The Democrats’ long-term plan to lower drug prices is close

WASHINGTON — For decades, as prescription drug prices have soared, Democrats have battled drug companies to pursue a tougher goal: legislation that could lower prices by allowing Medicare to negotiate with drugmakers. church immediately.

Now, they are on the verge of passing a major budget bill that will do just that, in a process that delivers President Biden a political victory that his party can take to the voters in November.

Giving Medicare the power to negotiate the price of up to 10 prescription drugs — and more — and many other measures aimed at lowering health care costs, would be the biggest change in health policy since the Affordable Care Act became law in 2010. , affects one. large population. It could save some older Americans thousands of dollars in medical bills each year.

The bill would extend, for up to three years, the large financial assistance that low- and middle-income people received during the coronavirus pandemic to obtain health insurance under the Affordable Care Act, and give it to those with high incomes who qualify getting that kind of help in time. disease to keep them. It will also allow drug manufacturers to get some of the cost of drugs whose prices are rising faster than inflation.

Significantly, it would also limit how much Medicare recipients would pay out-of-pocket for drugs and pharmacies to $2,000 a year — a huge boon for the industry. 1.4 million beneficiaries those who spend more than that per year, often use drugs for serious diseases such as cancer and multiple sclerosis.

The lower cost will make a big difference in the lives of people like Catherine Horine, 67, a retired secretary and lung recipient from Wheeling, Ill. His out-of-pocket costs for the drug cost about $6,000 a year. He digs through his savings, worried that he will soon run out of money.

“Two years ago, I was $8,000 in the hole,” he said. “Last year, I was $15,000 in the hole. I expect that I will be worse this year, because of inflation.”

Between 2009 and 2018, the average price more than double for prescription drugs and Medicare Part D, the program that covers over-the-counter products, the Congressional Budget Office found. Between 2019 and 2020, prices are increasing faster than inflation for half of all drugs Medicare covers it, according to research from the Kaiser Family Foundation.

No budget agency plan and the bill’s prescription drug system would save the federal government $288 billion over 10 years, in part by forcing drug companies to accept lower prices from Medicare for some of its larger sellers.

Opponents argue that the measure will stifle innovation and state a new CBO analysis and work that it will lead to really high prices when the first medicine comes to the market.

Medicines for common conditions such as cancer and diabetes affecting the elderly are likely to be selected for discussion. Analysts at investment bank SVB Securities pointed to the blood thinner Eliquis, the cancer drug Imbruvica and the drug Ozempic, which is prescribed to manage diabetes and obesity, as three of the first targets for negotiations.

Until recently, the idea that Medicare, which has about sixty-four million Those who benefit, will be able to use his muscles to reduce their relationship with drug manufacturers which is unimaginable. Democrats have been pushing for it since President Bill Clinton proposed his controversial health care plan in 1993. The pharmaceutical industry’s staunch opposition to it has become Washington lore.

“This is like lifting a curse,” Senator Ron Wyden, Democrat of Oregon and the architect of the bill, said of the Medicare negotiations. “Big Pharma is protecting the ban and discussion like it’s the Holy Grail.”

David Mitchell, 72, is among those who will help. A retired Washington, DC, socialite, he learned in 2010 that he had multiple myeloma, an incurable blood cancer. He pays $16,000 out of pocket each year for just one of the four medications he takes. He founded the advocacy group, Patients for Affordable Drugs.

“Drugs don’t work if people can’t afford them, and most people in this country can’t afford them,” Mr. Mitchell said. “Americans are angry, and they are being taken advantage of. They know it.”

Still, the measure won’t deliver any of the tools Democrats need to win back prescription drug costs. The negotiated prices won’t take effect until 2026, and even then will affect only a small portion of prescription drugs taken by Medicare beneficiaries. Pharmaceutical companies will still be able to pay Medicare higher fees for new drugs.

That was a disappointment to the progressive wing of the party; The American Prospect, a liberal newspaper, has removed the measure as “very modest.”

Prescription drug prices in the United States are higher than in other countries. A 2021 History of RAND CORP found that the price of drugs in this country is more than seven times higher than in Turkey, for example.

The pharmaceutical industry spends more than any other sector to promote its interests in Washington. Since 1998, it has spent $5.2 billion on racing, according to the report Open Privacy, which examines money and politics. The insurance industry, which is the next largest, has spent $3.3 billion. Drug dealers spread their money around, giving to Democrats and Republicans in equal measure.

