Biden Administration Maps Out Drug Price Negotiation Process
The federal government will select the Medicare program's 10 costliest prescription medicines based on gross spending. As part of a multi-step negotiation process it will then negotiate price cuts that will go into effect in 2026.
Axios:
Biden Admin Lays Out Medicare Drug Negotiation Process
The Biden administration on Wednesday began fleshing out how it will implement drug-pricing provisions in the Inflation Reduction Act, including a multi-step negotiation process for selected Medicare drugs starting next year. (Bettelheim, 3/16)
Reuters:
Biden Says 'More Coming' On Drug Pricing After Inflation Fines
U.S. President Joe Biden on Wednesday said his administration would subject 27 drugs to inflation penalties, a move that will reduce out-of-pocket costs for Medicare recipients by as much as $390 per dose, and he pledged more drug price cuts were coming. ... Drugmakers hiked the price for 27 drugs last quarter higher than the rate of inflation, and will have to pay the difference on those medicines to Medicare, the government healthcare program for those age 65 and older and the disabled. (Aboulenein and Holland, 3/15)
Reuters:
U.S. Issues Initial Medicare Drug Price Negotiation Guidance
The U.S. government will select the Medicare program's 10 costliest prescription medicines based on gross spending for negotiating price cuts that will go into effect in 2026, the U.S. Centers for Medicare and Medicaid Services (CMS) said on Wednesday. CMS will only accept one formal written counter offer during the negotiation process, but will allow up to three additional in-person or virtual negotiation meetings, the agency said in initial guidance issued on Wednesday for its Medicare drug price negotiation program. (Aboulenein and Erman, 3/15)
The Hill:
Biden Administration Names First Round Of Drugs To Face Medicare Rebate Penalties
In a press briefing, Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said her agency will invoice the drugmakers for these rebates beginning in 2025. “The Medicare prescription drug inflation rebate program is strengthening Medicare by making prescription drugs affordable for millions of people and discouraging drug companies from increasing prices faster than inflation,” Brooks-LaSure said. “It’s also protecting Medicare for our children and grandchildren.” (Choi, 3/15)
Stat:
Medicare Explains How It Will Choose Drugs For Negotiation
Medicare laid out Wednesday in the greatest detail yet how it will choose which drug prices it will negotiate in its brand-new program, and how it will figure out what the government’s opening offer will be. (Cohrs, 3/15)
On Biden's fiscal battle with Republicans —
AP:
Biden Says He's Focused 'Intensely' On Lowering Drug Costs
President Joe Biden on Wednesday said his administration was focused “intensely” on lowering health care costs and took aim at “MAGA” Republicans who he said are intent on dialing back Medicare coverage for millions of Americans. Biden used a speech in Las Vegas where he was wrapping a three-day Western swing to make the case there are stark differences in how Democrats are tackling skyrocketing drug prices compared to their Republican counterparts. (Seitz and Miller, 3/15)
The Wall Street Journal:
Biden Hits GOP On Drug Prices In Campaign Battleground State Of Nevada
He criticized Republicans for opposing the sweeping climate, healthcare and tax law passed last year, which featured several provisions meant to lower drug prices, including the measure that gave the government authority to negotiate prices for Medicare beneficiaries. The president urged Congress to pass additional policies on drug prices, calling for capping the cost of insulin at $35 for all Americans. The law caps insulin prices for people who rely on Medicare. Most Senate Republicans voted to strip a provision out of Democrats’ climate and healthcare bill that would have capped costs at $35 for patients with private insurance. (Restuccia and Collins, 3/15)
Axios:
Hill Democrats Search For The Next Big Health Care Target
First, it was passing the Affordable Care Act. Then, it was defending it. Then it was allowing Medicare to negotiate drug prices. But with those big boxes checked, it's not clear what congressional Democrats' next big health care goal is. (Sullivan, 3/16)
In related news about Medicare —
Stat:
The Medicare Policy That Has Hospitals Worried This Year
There are few things that get lawmakers in Washington salivating more than a wonky policy that saves the federal government a whole lot of money. As debate in the Capitol rages about the future of the Medicare program, hospitals are worried that lawmakers could finally be considering a change they hate — so-called site neutral payment policy. It’s somewhat of a unicorn on Capitol Hill — it saves the federal government tens of billions of dollars, reduces patient costs, and it’s gained bipartisan support over the years. (Cohrs, 3/16)
Stat:
Would The Federal Government Defer To States To Regulate PBMs?
After years of struggling to regulate the drug middlemen that create pharmacy networks, the federal government could lean on states to rein them in — even, potentially, in Medicare. The Department of Justice has until next month to tell a federal appeals court where the administration stands on the issue. (Wilkerson, 3/15)
NerdWallet:
When Will Medicare Cover Medical Marijuana?
One in five Medicare recipients currently uses medical marijuana, according to an April 2022 poll by the Medicare Plans Patient Resource Center, an organization that provides Medicare guidance and information. And nearly a quarter have used it in the past. Two-thirds of Medicare recipients think Medicare should cover it, the poll found. But Medicare doesn’t cover medical marijuana because it’s not federally legal and not approved by the Food and Drug Administration. Here’s where the situation stands. (Ashford, 3/15)
