free webpage hit counter

Democrats’ long-desired plan to lower drug costs is at hand

WASHINGTON — For decades, as drug prices have soared, Democrats have battled the pharmaceutical industry to pursue an elusive goal: legislation that would lower prices by allowing Medicare to negotiate directly with drugmakers.

Now they are on the verge of passing a broad budget bill that will do just that, and in the process deliver a political victory that President Biden can take to voters in November.

Since the Affordable Care Act became law in 2010, it has empowered Medicare to negotiate the prices of 10 drugs, along with several other provisions aimed at lowering health care costs. A major part of the population. This could save some older Americans thousands of dollars in drug costs each year.

For three years, the legislation would allow low- and moderate-income people to receive large premium subsidies received during the coronavirus pandemic to get health care under the Affordable Care Act, and allow those with higher incomes to be eligible for such subsidies. Contagious to keep them. This allows drug makers to absorb some of the cost of drugs whose prices rise faster than inflation.

Notably, it caps the amount that Medicare recipients must pay out-of-pocket for pharmacy drugs at $2,000 annually — a big boon for the 1.4 million beneficiaries who spend more than that each year, often on drugs for serious illnesses like cancer and multiple sclerosis.

The lower prices make a big difference in the lives of people like Catherine Horin, 67, of Wheeling, a retired secretary with an illness and a lung recipient. She lives on a fixed income of about $24,000 a year. Her out-of-pocket drug costs are about $6,000 a year. She is digging into her savings, worried that she will run out of money before long.

“Two years ago, I was $8,000 in the hole,” he said. “Last year, I was $15,000 in the hole. I expect it to be more this year because of inflation.

Between 2009 and 2018, the average price for a brand-name drug in Medicare Part D, the program that covers pharmacy-dispensed products, doubled, the Congressional Budget Office found. Between 2019 and 2020, the price of nearly half of all Medicare-covered drugs will outpace inflation, according to an analysis by the Kaiser Family Foundation.

The budget office estimates the bill’s prescription drug provisions would save the federal government $288 billion over 10 years by forcing the pharmaceutical industry to accept lower prices from Medicare for some of its biggest sellers.

Opponents argue that the move discourages innovation and cite a new CBO analysis that projects it will lead to higher prices when drugs first hit the market.

Drugs for common conditions that affect the elderly, such as cancer and diabetes, are often chosen for talks. Analysts at investment bank SVB Securities pointed to blood thinner Eliquis, cancer drug Imbruvica and diabetes and obesity drug Ozempic as three of the first targets of the consultation.

Until recently, the idea that Medicare, which has about 64 million beneficiaries, would be able to use its muscle to cut deals with drugmakers was unthinkable. Democrats have been pushing for it since President Bill Clinton proposed his controversial health care overhaul in 1993. Washington ideology is against the intense lobbying of the pharmaceutical industry.

“It’s like lifting a curse,” Senator Ron Wyden, Democrat of Oregon and architect of the measure, said of the Medicare consultation provision. “Big Pharma Defends Ban on Negotiation as Holy Grail.”

David Mitchell, 72, is one of those helping. A retired Washington, DC, public relations person, she was diagnosed with multiple myeloma, an incurable blood cancer, in 2010. They pay $16,000 out of pocket each year for one in four drugs they take. He founded the advocacy group, Patients for Affordable Medicines.

“Drugs don’t work if people can’t afford them, and too many people in this country can’t afford them,” Mr Mitchell said. “Americans are angry and they’re being taken advantage of. They know it.”

Still, the measure doesn’t deliver every tool Democrats want to control prescription drug costs. The negotiated prices don’t go into effect until 2026, and apply to only a small portion of the drugs Medicare beneficiaries take. Pharmaceutical companies are still able to charge Medicare higher prices for new drugs.

That has disappointed the progressive wing of the party; The American Prospect, a liberal magazine, dismissed the move as “too modest”.

Prescription drug prices in the United States are higher than in other countries. A 2021 report by the RAND Corporation found that drug prices in this country were seven times higher than in Turkey, for example.

