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“Medicare Autumn” Fact Sheet: American Seniors Will Save As Medicare Negotiates Lower Drug Costs

By October 24, 2023No Comments

Protect Our Care launched a new campaign, “Medicare Autumn,” to educate seniors on how Medicare is better than ever. Thanks to the Medicare Drug Price Negotiation Program included in the Inflation Reduction Act, Medicare now has the ability to negotiate drug prices to lower costs for seniors on Medicare. The Biden administration recently announced the first round of high-cost drugs whose prices will come down from negotiation. This includes some of the highest-priced prescription drugs used to treat conditions like diabetes, heart disease, cancer, arthritis, chronic kidney disease, psoriasis, Crohn’s disease, and ulcerative colitis – many of which disproportionately impact women, communities of color, and people in rural areas. 

For too long, Americans have been paying three to four times more than people in other countries for the prescription drugs they depend on, forcing people to choose between filling a prescription or filling their refrigerator. Giving Medicare the power to negotiate with drug companies will help bring the price of medicines in the U.S. more in line with what other countries pay.

The impact of lower prescription drug costs thanks to the Inflation Reduction Act will be felt by people across the country. Negotiating lower prices on certain popular high-cost drugs will help:

  • 3,505,000 Americans who pay an average of $441 out-of-pocket per year for Eliquis, sold by Bristol Myers Squibb, to treat blood clots.
  • 47,000 Americans who pay an average of $921 out-of-pocket per year for Enbrel, sold by Amgen, to treat arthritis and psoriasis. 
  • 521,000 Americans who pay an average of $357 out-of-pocket per year for Entresto, sold by Novartis, to treat heart failure. 
  • 639,000 Americans who pay an average of $260 out-of-pocket per year for Farxiga, sold by AstraZeneca to treat diabetes.
  • 763,000 Americans who pay an average of $121 out-of-pocket per year for Fiasp/NovoLog, sold by Novo Nordisk, to treat diabetes. 
  • 22,000 Americans who pay an average of $5,247 out-of-pocket per year for Imbruvica, sold by AbbVie, to treat blood cancers. 
  • 885,000 Americans who pay an average of $270 out-of-pocket per year for Januvia, sold by Merck, to treat diabetes. 
  • 1,321,000 Americans who pay an average of $290 out-of-pocket per year for Jardiance, sold by Boehringer Ingelheim, to treat diabetes. 
  • 20,000 Americans who pay an average of $2,058 out-of-pocket per year for Stelara, sold by Johnson & Johnson, to treat psoriasis and Crohn’s disease.
  • 1,311,000 Americans who pay an average of $451 out-of-pocket per year for Xarelto, sold by Johnson & Johnson, to treat blood clots.

Drug Price Negotiation Improves Other Medicare Benefits. As a result of Medicare negotiation negotiations, Americans with Medicare will have access to innovative, life-saving treatments at lower prices, translating into lower premiums and out-of-pocket costs for older Americans and producing savings that are being used to improve benefits, including: 

  • a new $35 cap on monthly insulin prescriptions; 
  • free recommended vaccines;
  • a $2,000 annual cap on prescription drug costs taking effect in 2025.

The First 10 Drugs Are Just The Beginning. Negotiations will occur over the coming year and new, lower prices will be announced by September 1, 2024, and take effect in 2026. The first ten drugs that will see lower prices are responsible for about 20% of total Medicare Part D prescription drug costs every year. The companies that market them have made more than $493 billion in revenue from these drugs. Medicare will negotiate lower prices for an additional 15 drugs for prices effective in 2027, and by 2029, Medicare will negotiate lower prices for 20 drugs per year. And President Biden and Democrats in Congress are already working to expand these cost savings to more Americans, no matter what age they are or how they get their health coverage. 

Medicare Drug Price Negotiation Is Overwhelmingly Popular. 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. A recent Hart Research poll shows that 96 percent of Americans agree that lowering drug prices “is an important way to help people afford the cost of living,” and nearly three-quarters of Americans favor Medicare negotiation. Meanwhile, pharmaceutical companies’ arguments against negotiation are overwhelmingly rejected by the American people.

Big Drug Companies Are Threatening To Keep Drug Prices High Through The Courts. Drug company giants including Merck, Bristol Myers Squibb, Johnson & Johnson-owned Janssen Pharmaceuticals, Boehringer Ingelheim, AstraZeneca, and Novartis, as well as mega lobbying groups PhRMA and the US Chamber of Commerce, have sued the federal government in an effort to stop Medicare from negotiating for lower prescription drug prices for Medicare beneficiaries. If the big drug companies get their way patients will pay more so the drug companies can make more money:

  • GONE: Medicare’s power to negotiate lower prices for the most popular and expensive prescription drugs. Under the Inflation Reduction Act, Medicare is set to begin negotiating prices for 10 of the top 50 most expensive Part D drugs in 2026, adding another 15 drugs in 2027 and 2028, and another 20 in 2029 and subsequent years.
  • GONE: $98.6 billion in Medicare savings over the next decade from the drug negotiation program, which translates into savings for patients and taxpayers.
  • GONE: Lower Part D premiums and lower out-of-pocket drug costs for certain Medicare beneficiaries who rely on qualifying drugs.

The plaintiffs assert several sweeping claims, including under the First Amendment, the Fifth Amendment, and the Eighth Amendment across the lawsuits, but experts agree that these meritless arguments are merely an attempt to maintain the status quo where drug companies can protect their massive profits by charging whatever they want at the expense of patients and taxpayers.