CMS announces 10 drugs under new price controls, advocates caution against ‘cruel’ consequences.
The Centers for Medicare and Medicaid Services Announce Drug Price Negotiation Program
The Centers for Medicare and Medicaid Services (CMS) has recently unveiled the list of 10 medications that will be included in the groundbreaking Drug Price Negotiation Program. This program, established through the Inflation Reduction Act, is set to impact an estimated 9.7 million patients suffering from various illnesses such as heart failure, blood clots, diabetes, and arthritis.
“For far too long, pharmaceutical companies have prioritized their profits over the well-being of American families. The exorbitant prices of life-saving prescription drugs have left many unable to afford the treatment they desperately need. However, thanks to the Inflation Reduction Act, we are now one step closer to achieving President Biden’s vision of increased accessibility and reduced costs for prescription drugs,”
said Secretary of Health and Human Services, Xavier Becerra.
Impact on Patients and Medications
The list of medications includes some of the most expensive drugs on the market, such as Eliquis, used to prevent blood clots, and Jardiance, prescribed for diabetes and heart failure. Other medications on the list include Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, as well as various products associated with diabetes medications Fiasp and NovoLog.
According to the HHS, these ten drugs accounted for a staggering $50.5 billion in Medicare Part D spending between June 2022 and May 2023, representing approximately 20% of the total Part D gross covered prescription drug costs.
The Negotiation Process and Future Plans
The Inflation Reduction Act grants the HHS secretary the authority to negotiate a maximum fair price for Medicare Part D coverage of expensive medications without generic or biologic alternatives. Secretary Becerra will finalize the first round of maximum fair prices by September 2024, and they will go into effect in the market starting from 2026.
Looking ahead, by 2029, the HHS plans to expand the negotiation program to include 20 drugs applicable to both Medicare Parts B and D.
Concerns and Perspectives
While the price controls on medications aim to benefit many patients, there are concerns about the potential negative impact on those with rare conditions. The costs associated with treating these conditions are often offset by patients who use less expensive drugs for more common illnesses.
Tom Schatz, president of Citizens Against Government Waste, warns that the IRA’s Medicare pricing provision has already hindered pharmaceutical research, potentially depriving patients of new life-saving drugs. He emphasizes the importance of allowing pharmaceutical manufacturers to recover their investments, even for drugs that do not reach the market.
On the other hand, patient advocate John “CZ” Czwartacki, founder and chairman of Survivors For Solutions, credits government support for innovation in helping find a cure for multiple sclerosis (MS). He believes that the IRA’s disincentives would have hindered the development of the treatments he needed, ultimately impacting his quality of life.
For individuals battling complex and rare diseases like MS, Czwartacki argues that the price negotiation program will hinder their access to vital treatments, reducing the pipeline of innovative solutions.
In conclusion, while the Drug Price Negotiation Program aims to address the issue of skyrocketing drug prices, it is crucial to consider the potential consequences for patients with rare conditions. Striking a balance between affordability and innovation remains a challenge that policymakers must navigate.
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