The Biden administration is targeting drugs in price negotiations to lower Medicare costs


Washington (AFP) – The President Joe Biden On Tuesday, the administration will announce the first prescription drugs that the U.S. government is targeting in price negotiations as part of efforts to lower prices. medical care costs.

This announcement is an important step inflation reduction law, which Biden signed last year. The law requires the federal government to begin negotiating directly with companies about the prices they charge for some of Medicare’s most expensive drugs.

I have charted the process Legal challenges from drug makers And harsh criticism from Republicans in Congress. It is also a focus of Biden’s re-election campaign as he seeks a second term in office by touting his work to cut costs for Americans at a time when the country is suffering from inflation.

Biden plans to deliver a speech on health care costs from the White House after the announcement. He will be joined by Vice President Kamala Harris.

More than 52 million people age 65 or older or have certain disabilities or severe illnesses have prescription drug coverage through Medicare’s Part D program, according to the Centers for Medicare and Medicaid Services, or CMS.

About 9% of Medicare beneficiaries aged 65 and over in 2021 said they had not filled a prescription or missed a dose of medication because of cost, according to research by the Commonwealth Trust, which studies healthcare issues.

CMS aims to negotiate a maximum fair price for the drugs on the list released on Tuesday. This can help some patients who have coverage but still face large bills such as higher deductible payments when they get a prescription.

Currently, pharmacy benefit managers who administer Medicare prescription plans negotiate discounts on the drug price. These deductibles sometimes help reduce the premiums customers pay for coverage. But it may not change what the patient spends at the pharmacy.

Gretchen Jacobson, who researches Medicare issues in the Commonwealth, said the new drug price negotiations aimed to “make medicines more affordable while also allowing for profit to be made”.

Pharmaceutical companies that refuse to be part of the new negotiating process will be subject to heavy taxes.

The pharmaceutical industry has been preparing for months to fight these rules. The plan is already facing numerous lawsuits, including complaints from drugmakers Merck and Bristol-Myers Squibb and a major lobby group, the American Pharmaceutical Research and Manufacturers Association, or PhRMA.

In a complaint filed in federal court earlier this year, PhRMA said the law forces drug makers to agree to a “government-dictated price” under threat of an exorbitant tax and gives price-setting power to the US Department of Health and Human Services. .

PhRMA representatives also said pharmacy benefit managers can still restrict access to drugs at negotiated prices by moving the drugs to a category of their formulary — the Covered Drug List — which may require higher out-of-pocket payments. Pharmacy benefit managers can also ask patients to try other medications first or seek approval before a prescription is covered.

Republican lawmakers have also criticized the Biden administration over its plan, saying the companies may hold back from offering new drugs that could be subject to bargaining in the future. They also wondered if the government knew enough to suggest drug prices.

CMS will begin negotiations on which drugs it will spend the most money on. The drugs must also be from generic competitors and be approved by the Food and Drug Administration.

CMS plans to meet this fall with drug companies that have a drug on its list, and government officials say they also plan to hold patient-focused hearings. By February 2024, the government will submit its first offer on a maximum fair price, and then give drug companies time to respond.

No prices will be negotiated until 2026. More drugs could be added to the program in future years.


Murphy reported from Indianapolis.

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