BIOtech Now
Brian Newell
The Medicare prescription drug program has been a remarkable success for both seniors and taxpayers, providing affordable medicines to millions of Americans. Yet some lawmakers on Capitol Hill have introduced legislation that would ultimately break a program that’s working in order to address a problem that doesn’t exist.
This new bill is based on an old concept. It would empower the federal government to directly negotiate the price of prescription drugs in Medicare. While it may be well intended, the legislation will ultimately lead to federal price controls and restrict the ability of seniors to afford the medicines they need. As Gary Puckrein, head of the National Minority Quality Forum, recently wrote:
“The only way the government could lower drug prices, according to the [Congressional Budget Office], would be to create a ‘one-size-fits-all’ formulary. That means federal officials would decide which medicines Part D would cover. To keep costs down, the government would exclude certain medicines currently offered on Part D plans.”
That’s why more than 200 patient-advocacy groups have urged Congress to reject this idea because it could “jeopardize beneficiaries’ access to comprehensive, affordable prescription drug coverage.”
Congress shouldn’t inflict this kind of hardship on seniors, and it shouldn’t upend a program that’s delivering positive results.
- The private insurance plans that administer the program already negotiate aggressively with drugmakers to achieve savings on behalf of seniors and taxpayers. In fact, a leading pharmacy benefit manager reports a negative trend for Medicare drug costs during the first half of this year.
- Plans and patients in Medicare Part D pay an estimated 35% below list price for a dozen widely-used treatment areas — a better discount than what the private sector generally receives for the same drugs.
- Premiums for Medicare Part D beneficiaries are projected to decrease by more than 3% in 2018 and cost seniors on average just $33.50 per month.
- The Medicare Part D prescription drug program has cost taxpayers $349 billion less than originally projected and nearly 90% of seniors are satisfied with the program.
Instead of breaking a program that’s working, Congress should pursue a more responsible approach for improving patient access to affordable medicines. It can start by examining a proposal put forward by drugmakers, insurers, patient advocates, pharmacy benefit managers, and others. Introduced by the Council for Affordable Health Coverage, this consensus proposal relies on market-based solutions, which has proven to be a better approach for seniors and all Americans.
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