Tag Archives for Nancy LeaMond

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.

A Call for Supporting the Nation’s Caregivers

Published in RINewsToday on June 12, 2023

Just 519 days until the 2024 Presidential Election (Nov. 5, 2024), older voters call on Congress to provide more support for the nation’s family caregivers, according to a new AARP Family Caregiving study, released on May 5, 2023, conducted by the bipartisan polling team of Fabrizio Ward and Impact Research.

Former First Lady, Rosalynn Carter, observed that “there are only four kinds of people in the world. Those who have been caregivers. Those who are currently caregivers. Those who will be caregivers, and those who will need a caregiver.” The results of AARP’s survey of U.S. registered voters, compiled in the 26-page report, U.S. Voters’ Views on Support for Family Caregivers, gives weight to the truth behind Carter’s quote as one-third of the voters in this study were caregivers in the past, one-fifth are currently caregivers, and half expect to be a caregiver in the future.

Caregivers Call for Government Support 

According to AARP, this is especially true for those age 50 and older: over two-thirds of voters, and 75% of voters 50+, say it is very important for Congress to help seniors live in their own homes. More than half (57%) say the same for supporting unpaid family caregivers, notes the poll’s findings.

An overwhelming majority of voters, 78%, are either a current, past, or future family caregiver. Over 70% of voters across the political spectrum say they would be more likely to support a candidate who backed proposals to support family caregivers, such as a tax credit, paid family leave, and more support and respite services.

“Family caregivers are the backbone of a broken long-term care system, providing $600 billion in unpaid labor each year and saving taxpayers billions,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy and Engagement Officer in a statement announcing the release of the poll findings. “It is long past time for lawmakers to enact commonsense solutions that support family caregivers and help older Americans live independently in their homes, where they want to be,” she says.

The poll’s findings indicate that legislative caregiving proposals are strongly supported across party lines: 89% of Democrats and 72% of Republicans support expanding services to help seniors live at home in the community rather than in a  nursing home. Requiring minimum staffing standards in nursing homes so residents receive quality care is supported by 8 of Democrats and 74% of Republicans polled in this survey. 

The researchers say that black voters, women, Democrats, and Latinos are especially likely to see long-term care and support for caregivers as key issues to be addressed by Congress. Among those groups, 77% of women, 82% of Black voters, 71% of Latinos and 77% of Democrats say expanding services to help seniors live independently in their own homes instead of a nursing home is very or extremely important.

Most caregivers feel stressed emotionally, stretched thin in both time (18%) and money (18%), and overwhelmed; 40% of all family caregivers say they spend over 20 hours a week on caregiving, with almost half (48%) of women caregivers spending over 20 hours a week.

“Anxiety over caregiving is not limited to those currently providing care,” says AARP, noting that more than two-thirds of voters express concerns about whether they will be able to get the care they need as they grow older or live independently.

“The data is clear: regardless of your political stripes, people adamantly want to age at home rather than a nursing home,” said Tony Fabrizio, partner in Fabrizio Ward, noting “It’s why support for helping caregivers is so politically important.”

“Family caregivers are stressed emotionally and financially, and proposals to help them are overwhelmingly popular and key to helping older Americans remain in their homes,” said John Anzalone, founder of Impact Research. “This may be the sleeper issue of the 2024 elections with a voting group that makes up one in five Americans,” he says.

Caregivers Need Assistance

For many caregivers, providing care to their loved ones takes a big chunk out of their yearly finances, and time that they must give to providing the caregiving. According the AARP’s report, four in ten family caregivers report spending over 20 hours a week on their caregiving responsibilities, while roughly six in ten incur $1,000 or more in annual out-of-pocket expenses on items such as medical supplies and equipment, transportation, or home modification. Emotional stress, having to miss important events, and needing to balance their work, family, and caregiving responsibilities are impact the majority of family caregivers.

When asked what they would like Congress or their state government to do, family caregivers say they would like increased access to healthcare and financial support. Seven in ten voters ages 18 and older say they would be more likely to support a political candidate who backed legislative proposals to support family caregivers, such as paid family leave; a tax credit of up to $5,000; and expanded access to support and respite services. These policies would allow family caregivers an opportunity to take a break from caregiving, helping to prevent their burnout and allowing them to continue providing caring for their loved ones.

According to the polls findings, most voters ages 18 and older express concern about whether or not they will be able to get the care they need when they grow older. Roughly two-thirds says they are concerned they won’t have enough money to pay for the care they need, or they won’t be able to live independently at home, while six in ten are worried that they will need to live in a nursing home providing poor care.

The Support for Family Caregiving study was conducted by the bipartisan polling team of Fabrizio Ward and Impact Research for AARP. The poll used a sample of U.S. voters age 18 and older (with oversamples of voters age 50 and over, black voters, Hispanic voters, Asian and Pacific voters and family caregivers) using a combination of phone and text to web sampling. A total of 1,425 completed 20-minute in length interviews, were  conducted in English from April 4-10, 2023.

