HHS announces cost savings for 64 prescription drugs
The drugs will have a lowered Part B coinsurance rate, since each drug company raised prices faster than the rate of inflation.
Photo: Jose Luis Pelaez/Getty Images
The Department of Health and Human Services through the Centers for Medicare and Medicaid Services has announced that some Medicare enrollees will pay less for 64 drugs available through Medicare Part B.
Under the Inflation Reduction Act and Medicare Rebate Program, some people with Medicare will pay less for some Part B drugs if the drug's price increased faster than the rate of inflation.
The drugs will have a lowered Part B coinsurance rate from July 1 through September 30.
CMS lists the drugs with adjusted coinsurance amounts for the quarter July 1–September 30.
Over 750,000 people with Medicare use these drugs annually, which treat conditions such as osteoporosis, cancer and infections.
WHY THIS MATTERS
Some people may save between $1 and $4,593 per day, CMS said.
Padcev, a medication used to treat advanced bladder cancer, is one example of a drug whose price increased faster than inflation. A beneficiary taking Padcev as part of their cancer treatment may have saved as much as $1,181 from April 1, 2023, through March 31, 2024, depending on their coverage and course of treatment, CMS said.
Another example, Crysvita, treats a rare genetic disorder that causes impaired growth, muscle weakness, and bone pain. A beneficiary taking Crysvita may have saved as much as $765 from July 1, 2023 through March 31, 2024 depending on their coverage and course of treatment.
THE LARGER TREND
The Inflation Reduction Act requires drug companies to pay rebates to Medicare when prices increase faster than the rate of inflation for certain drugs.
CMS intends to begin invoicing prescription drug companies for rebates owed to Medicare no later than fall 2025. The rebate amounts paid by drug companies will be deposited in the Federal Supplementary Medical Insurance Trust Fund, which will help ensure the long-term sustainability of the Medicare program.
In addition to the Medicare Prescription Drug Inflation Rebate Program, the Inflation Reduction Act expanded eligibility for full benefits under the Low-Income Subsidy program (LIS or "Extra Help") under Medicare Part D at the beginning of this year. Nearly 300,000 people with low and modest incomes are now benefiting from the program's expansion.
CMS said a public education campaign is underway to reach the more than three million people who are likely eligible for the program but are not yet enrolled.
In addition, as of January 1, some people enrolled in Medicare Part D who have high drug costs have their annual out-of-pocket costs capped at about $3,500. In 2025, all people with Medicare Part D will benefit from a $2,000 cap on annual out-of-pocket prescription drug costs.
ON THE RECORD
"Everyone should be able to afford their medication, and the Inflation Reduction Act continues to deliver on this goal to improve affordability," said CMS Administrator Chiquita Brooks-LaSure. "Discouraging drug companies from price increases above the rate of inflation is a key part of this effort, and CMS continues to implement the law to bring savings to people with Medicare."
Email the writer: nathaneddy@gmail.com
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