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HHS Announces Cost Savings for 64 Prescription Drugs
Photo: Jose Luis Pelaez/Getty Images
O Department of Health and Human Services through the Centers for Medicare and Medicaid Services announced that some Medicare enrollees will pay less for 64 drugs available through Medicare Part B.
Under the Inflation Reduction Act and the Medicare Discount Program, some people with Medicare will pay less for some Part B drugs if the price of the drug increases faster than the rate of inflation.
Drugs will have a reduced Part B coinsurance rate from July 1 to September 30.
CMS list the drugs with coinsurance amounts adjusted for the quarter from July 1 to September 30.
More than 750,000 people with Medicare use these medications annually, which treat conditions such as osteoporosis, cancer and infections.
WHY IS IT IMPORTANT
Some people can save between $1 and $4,593 a day, CMS said.
Padcev, a drug used to treat advanced bladder cancer, is an example of a drug whose price has increased faster than inflation. A beneficiary taking Padcev as part of their cancer treatment could have saved up to $1,181 from April 1, 2023, to March 31, 2024, depending on their coverage and course of treatment, CMS said.
Another example, Crysvita, treats a rare genetic disease that causes impaired growth, muscle weakness and bone pain. A beneficiary taking Crysvita could have saved up to $765 from July 1, 2023, to March 31, 2024, depending on their coverage and course of treatment.
THE BIGGEST TREND
The Inflation Reduction Act requires drug companies to pay rebates to Medicare when prices rise faster than the rate of inflation for certain drugs.
CMS intends to begin billing prescription drug companies for rebates owed to Medicare by the fall of 2025. Rebate amounts paid by pharmaceutical companies will be deposited in the Federal Supplemental Medical Insurance Trust Fund, which will help ensure long-term sustainability. term 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 (LIS or “Extra Help”) program under Medicare Part D earlier 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 more than three million people who are likely eligible for the program but are not yet enrolled.
Additionally, starting January 1, some people enrolled in Medicare Part D who have high drug costs will have their annual payment out of pocket costs capped at about $3,500. By 2025, everyone with Medicare Part D will benefit from a $2,000 cap on annual prescription drug costs.
ON REGISTRATION
“Everyone should be able to afford their medications, and the Inflation Reduction Act continues to deliver on that goal of improving affordability,” said CMS Administrator Chiquita Brooks-LaSure. “Discouraging drug companies from raising prices above the rate of inflation is a key part of that 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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