/7/23]

News Center Maine: How Mainers Will Benefit From Medicare Price Negotiations. “President Joe Biden has revealed a plan to lower the cost of 10 prescription drugs for seniors by allowing Medicare to negotiate the price with drug companies. The drugs include those that treat diabetes, heart disease, and cancer. Dr. Karen Saylor works at Coastal Maine Direct Care in Falmouth. She said her patients sometimes have to choose between paying large amounts of money for important medications or not taking them at all. But that might change. Some of those medications are among 10 drugs that could have their prices slashed in negotiations between the government and drug manufacturers, which was authorized by the Inflation Reduction Act passed by Congress last year. The effects of this change are expected to be wide-reaching in Maine. Medicare enrollees taking the medications here in the state paid out-of-pocket costs of up to nearly $5,000 in 2022. Savings for the 10 drugs won’t come until 2026, but for Saylor’s patients, she said it will be worth the wait.” [News Center Maine, 9/1/23]

MASSACHUSETTS 

Boston Globe (Opinion): Medicare Drug Price Talks Are Lauded by Americans. “[W]e the people are winners as we begin reining in excessive prescription drug prices. Skyrocketing prices lead to higher health care premiums, higher taxes to pay for Medicare and Medicaid, and higher costs at the pharmacy counter. According to the state Center for Health Information and Analysis, prescription drug spending increases outpace other health care spending in Massachusetts. Spending on prescription drugs grew 7.7 percent in 2020, more than twice the 3.1 percent state benchmark for increases in overall health care spending. President Biden’s plan to allow Medicare and Medicaid to negotiate prices for some prescription drugs unraveled an absurd prohibition the pharmaceutical industry pushed through Congress 20 years ago. Negotiation is crucial as drug companies keep US prices inflated by blocking generic competitors through patent-extending tactics. Unsurprisingly, the pharmaceutical industry opposes the plan. The rest of us are all in. We’ll need more reforms for a fairer medication marketplace, but this is a great start.” [Boston Globe (Opinion), 9/4/23]

NORTH DAKOTA

Public News Service: North Dakotans See Light at the End of the Tunnel on Prescription Costs. “Older North Dakotans and a key advocacy group are hopeful that seniors will see relief from the heavy burden of prescription drug costs – and they’re hailing a big step announced this week. The Biden administration unveiled the first 10 medications that will be subject to price negotiations under the Medicare program. The action is part of the Inflation Reduction Act approved by Congress. Bismarck resident Bob Entringer has used one of the medications on the list since 2017. When he retired and switched to Medicare, he found out the blood thinner would be almost $500 for a 90-day prescription. Policy experts note that other IRA provisions are already helping beneficiaries. Josh Askvig, AARP North Dakota state director, [said] that for too long, drug makers have prioritized profits over the people who desperately need some of these medications. ‘We know the number one reason seniors skip or ration their prescriptions is because they can’t afford them,’ he said, ‘and this must stop, and this is an important step in that direction.’” [Public News Service, 9/1/23]

PENNSYLVANIA

Lehigh Valley News: U.S. Rep. Susan Wild: Start of Medicare Drug Negotiations Is Cause for Celebration. “Niebell’s cardiologist had prescribed her two of the 10, the blood thinners Xeralto and Eliquis, as they searched for critical medication to which she wouldn’t have an allergic reaction. […] “These prices never should have been this high,” Niebell said, using a hot pink cane to keep her balance at the podium. “We, as seniors, we have enough to worry about, and the doctor shouldn’t have to listen to me whine about the cost every time he sees me.” [Lehigh Valley News, 9/5/23]

The Morning Call: ‘These Prices Never Should Have Been So High’: Susan Wild, Advocates Tout Savings From Medicare Drug Price Negotiations. “The savings primarily will benefit the 65 million people enrolled in Medicare. Enrollees in the government health insurance program paid $3.4 billion out-of-pocket last year for the 10 aforementioned prescription drugs — a number that will likely be slashed thanks to price negotiations. The United States has historically been behind countries like Canada, Mexico and many European countries that allow price negotiations and tend to have more affordable prescription drugs.” [The Morning Call, 9/5/23]

The Philadelphia Tribune (Commentary): Medicare Price Negotiations Will Give Pennsylvania Seniors Relief at the Pharmacy Counter. “On Aug. 29, the U.S. Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, announced more federal action to increase access and affordability for Medicare recipients. Medicare will now be able to negotiate the price of prescription drugs, starting with 10 medications covered under Medicare Part D, thanks to the Inflation Reduction Act. I applaud President Joe Biden’s continued efforts to improve health equity for elder Americans. Citizens of all ages, not just here in Philadelphia but across the state and country, struggle to afford critical, lifesaving medications to help manage their chronic conditions. Sen. Bob Casey, a vocal supporter of lowering drug prices and providing more access to life-saving treatment, is providing additional support at the federal level. I am proud to see the Affordable Prescriptions for Patients Act introduced in Washington. That legislation would prohibit the pharmaceutical industry from using anticompetitive practices that block competition and keep drug prices high. These critical steps at the federal and state level are necessary and long overdue to help solve our drug pricing crisis while increasing access and affordability. Together, we can help everyone see relief at the pharmacy counter.” [The Philadelphia Tribune, 9/5/23]

VIRGINIA

Loudoun Times-Mirror: HHS Secretary Touts New Drug Price Negotiation Rule at Clinic in Virginia. “Becerra compared Medicare not being able to negotiate to a car buyer who has to pay the sticker price on a vehicle in a car lot. He noted the U.S. Department of Veterans Affairs negotiates on drug prices, as do many governments in other industrialized nations. Becerra added that the 10 drugs account for 20% of all annual Medicare spending for prescription drugs. Under the IRA, the results of negotiations for an additional 15 drugs take effect in 2027. Another 15 take effect in 2028. Becerra said the number rises to 20 drugs annually beginning in 2029. In a brief interview after the event, Becerra vowed to ‘vigorously defend’ the IRA in court. ‘We feel very confident that what Congress passed, they took into account all the different factors in making it possible for us to negotiate,’ he said. ‘We feel like the law is on our side and we are going to be vigorous in defending this new law because we know that tens of millions of Americans are counting on it.’” [Loudoun Times-Mirror, 9/5/23]