Millions of seniors depend on their Medicare coverage for affordable access to prescription medicines. Yet, policymakers are considering a number of changes to the Medicare programs that would impact seniors’ access to care. While some changes would lower their out-of-pocket costs, others would restrict access to medicines. Any changes to seniors’ Medicare coverage should be for beneficiaries’ benefit – not to their detriment.
One recent proposal would significantly improve seniors’ access and affordability to lifesaving medicines through Medicare Part D. The Department of Health and Human Services recently proposed a rule that would encourage the rebates Medicare Part D plans negotiate with biopharmaceutical companies to be entirely passed through to beneficiaries at the pharmacy counter.
Analysis shows that when rebates are shared with seniors, their out-of-pocket costs significantly decrease, making it easier to afford and maintain their prescribed treatments. For example, a patient with diabetes taking five medicines, including insulin, may see his annual premium increase by $67, but he would save $895 at the pharmacy counter for his medicines.
Patients should share in the $166 billion in rebates and discounts biopharmaceutical companies pay to insurance companies, the government and middlemen. That’s the right approach for seniors.
Meanwhile, some proposals would put seniors’ Medicare benefits in jeopardy. These changes aim to constrain costs for the government but come at the expense of seniors’ access to the medicines and care they need.
The proposed International Pricing Index (IPI) model is a proposed policy that would have harmful impacts on seniors’ Medicare benefits. This concerning proposal from the Department of Health and Human Services would set U.S. prices for Part B medicines based on the prices set by foreign governments. Research shows that every time other countries have set prices for medicines – as this proposal would – it has resulted in restriction in access. For instance, on average, just half of new cancer medicines launched since 2011 are available in the 14 comparator countries that Medicare prices would be based on under the proposal. While 96% of newly approved cancer medicines are available in the United States. Not only do patients in these countries have fewer options than in the United States, but they have to wait longer, on average, for new medicines than U.S. patients – not the kind of care we want for America’s seniors.
Policymakers should implement Medicare changes that ensure seniors have access to innovative treatments to improve their overall well-being. To learn more about potential changes to Medicare and their impact on senior health care visit PrescriptionForMedicare.org.