The margin of error for the 1,425 adults’ sample is +/- 3.4% at the 95% level of confidence. For the oversampled groups, the margins of error are: +/- 3.4% for voters 50+, +/- 6.9% for Black and Latino voters, +/- 8.9% for AAPI voters, and +/- 4.9% for voters 50+.

To see poll findings, go to https://www.aarp.org/content/dam/aarp/research/surveys_statistics/ltc/2023/voters-views-caregiving-support-report.doi.10.26419-2Fres.00616.001.pdf.

For more details, contact Teresa Keenan, AARP’s Director, Consumer Insights, Health and Health Security, at TKeenan@AARP.org.

Ratcheting up SSA’s customer service will take more funding 

Published in RINewsToday on May 1, 2023

Over two months ago, as required by law, Kilolo Kijakazi, Acting Commissioner of Social Security Administration (SSA) released the fiscal year 2023 operating plan to Sen. Patty Murray (D-Wash.), chair of the Senate Appropriations Committee. The report, released on Feb. 10, 2023, details how SSA plans to use its $14.1 billion budget allocation for the year. 

Kijakazi wrote in the report’s transmittal letter: “In FY 2023, we will build the foundation for improved services by rebuilding our workforce after ending FY 2022 at our lowest staffing level in over 25 years.”

According to Kijakazi, at the end of Dec. 2022 the initial SSA claims-pending level soared to almost 975,000 cases.  This was more than 380,000 cases higher than at the end of FY 2019. “The average initial claims wait time through Dec. 2022 was 206 days compared to 120 days in FY 2019.  It will take a multi-year effort and sustained funding to restore our average initial disability claims wait times to pre-pandemic levels,” she says.

While Kijakazi anticipates processing 129,000 or 7% more initial disability claims in FY 2022 (52 weeks), she expects wait times for a disability decision at the initial and appeal levels to increase for a period of time because backlogs will continue to grow while the agency hires and trains new staff. 

Although the FY 2022 outlay represents $785 million of the agency’s budget of $13.34 billion, it was less than the $14.8 billion President Joe Biden requested for administration funding. In February 10th correspondence to the House and Senate Appropriation Committees, Kijakazi stated that while budget increases will cover fixed costs and support staffing in the upcoming fiscal year, “some performance will show improvement in FY 2023, while others will show temporary degradation.” 

Conversations regarding SSA’s customer service challenges

In February 28th correspondence to SSA’s Kijakazi, AARP’s Nancy LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer, recognized increased funding was necessary for SSA to address its customer service problems. AARP recognizes that federal funding has not kept pace with increases in operational cost and demands, but the agency “needs to do more to constrain operating costs and increase productivity,” Kijakazi says.

LeaMond called the “expected decline in service troubling, given multiple assurances from SSA that the funding level received would be sufficient to at least maintain the modest customer service improvements made last year.”

“Your operating plan asserts that the already unacceptable average of call wait time of 33 minutes will be longer this year, increasing to 35 minutes, and people trying to call the agency will get a busy signal 15 percent of the time, more than double the rate last year.  This is an unacceptable step backward,” wrote LeaMond.

LeaMond says that SSA’s operating plan doesn’t address several customer service areas, especially the challenges of beefing up staff to improve in-person services and reducing wait times and busy rates that the public should expect when calling their local office.  She called for more details and when beneficiaries can expect improvements to online services.

“Even more concerning is the fact that the operating plans note that disability-related service improvements are not expected to occur before 2024 fiscal year,” adds Leamond. While the plan provides details about disability claims, and appeal workloads, as well as prioritization of claimants who have been waiting the longest, she calls on SSA to “act more quickly to improve the disability process.”

“The Social Security Administration (“SSA”) has large fixed costs, such as rent on its network of 1200 field offices, and those fixed costs increase every year. SSA’s funding does not come from the general government budget, but rather from Social Security’s accumulated reserve of $2.8 trillion. Yet for over a decade, Congress has restricted SSA from spending the funds necessary for adequate service,” says Nancy Altman, President of Social Security Works (SSW).

Adds Altman, “While Congress this year allowed SSA to spend more, the additional dollars did not even cover all the fixed costs. They certainly did not correct the many years of underfunding. Service will not significantly improve unless Congress allows SSA to spend more of  Social Security’s accumulated reserve  — at the bare minimum,  the $15.5 billion that President Biden has requested — but ideally significantly more.”

Biden budget seeks to fix SSA’s customer service issues

In a blog article penned on March 30, 2023, Kathleen Romig, Director of Social Security and Disability Policy at the Washington, DC-based Center for Budget and Policy Priorities, says that SSA has an opportunity to ratchet up its consumer service impacted by decades of restricted funds by receiving increased funding. “With additional funding in for the coming year, the agency could invest in the staff and technology it needs to better serve the public,” she says.

