We are no strangers to working across the aisle to find solutions to some of America’s most difficult problems. We have banned pharmacy gag clauses, and we are working to hold insulin manufacturers accountable for unnecessarily high drug costs as well as to increase access to health services in rural communities.
Now, we are working together again to continue to take action to lower drug prices.
There is no question that America’s health care system requires substantial reform. The status quo of soaring health care costs, struggling families and limited access to care is unacceptable. We have heard so many heartbreaking stories from people who find it increasingly difficult to afford their medications.
For instance, a father from New Gloucester discovered that the cost of a 90-day supply of insulin for his 13-year-old son, who has Type I diabetes, had tripled to more than $900. A Falmouth woman saw her out-of-pocket cost for the arthritis medication Enbrel soar from $10 to $3,800 per month when she transitioned from employer-sponsored insurance to Medicare. Flustered parents in Iowa have had to figure out how to pay for the skyrocketing price of EpiPen injectors in order to send their children to school. We have even heard from folks who had to leave prescriptions at the pharmacy counter because they were too expensive. This should never be the case.
In July, the Senate Finance Committee passed the Prescription Drug Pricing Reduction Act, landmark legislation that would save taxpayers more than $100 billion and save seniors more than $30 billion in out-of-pocket costs for their prescriptions. This bill takes a pragmatic approach to health care reform, focusing on increased transparency in the health care system and eliminating opportunities for drug manufacturers and health care “middlemen” like pharmacy benefit managers to take advantage of our health care system.
Some of the significant cost savings come from changes to Medicare Part D that will protect seniors with an out-of-pocket spending cap. We have heard from patients who have stopped taking their prescriptions and have even had to refinance their homes to afford lifesaving medications. This change is long overdue and would ensure that patients with high-cost conditions, such as cancer, multiple sclerosis and rheumatoid arthritis, can get the prescriptions they need.
The Prescription Drug Pricing Reduction Act would improve incentives to increase negotiations between prescription drug plans and manufacturers. This would help increase competition and lower drug costs. Further, the legislation would protect taxpayers from higher-than-inflation increases in drug prices, while reducing government spending, premiums and overall out-of-pocket costs.
Additionally, the bill would improve the accuracy of pricing calculations in the Medicaid program and prevent drug manufacturers from avoiding their fair share of financial obligations in exchange for having their drugs covered under the program. The bill would also prevent pharmacy benefit managers from engaging in “spread pricing” in the Medicaid program, which has driven up costs to state governments.
The Congressional Budget Office estimates that the combination of the Medicare Part D redesign and the inflation-rebate policies included in this bill would save taxpayers approximately $90 billion in addition to more than $15 billion in Medicaid reforms over 10 years. Beneficiaries would save $25 billion in out-of-pocket expenses and $6 billion in premiums. Americans in the commercial insurance market would also see savings.
Nearly a quarter of Maine’s population uses the Medicare program and more than 20 percent is covered by Medicaid. The Prescription Drug Pricing Reduction Act would benefit every American, especially seniors and those with disabilities, by expanding access to care and decreasing the outrageous cost of many prescription drugs.
This is bipartisan legislation that addresses some of the most pressing problems in our health care system. It focuses on areas of consensus and provides substantive solutions that put patients over politics. It also complements legislation the Senate Health Committee advanced to eliminate anti-competitive practices by brand drug makers, such as by requiring earlier and broader disclosure of patents for expensive biologic drugs, as well as thwarting strategies that prevent generic drug manufacturers from obtaining samples of a brand drug to make a lower-cost alternative. This is an opportunity for Congress to deliver a decisive victory in lowering health care costs for the people of Maine, Iowa and the entire nation.