Tag Archives for Inflation Reduction Act

Wake up call on spiraling brand-name drug prices 

Published in RINewsToday on August 14, 2023

By Herb Weiss

A new pharmaceutical drug price report that is both timely and overdue has been released by AARP’s Public Policy Institute, following on the heels of the Centers for Medicare & Medicaid Services (CMS) releasing in June, which revised guidance for the historic Medicare Drug Price Negotiation Program.  

This report details the list prices for the 25 brand-name drugs with the highest total Medicare Part D spending in 2021, noting that prices have increased by an average of 226%—or more than tripled—since they first entered the market. Those 25 drugs were responsible for $80.9 billion in total Medicare Part D spending in 2021, about 37% of the total spending, and were used by more than 10 million Part D enrollees.  It noted that, on average, nearly 60% of their current list price was due to price increases after the product entered the market.

The price of Enbrel, used to treat rheumatoid arthritis and psoriatic arthritis, has increased by 701% since coming to market in 1998, and the price of Januvia, used to treat diabetes, has increased by 275% since entering the market in 2006.

Overall, the lifetime price increases ranged from 20% to 739%, and all but one of the drugs’ lifetime price increases greatly exceeded the annual rate of inflation over the same period of time. 

Brand-name drug prices increase faster than inflation has – for decades

“Brand-name drug prices have increased dramatically faster than inflation for decades,” said Leigh Purvis, Prescription Drug Policy Principal, AARP Public Policy Institute, and author of the report.  “The median price of a new brand-name prescription drug is now approximately $200,000 per year, so even relatively small percentage price increases can translate into thousands of dollars and put life-saving medications out of reach of the patients who need them,” she said. 

“We know that there is lot of media attention on individual drug prices that take place year after year.  However, a lot less attention is paid to how those price increases are often building on top of a long line of price increases and how those relentless price increases add up over time,” says Purvis, during a press call to journalists scheduled on the day of the report’s release.

“These findings have huge implications for the people that AARP represents, many of whom need prescription drugs to help them stay well,” Purvis said. “People on Medicare prescription drug plans take on average of between 4 and 5 prescription drugs per month and their drugs are increasing covered using coinsurance where you pay a percentage of the drugs price instead of a flat co-pay.  In fact, across the country more and more people are facing cost sharing directly affected by drug price increases, whether it is by coinsurance or simply before they meet their deductible.  Millions of other people don’t have health coverage and are having to absorb the cost associated with growing drug prices on their own,” she said.

“Our analysis shows that drugs that have been on the market for twenty years or more have seen an average lifetime price increase of 592 percent.  In real terms this can be the difference of thousands of dollars for one person and enough to force the trade-offs that we often hear about, like choosing to put food on the table or being able to pay for gas,” notes Purvis.

“There is no justification for drug companies to engage in these type of price increases every year they are on the market, particularly increases that are so much higher than the price increases for other goods and services,”  adds Purvis. 

CMS releases revised guidance for negotiating with drug manufacturers 

Congress recently passed the Inflation Reduction Act (IFA), a federal law requiring drug companies to pay a penalty to Medicare if their drug’s price increases faster than the rate of inflation. The law will also give Medicare the ability to negotiate lower drug prices with drug companies for the first time. CMS is expected to announce the first 10 drugs selected for negotiation by September 1st, and the negotiated prices will become available in 2026.

“This historic law cracks down on the big drug companies and [will bring] real relief to millions of seniors who have been struggling with out-of-control prescription drug prices,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy and Engagement Officer. “American families simply can’t afford to keep paying the highest prices in the world for the medications they need.”

Last March, CMS issued initial guidance to seek comments on its historic Medicare Drug Negotiation Program.  The agency received over 7,500 comments from consumer, patient groups, drug companies and pharmacies.  In June, CMS released its revised guidelines detailing the requirements and parameters of how the agency will oversee the new program.