The pharmaceutical industry spends more than any other sector to advance its interests in Washington. Since 1998, it has spent $5.2 billion on lobbying, according to Open Secrets, which tracks money in politics. The insurance industry, the next largest spender, spent $3.3 billion. Drug makers spread their money around, giving roughly equal amounts to Democrats and Republicans.

At a media conference last week. Stephen J. Ubl, chief executive of PhRMA, the drug industry’s main lobbying group, warned that the bill would reverse progress on the treatment front, particularly in cancer care — a high priority for Mr. Biden, whose son died of a brain tumor. .

“Democrats are about to make the historic mistake of ravaging patients desperate for new treatments,” Mr. Ubl said, “Fewer new drugs are a steep price to pay for a bill that doesn’t do enough to make drugs more affordable.”

But Harvard Medical School and Brigham and Women’s Hospital Professor of Medicine Dr. Aaron S. Kesselheim said he believed the move would encourage innovation, “by encouraging investment in major new products rather than encouraging pharmaceutical companies to delay generic access to the same product and for as long as possible.”

In 1999, after his health care plan failed, Mr. Clinton resurrected the idea of ​​Medicare prescription drug coverage. But this time, instead of negotiating with Medicare companies, he suggested leaving it to the private sector.

“At that point, what we’re trying to do is accommodate the recognition that Republicans are in lockstep against any kind of government role,” said former Senate Democratic leader Tom Daschle.

But Republican President George W. It took Bush and a Republican Congress to push the prescription drug benefit over the finish line.

Medicare Part D had the support of the drug industry for two reasons: the companies were convinced it would gain millions of new customers, and the bill included a “non-interference clause” that expressly barred Medicare from negotiating directly. with drug manufacturers. Repealing that clause is at the heart of the current legislation.

The architect of the benefit was a colorful Louisiana Republican congressman named Billy Touzin, who at the time headed the House Energy and Commerce Committee. In Washington, Mr. Touzin remembers best: He left Congress in January 2005 to run PhRMA, charging that he was being rewarded for the bidding of companies — Mr. Tauzin insists it’s a false “narrative” created by Democrats to paint Republicans as corrupt.

Joel White, a Republican health policy adviser who helped write the 2003 law that created Medicare Part D, said the program was designed to use their leverage to lower prices for private insurers, pharmacy benefit managers and companies that already negotiate discounts for Medicare plan sponsors. .

“The whole model is designed to encourage private competition,” he said.

In the years since Medicare Part D was introduced, polling has consistently found that majorities of Americans in both parties want the federal government to negotiate drug prices. Former President Donald J. Trump only embraced the idea during his campaign.

The new legislation targets widely used drugs at a certain point in their existence — when they’ve been on the market for several years and still lack generic competition. The industry has been criticized for deploying strategies to extend patent life, such as slightly tweaking drug formulas or reaching “pay-for-delay” deals with rival manufacturers to delay the arrival of cheaper generics and “biosimilars,” like generic versions of biotech drugs. is called

Drugmaker AbbVie, for example, has racked up new patents to maintain a monopoly on its blockbuster anti-inflammatory drug Humira — and since its main patent expired in 2016 it has reaped about $20 billion a year from the drug.

Ten drugs will qualify for negotiation in 2026, with more to be added in subsequent years. The bill outlines criteria for selecting drugs, but the final decision rests with the health secretary — a Republican adviser to Mr. White warned that it could lead to a “tremendous lobbying campaign”. Or keep them away.

Analysts say the bill will hurt drugmakers’ bottom lines. Analysts at investment bank RBC Capital Markets estimate that most companies affected by the move will bring in 10 to 15 percent less revenue annually by the end of the decade.

But PhRMA warns that the drop in revenue will make drugmakers less willing to invest in research and development, with the Congressional Budget Office estimating that just 15 fewer drugs out of an estimated 1,300 will reach the market over the next 30 years. That time.

If the bill passes, as expected, it will inject an aura of drug industry power in Washington, opening the door for more drugs to be negotiated, said Leslie Dach, founder of Protect Our Care.

“Once you lose your invincibility, it’s very easy for people to take the next step,” he said.

Leave a Reply

Your email address will not be published.

Previous post Apple’s coveted cash hoard is dwindling — and that’s surprisingly good news for the stock price
Next post Calgary Sinzere hip-hop artist has big ambitions on the first full album