Medicare Orphan Drug Costs Increase
Summary of the Text: Higher Medicare Drug Costs Due to Recent Law Changes
This text details how recent changes to the tax and budget law are likely to increase out-of-pocket costs for Medicare beneficiaries and cost the federal government billions of dollars by delaying or excluding certain drugs – notably orphan drugs – from Medicare price negotiation.
here’s a breakdown of the key points:
* Delayed Negotiation = Higher Prices: The law delays or prevents Medicare from negotiating lower prices for some drugs, maintaining higher prices than would otherwise be possible.
* Increased Beneficiary costs: Higher drug prices translate directly into higher out-of-pocket costs for beneficiaries,especially those with coinsurance or without supplemental coverage.This could lead to access problems due to cost.
* Illustrative Savings Lost: The text provides examples using Keytruda and Opdivo:
* Keytruda: A 22% negotiated discount could save beneficiaries around $550 per claim,reducing out-of-pocket costs to under $2,000 and providing annual savings of around $3,300.
* Opdivo: A 22% discount could save beneficiaries around $460 per claim, reducing costs to around $1,600 and providing annual savings of around $3,000.
* Continued Financial Burden: Even with reduced cost-sharing, these drugs remain expensive and can be a meaningful financial burden, particularly for those in traditional Medicare or early in their Medicare Advantage plan year.
* significant Federal Cost: The Congressional Budget Office (CBO) estimates the changes will increase Medicare spending by several billion dollars over the next decade.
In essence,the text argues that the recent law changes undermine the potential cost-saving benefits of Medicare drug price negotiation,ultimately harming both beneficiaries and the federal budget.