“Since 2010, SSA’s customer service budget has fallen by 17 percent after inflation, with its staffing falling a commensurate 16 percent – marking the lowest level in 25 years. These cuts happened even as the number of Social Security beneficiaries grew by 12 million, or 22 percent. Being forced to serve millions more people with fewer staff and resources has caused tremendous strain at SSA, and beneficiaries are suffering the consequences,” says Romig.

On March 9th, Biden released a FY 2024 budget calling for increased appropriations to SSA. According to the Office of Management and Budget (OMB), the president’s budget provides an increase of $1.4 billion (a 10% increase) over the FY 2023 budget to cover salaries, benefits and rent increases. It would also improve customer service at field offices, state disability determination services, and teleservice centers.   

Each year, SSA processes more than 6 million retirement, survivors, and Medicare claims, and more than 2 million disability and SSI claims, says OMB, charged with producing the president’s budget. Biden’s budget increase boosts staffing levels from FY 2023, allowing the agency to process about a half a million more disability cases in FY 2024 that were completed in FY 2022, significantly reducing wait times for those decisions.

GOP debt limit bill drastically cuts SSA’s operating budget

Just last week, by a razor thin margin, House Speaker Kevin McCarthy (R-CA)’s Limit, Save, Grow Act of 2023 (H.R. 2811) passed by a partisan vote of 217-215. Four Republicans voted “no”. While this legislation to lift the nation’s debt limit allows the U.S. Treasury to pay the nation’s bills, it has no chance for passage in the Democratic-controlled Senate. However, it will force the president’s team to the negotiation table with Republican House and Senate leadership, hoping it will push compromise on future spending limits.

Failure to increase the debt limit would have catastrophic consequences for the U.S. and global economies, as well as for all Americans, who rely on the federal budget to provide public services. (from Social Security and Medicare to food safety inspection, air traffic control, school nutrition, and environmental. 

After the House vote, Alex Lawson, SSW’s Executive Director of Social Security, charged that 217 House Republicans just voted to cut Social Security. “Nearly every Republican in the U.S. House just voted to slash the already inadequate funding of the Social Security Administration (SSA). If this bill becomes law, it will force SSA to close field offices, reduce hours, and lay off thousands of workers. This will make it far harder for Americans to claim the benefits they’ve earned,” warned Lawson. “Cuts to SSA are cuts to Social Security, and we will hold every single one of these members accountable,” he says.

Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) agrees with SSW’s assessment. One day before the vote, he wrote House members to urge them to pass “clean’ debt limit legislation.

“If the spending cuts and other [GOP] legislative changes that are incorporated in this legislation were ever to become law, the negative impact would be felt by virtually every American family in every Congressional District in the country,” wrote Richtman.

According to Richtman, the GOP’s proposed debt limit legislation includes among its provisions a roll-back of ALL discretionary federal spending to Fiscal Year 2022 levels in FY 2024, with growth limited to one prevent annually for the next decade. “This is not a minor trimming of spending that has been portrayed by some, but a dramatic slashing that will have devastating impacts on the Americans who rely on the affected programs for their health and well-being,” says the nationally recognized Social Security advocate. 

Reluctance to cut Defense and Veteran Health funding would have at least a 23 percent reduction to all other programs for FY 2024, charges Richtman, this resulting in funding cuts to SSA’s customer service budget.

“Cutting funding by six percent would significantly affect SSA’s ability to serve the public and undermine the Agency’s core-mission – producing longer wait times for benefits and to reach SSA representatives, as well as reduced access to in-person programs, noted Richtman, stressing that face-to-face access with SSA’s employees is critical to those who are elderly and disabled.

SSA calculates that for every $100 million in additional funding cut the federal agency would be forced to lay off an additional 1,000 employees, this equivalent to closing 40 field offices, says Richtman.

Since 1960, Congress has acted 78 separate times to permanently raise, temporarily extend, or revise the definition of the debt limit – 49 times under Republican presidents and 29 times under Democratic presidents, says the U.S. Treasury.  Like in the past, this Congress must follow to raise the nation’s debt limit, and is expected to do so.

Ultimately, it is crucial for Biden and McCarthy’s negotiations to hammer out a “clean” debt limits bill that will not cut SSA’s operational funding further which could send the agency’s customer service efforts into a tailspin. It is time for Congress to fix SSA’s operational funding issues once and for all to improve customer service provided to 65 million beneficiaries. 

For a copy of SSA’s 2023 Operating Plan go to https://www.ssa.gov/budget/assets/materials/2023/2023OP.pdf.

For a summary of H.R. 2811, Limit, Save, Grow Act of 2023, go to 

https://www.govtrack.us/congress/bills/118/hr2811/summary

For a copy of President Biden’s FY 2024 Budget, go to:  https://www.whitehouse.gov/omb/briefing-room/2023/03/09/fact-sheet-the-presidents-budget-for-fiscal-year-2024.