And a social media last week. Stephen J. Ubl, CEO of PhRMA, which oversees the pharmaceutical industry, warned that the bill will change the progress of treatment, especially in cancer care – the most need for mr. Biden, whose son died of a brain tumor. .

Mr. Ubl said, “Democrats are trying to make a historic mistake that will harm patients who want new treatments,” said Mr. Ubl. Ubl said, adding, “A few new drugs are a high price to pay for the debt that does not do enough to make medicine more affordable.”

But Dr. Aaron S. Kesselheim, a professor of medicine at Harvard Medical School and Brigham and Women’s Hospital, said he believes the system will stimulate innovation, by “encouraging investment in new products that are needed instead of forcing domestic energy medicine work as they strive to keep pushing. a product that delays the introduction of prices as long as possible.”

In 1999, when his health care plan failed, Mr. Clinton brought up the idea of ​​Medicare drug coverage. But this time, instead of suggesting that Medicare negotiate with corporations, he suggested leaving that to the private sector.

“At the time, what we were trying to do was to get the recognition that Republicans were against any kind of government activity,” said Tom Daschle, former Democratic Senate leader.

But it took a Republican president, George W. Bush, and a Republican Congress to push prescription drug benefits across the board.

Medicare Part D, as the benefit is known, has the support of the pharmaceutical industry for two reasons: The company is convinced that they will get millions of new customers, the bill has “non-stop clauses,” which clearly prevented Medicare from communicating directly. with pharmaceutical manufacturers. Repeal of that clause is the core of the current law.

The architect of that benefit was the brilliant Louisiana Republican senator, Billy Tauzin, who chaired the House Energy and Commerce Committee at the time. In Washington, Mr. Tauzin is best remembered as an example of the influence of the pharmaceutical industry: He left Congress in January 2005 to run PhRMA, drawing accusations that he was being paid to do business with the company – allegations Mr. . Tauzin insists that this is a “story” created by the Democrats to paint the Republicans as corrupt.

Joel White, a Republican health activist who helped write the 2003 law that created Medicare Part D, said the program was designed for private insurers, pharmacies and companies that Reimbursements for Medicare plan sponsors have been cut to reduce costs. .

“The whole model was designed to promote private competition,” he said.

In the years since Medicare Part D was introduced, Always check the polls and majorities of Americans from both parties want the federal government to be allowed to negotiate drug prices. A former president Donald J. Trump accept the ideaalthough it was only during his campaign.

The new law targets commonly used drugs during one phase of their existence – when they have been on the market for years but have no competition. The agency has been criticized for adopting measures to extend patent life, such as making drug formulations smaller or reaching “fees for delay” and manufacturers colluding to delay the arrival of cheaper generics and “biosimilars,” as a form of pharmaceutical biotechnology. is calling.

Drugmaker AbbVie, for example, collected new patents to maintain rights to its anti-inflammatory drug Humira — and it earns about $20 billion a year from the drug since its original patent expired. in 2016.

Ten drugs will be eligible for negotiation in 2026, with more being added in subsequent years. The bill specifies the criteria by which the drugs will be selected, but the final decision will depend on the secretary of health – provision of Mr. White, the Republican adviser, warned it would lead to a “tremendous campaign” to get the drug on the list. or keep them in it.

Analysts say the bill will damage the bottom line of pharmaceutical manufacturers. Analysts at the investment bank RBC Capital Markets estimated that many companies affected by the process will bring 10 to 15 percent lower income per year at the end of the decade.

But while PhRMA has warned that reduced revenue will make pharmaceutical manufacturers less willing to invest in research and development, the Congressional Budget Office has predicted that only 15 fewer drugs will reach the market over the next 30 years, out of an estimated 1,300 at the time.

The Senate is expected to take up the bill early Saturday morning, then send it to the House. If it passes, as expected, it will undermine the power of the pharmaceutical industry in Washington, opening the way for other drugs to enter the negotiations, said Leslie Dach, founder of Safe Care Care, an advocacy group. said.

“Once you lose you can’t win, it’s easy for people to do something else,” he said.

The Democrats’ long-term plan to lower drug prices is close

Source link The Democrats’ long-term plan to lower drug prices is close

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