Morning Briefing
Summaries of health policy coverage from major news organizations
CMS Readies List Of 10 Drugs That Will Be First In Medicare Price Negotiations
Bloomberg: Billion-Dollar Drugs’ Makers Set To Face Their First US Price Negotiations
Some of the most widely used drugs in the US may be heading for lower prices under Medicare, a move that could save taxpayers billions of dollars and squeeze profits for big pharmaceutical companies. The US government is preparing to release a list this week of 10 drugs that the health program for the elderly will be able to negotiate prices for — one of the key elements of President Joe Biden’s signature Inflation Reduction Act. Analysts expect Johnson & Johnson’s Xarelto blood thinner and Eli Lilly & Co.’s Jardiance for diabetes to be among the medications chosen. (Tozzi and Cattan, 8/28)
USA Today: Medicare's Priciest Drugs May Get Cheaper As Feds Start Negotiations. Big Pharma Objects.
For the first time, the federal government is allowed to negotiate drug prices for older Americans because of the Inflation Reduction Act, the sweeping climate and health legislation passed by Congress last year. The Centers for Medicare & Medicaid Services must publish the list of 10 drugs by Friday, but administration officials have signaled the announcement could come earlier in the week. (Alltucker, 8/27)
Stat: AstraZeneca Challenges Medicare Drug Negotiation Program
AstraZeneca is the sixth drugmaker to pile on a legal challenge to the Biden administration’s drug pricing reform law. The Medicare drug price negotiation program created in the Inflation Reduction Act is set to kick off in the next week, as officials will release the names of the first 10 medicines that will be selected for the program. Medicines are eligible for selection if they are one of the highest-spend drugs for Medicare, and they have no generic competition. (Cohrs, 8/25)
Politico: The Real Reason Drugs Cost So Much — And Do Too Little
Until 2003, Medicare covered most hospital and doctor visits for the elderly, but it did not cover the ever-growing costs of prescription medications. Former President George W. Bush changed that when he signed a law adding prescription drug coverage to Medicare. But there was a catch. At drug companies’ behest, the Republican-controlled Congress banned Medicare from using its market power to drive down drug prices. The prohibition was controversial at the time — Nancy Pelosi, then the House Minority Leader, called it “unconscionable.” Critics saw the prohibition as the government’s abandonment of the single most effective tool for restraining drug costs. (Bagley, 8/27)
In other Medicare news —
The Wall Street Journal: Paying Extra For Medicare? See If You’re Due A Refund
For more than five million Americans, even a dollar of extra income can boost annual Medicare premiums by hundreds or thousands of dollars—but refunds of these surcharges are sometimes available. Many Medicare recipients don’t know this, says Drew Tignanelli, a CPA and adviser who has obtained dozens of refunds for clients: “We warn them when they could get hit hard and tell them to call us when they get the letter.” (Saunders, 8/25)
Stat: Feds Fine Medicare Advantage Plans For Overcharging Members
The federal government has started penalizing Medicare Advantage insurers that have one common, glaring problem: Faulty technology systems are leading to people paying more for care and coverage than they should be. (Herman, 8/28)
