BETHLEHEM, Pa. — With the new year comes new changes to drug prices.
Some of the most popular prescriptions are getting cheaper for those on Medicare.
The Center for American Progress held a briefing this week to discuss the cost-saving provisions taking effect this year, following the 2022 Inflation Reduction Act.
The act granted the federal government the authority to negotiate with pharmaceutical companies for lower prices on 10 widely prescribed drugs.
The changes affect people with Medicare Part D prescription drug coverage.
Health policy expert Andrea Ducas from the Center for American Progress explained that the provision that went into effect in January eliminates the 5% coinsurance and caps the amount those on Medicare will spend on prescriptions.
"Effectively, you're going to be spending no more than $3,500 or so this year on brand name drugs. Next year, you shouldn't be spending more than $2,000 a year on any drug."Andrea Ducas, Center for American Progress
“If you're taking brand name drugs, and many people on Medicare are, those are very expensive drugs,," Ducas said.
"Effectively, you're going to be spending no more than $3,500 or so this year on brand name drugs. Next year, you shouldn't be spending more than $2,000 a year on any drug, like your total drug spend.
“There's a precursor step to that $2,000-a-year annual cap on all out-of-pocket expenses, which is eliminating 5% coinsurance that prior to this January, everybody on Medicare Part D had to pay.”
During the briefing, two Pennsylvanians shared their experiences with high drug costs.
'This is huge'
Yamelisa Jimenez Taveras, of Allentown, was among those women. She has live with Type 1 diabetes since she was 10 years old.
“There are still so many things that are in place that honestly get in the way of individuals accessing life-sustaining medications," Taveras said. "So this is huge."
The cost of insulin was capped at $35 a month for seniors on Medicaid as part of the Inflation Reduction Act she supported.
“There are just so many people, not just in the district where I live, but all around, that are struggling with this, and that will truly greatly benefit from continuing to cap life-sustaining medications such as insulin.”
Tavaras, an Allentown business owner, is a diabetes advocate and appeared at the 2020 State of the Union with U.S. Rep. Susan Wild, D-Lehigh Valley, who serves Pennsylvania’s 7th Congressional District encompassing Allentown, Easton and Lehighton.
Wild has made affordable prescriptions a top priority since taking office. She spoke out on the topic in the fall when 10 drugs that will be capped were announced.
“Medicare negotiation is an enormous win that will lower costs for the more than 455,000 Pennsylvanians that depend on any one of these 10 drugs," she said.
"And it’s projected to save taxpayers nearly $100 billion by 2031.”
The Biden administration recently submitted its initial offers to pharmaceutical companies that produce those 10 widely prescribed medications.
Those prices are expected to be finalized by August and go into effect in 2026.
