The Biden administration has announced significant reductions in the list prices of 10 of Medicare’s most expensive drugs, potentially saving billions for taxpayers and seniors. These reductions, ranging from 38% to 79%, are set to take effect in 2026.
According to the White House, taxpayers could save $6 billion, and Medicare beneficiaries might collectively save $1.5 billion annually on these drugs. The list of drugs affected includes high-cost medications such as blood thinners Xarelto and Eliquis, and diabetes drugs Jardiance and Januvia.
Challenges in Predicting Savings
While the new prices are expected to reduce overall costs, the exact savings for individual seniors remain uncertain. The final price paid at pharmacies depends on various factors, including discounts, coinsurance, and copays associated with individual Medicare plans.
Tricia Neuman of the health policy research nonprofit KFF notes that while lower negotiated prices should result in reduced out-of-pocket costs for those with coinsurance plans, the impact will vary based on individual insurance plans and payment structures.
Immediate Relief and Future Projections
Before the new prices take effect, Medicare enrollees will benefit from a new rule starting next year that caps annual drug costs at $2,000. This interim measure is expected to provide some relief from high drug costs.
Political Reactions and Criticisms
Vice President Kamala Harris highlighted the achievement as a major win for the administration, emphasising the role she played in enabling Medicare’s negotiation power through the Inflation Reduction Act (IRA). However, the law faced Republican opposition and was narrowly passed in Congress.
Critics, including Steve Ubl of the Pharmaceutical Research and Manufacturers of America (PhRMA), argue that while the IRA's price-setting scheme may garner political praise, it could result in higher drug plan premiums and potential cost increases in other areas. Drug companies, which initially attempted to block the negotiations, have suggested that the new pricing might lead to higher consumer costs elsewhere.
Expert Perspectives
Health law expert Rachel Sachs notes that drug companies often support price caps due to their potential to expand market access and increase revenue through higher patient affordability. Despite criticisms, the new law is seen as a step toward making medications more affordable for seniors.