“Issuing final guidance for the Medicare Drug Price Negotiation Program is an important “next step” in controlling spiraling high drug prices, says AARP’s LeaMond, noting that Medicare’s new buying power will get a better price for Medicare beneficiaries, saving the program billions of dollars and making prescription drugs more affordable.

Opposition, of course

At press time, the Pharmaceutical Research and Manufacturers of America (PhRMA), the leading industry lobby group for pharmaceutical companies, along with a group of pharmaceutical companies and trade groups, are suing the U.S. Health and Human Services to block the implementation of the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act enacted by President Biden last August. The U.S. Chamber of Commerce has also filed a lawsuit in a U.S. District Court in Ohio to ask for an injunction to keep the negotiations from going forward. The trade group is challenging the constitutionality of the IFA’s drug price negotiation program.   

It’s a very high lift and big burden to meet the standard to stop the law from being implemented,” noted Kelly Bagby, AARP’s Vice President at AARP Foundation Litigation, before AARP’s press call ended.

“It is entirely appropriate and is necessary and the public interest is so enormous in balancing of the government’s interest verses the pharmaceutical companies and Chamber’s interest in this case,” says Bagby,” stressing that beneficiaries have to win this case. “It’s so obvious that pharmaceutical companies are not the victims they are painting themselves to be, she adds, affirming her belief that beneficiaries and Medicare have the strongest argument.  

Bagby noted, “AARP is working to protect the integrity of whole Medicare program for everybody and to allow for older people to not have to make horrible choices about do I pay my rent or do I get to take my life saving drugs.” 

Reports a Wake-Up Call

Although PhRMA,  pharmaceutical companies and trade groups along with the U.S. Chamber are strongly opposed to CMS’s new program to negotiation drug prices, polls show that people aged 50 and over, view the lowering of the price of costly prescription drugs to be a very important policy issue to them. Purvis hopes that the recently released AARP report will serve as a wake-up call for every American who is skeptical about the importance of lowering prescription drug prices. “Higher government spending driven by drug price increases will affect all Americans in the form of higher taxes, cuts to public programs, or both,” she predicts.  

For a copy of AARP’s Medicare Part D Drug Price report, go to https://www.aarp.org/pri/topics/health/prescription-drugs/prices-top-medicare-part-d-drugs-tripled-since-entering-market.html.

Will Social Security survive the midterms?

Published in RINewsToday on October 31, 2022

With the midterm elections just a week away, the sputtering economy and inflation top the public’s agenda. If voters hold President Joe Biden and Democratic lawmakers accountable for these concerns, voting for Republican candidates might just give control of Congress to the GOP.  By controlling the legislative agenda of both chambers, the GOP could drastically impact the future of Social Security and Medicare, warns the Washington, DC-based Center for American Progress (CAP), a public policy research and advocacy organization.   

House Minority leader Kevin McCarthy (R-CA) signaled on Oct. 18 during a Punchbowl News interview that the GOP would use next year’s debt limit threat as a bargaining chip to force spending cuts to entitlement programs including Social Security and Medicare, warns CAP, sounding the alarm in an Oct. 21st website article.

CAP’s article reported that McCarthy’s statement reveals how he might use the upcoming debt-limit debates next Congress to make cuts in entitlement programs if he takes control of the House’s legislative agenda next Congress. “You can’t just continue down the path to keep spending and adding to the debt.  And if people want to make a debt ceiling {for a longer period of time}, just like anything else, there comes a point in time where, okay, we’ll provide you more money, but you got to change your current behavior.” When pressed on whether the GOP would seek cuts to entitlement programs in a debt ceiling fight, the House Minority Leader refused to take Social Security and Medicare cuts off the table, saying “he wouldn’t predetermine anything,” he said.

Over the past ten months some Republican lawmakers have transparently outlined their plans to change the entitlement programs, noted CAP, detailing these examples:  

Nearly 75% called for slashing and privatizing Social Security, raising the retirement age to 70, and ending Medicare as we know it as part of the Republican Study Committee FY 2023 budget, says CAP.  

