The United States government has proposed new rules that would reduce the cost of prescription drugs for millions of Americans who rely on Medicare and Medicaid programs. The move comes from President Joe Biden’s efforts to lower drug prices, a long-standing issue for many Americans.
According to a statement from the Centers for Medicare & Medicaid Services (CMS), the new proposed rule would require Medicare Part D plans to cover at least one drug in each therapeutic category, including drugs with generic versions that cost no more than $3 per month. This change would ensure that patients have access to more affordable medication options.
The proposed rule would also require Medicare Part D plans to provide more information to patients about the cost of their prescription drugs. This includes notifying patients when they reach the coverage gap, also known as the “donut hole,” where they must pay more for their drug costs. Additionally, the proposed rule would require Medicare Part D plans to provide patients with information about lower-cost alternatives and other ways to save money on their prescriptions.
CMS Administrator Chiquita Brooks-LaSure said, “We’re proposing changes to the Medicare Part D program to help lower out-of-pocket costs for beneficiaries and ensure access to affordable drugs. This rule reflects our commitment to putting patients first and making healthcare more affordable for all Americans.”
Various healthcare organizations and advocacy groups support the proposal, including the National Association of Chain Drug Stores, the National Community Pharmacists Association, and the Medicare Rights Center.
“Access to affordable, effective medicines is a fundamental component of quality healthcare,” said NACDS President and CEO Steven C. Anderson. “The proposals would help to ensure that seniors and individuals with disabilities can obtain the prescription drugs they need at a cost they can afford, especially those in underserved areas.”
However, the proposed rule has also faced criticism from some who argue it could negatively affect drug innovation and development. For example, in a statement to Reuters, the Pharmaceutical Research and Manufacturers of America (PhRMA) said, “The policies proposed by CMS could lead to increased utilization of lower-cost drugs, but they do nothing to address the root cause of high drug prices.”
Despite the criticism, the Biden administration has continued emphasizing the importance of making prescription drugs more affordable for Americans. For example, in a recent speech, President Biden said, “We’re going to take on the pharmaceutical companies that knowingly price their prescription drugs unaffordable. The American people shouldn’t have to pay more for their medicines than folks do in other countries.”
If the proposed rule is finalized, it will go into effect on January 1, 2024. However, the CMS accepts public comments on the proposal until April 4, 2023.
Overall, the proposed rule has the potential to significantly impact the cost of prescription drugs for millions of Americans who rely on Medicare and Medicaid programs. While there are concerns about its potential impact on drug innovation, the proposed rule has garnered support from various healthcare organizations and advocacy groups. However, with public comments now open, it remains to be seen what changes will be made to the proposal before it is finalized.
