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.