According to CAP, statements made by two Republican Senators might gain traction in a GOP controlled Congress.  Specifically, Rick Scott (R-FL), Chair of the National Republican Senatorial Campaign Committee, might gain support for his “Rescue America” plan, that would sunset Social Security and Medicare after five years, and recreate it every five years.

Over four months ago, Senator Lindsey Graham (R-SC), a key Republican on the Senate Budget Committee, promised “entitlement reform is a must for us to not become Greece” if the Republicans control the upper chamber,” noted CAP. 

CAP also noted that Republican Senate and House candidates in hotly contested races also called for changes to Social Security and Medicare and prescription drug reforms that lower drug costs for seniors. 

Added CAP, “Forty seven percent of Republican candidates for U.S. House running in toss-up districts, according to the Cook Political Report, actively support ending Social Security or Medicare as we know it.”

House and Senate Republicans are calling for the repeal of the recently enacted Medicare drug reforms. “In a Sept. 2022 story in Axios, several House Republicans called for repealing the prescription drug reforms included in the [recently enacted] Inflation Reduction Act.  Rep. Kevin Brady (R-TX), the ranking member of the powerful House Ways and Means Committee, saying, “I would image that will be a top priority for Republicans in the new [Congress],” says CAP.

Even before the dust settles after the upcoming midterm elections, Republican Senators have sponsored legislation to eliminate Medicare prescription reforms, says CAP.  “Senate Republicans Marco Rubio (R-FL), Mike Lee (R-UT), Cynthia Lummis (R-WY), and James Lankford (R_OK) have sponsored legislation to repeal the Inflation Reduction Act’s prescription drug provisions, including the creation of a $2,000 out-of-pock cap on prescription drug spending for Medicare Beneficiaries; a crackdown on drug companies that increase drug prices in the Medicare program faster than inflation; and empowering Medicare to negotiate for lower prescription drug prices,” notes the web article.  

Can Rhode Island’s new congressman stand up to House GOP leadership?

Throughout the CD2 campaign, RI General Treasurer Seth Magaziner has tried to tie former Mayor Allan Fung to the GOP agenda to cut Social Security and Medicare.  Fung has called his Democratic opponent “a liar,” stating that his own mother relies on her Social Security check. During his debates, the GOP candidate says,  “Do you think I would ever do anything to hurt my own mother?” he says.

Fung calls for bipartisan support to strengthen Social Security – like “Scrapping the Cap” that will tax persons at higher incomes, and for the expansion of coverage for dental work, vision care, and hearing aids.  

Fung also distances himself from the far-right Republicans by consistently saying he has a long history of being a political moderate and taking a balanced approach and working across the aisle to get things done. He pledges to co-sponsor bipartisan legislation.

While Fung stays razor focused on tying Magaziner, President Biden and Congressional Democrats to causing high inflation rates and a sputtering economy, Magaziner says don’t forget about Social Security and Medicare.

In an interview with Politico Fung said, “I’ve always been that middle-of-the-road, common sense-type person. They’re talking like, ‘Oh, there’s this radical Republican.’ That’s not me.”

Politico continues, “Fung is among a small cadre of centrists looking to revive the mantle of New England Republican in the House. They’re largely running away from Trump and social conservatism, hitting their Democratic opponents on record-high prices and betting that inflation worries over everything from home heating oil to fertilizer will resonate in the region’s mix of tiny blue-collar cities, wealthy suburbs and family farms.”

Fung talks frequently about his intent, if elected to be involved in the “Problem Solvers Caucus”,  an independent member-driven group in Congress, comprised of representatives from across the country – equally divided between Democrats and Republicans – committed to finding common ground on many of the key issues facing the nation. He hopes to have a leadership role in this group, bringing a more moderate Republican influence to Congress.

As a moderate freshman congressman, can Fung be a strong voice to the GOP leadership against any proposal that would make cuts to Social Security and Medicare?  As a moderate freshman congressman, can Magaziner be a strong voice to the Democratic leadership?

It’s clear that after a Congressman (Langevin) with considerable years of clout in congress, both candidates will have a path in front of them to create their own influence and strength.