•   
  •   
  •   

Politics Ban on negotiating Medicare drug prices under pressure

21:00  06 october  2021
21:00  06 october  2021 Source:   msn.com

Biden re-ups 'vision' for letting Medicare negotiate drug prices, calls on Congress to take action

  Biden re-ups 'vision' for letting Medicare negotiate drug prices, calls on Congress to take action President Joe Biden will outline on Thursday his "vision" for lowering prescription drug prices, but the proposal will require new legislation from Congress. © Provided by Washington Examiner The announcement, framed as another facet of Biden's Build Back Better agenda, is set to come during the president's final remarks before departing Washington, DC for Wilmington, Delaware, according to the White House.

WASHINGTON (AP) — Donna Weiner looks at Medicare’s prescription drug program from two different points of view.

Retiree Donna Weiner shows the daily prescription medications that she needs and pays over $6,000 a year through a Medicare prescription drug plan at her home, Tuesday, Oct. 5, 2021, in Longwood, Fla. Weiner supports giving Medicare authority to negotiate drug prices. Negotiating Medicare drug prices is the linchpin of President Joe Biden's ambitious health care agenda. Not only would consumers see lower costs, but savings would be plowed into other priorities such as dental coverage for retirees and lower premiums for people with plans under the Obama-era health law. (AP Photo/Phelan M. Ebenhack) © Provided by Associated Press Retiree Donna Weiner shows the daily prescription medications that she needs and pays over $6,000 a year through a Medicare prescription drug plan at her home, Tuesday, Oct. 5, 2021, in Longwood, Fla. Weiner supports giving Medicare authority to negotiate drug prices. Negotiating Medicare drug prices is the linchpin of President Joe Biden's ambitious health care agenda. Not only would consumers see lower costs, but savings would be plowed into other priorities such as dental coverage for retirees and lower premiums for people with plans under the Obama-era health law. (AP Photo/Phelan M. Ebenhack)

As a participant, she wants to pay less for her medicines, which cost her about $6,000 a year. As a retired accountant who spent 50 years handling the books for companies, she sees a way to get there.

Dental coverage for Medicare recipients divides parties

  Dental coverage for Medicare recipients divides parties Lawmakers are split along party lines on a proposal to include dental coverage for all Medicare recipients included in Democrats' $3.5 trillion reconciliation package.Speaking at The Hill's "Future of Medicare and Oral Health" event on Wednesday, Rep. Nanette Diaz Barragán (D-Calif.) called dental care "a crucial part of health care" and "not a luxury.""There is a lot of support for providing dental coverage. Unfortunately, depending on who you talk to, it comes down to a conversation on cost. 'Can we afford it?'" Diaz Barragán, a member of the Congressional Progressive Caucus, told The Hill's Steve Clemons.

“You know from working in a business that it makes no sense for an administrator of a plan or a company not to be involved in what they have to pay out,” said Weiner, who lives near Orlando, Florida. For Medicare “to negotiate those prices down would be thousands of dollars back in my pocket every year,” she said.

Retiree Donna Weiner shows some of the daily prescription medications that she needs and pays over $6,000 a year through a Medicare prescription drug plan at her home, Tuesday, Oct. 5, 2021, in Longwood, Fla. Weiner supports giving Medicare authority to negotiate drug prices. Negotiating Medicare drug prices is the linchpin of President Joe Biden's ambitious health care agenda. Not only would consumers see lower costs, but savings would be plowed into other priorities such as dental coverage for retirees and lower premiums for people with plans under the Obama-era health law. (AP Photo/Phelan M. Ebenhack) © Provided by Associated Press Retiree Donna Weiner shows some of the daily prescription medications that she needs and pays over $6,000 a year through a Medicare prescription drug plan at her home, Tuesday, Oct. 5, 2021, in Longwood, Fla. Weiner supports giving Medicare authority to negotiate drug prices. Negotiating Medicare drug prices is the linchpin of President Joe Biden's ambitious health care agenda. Not only would consumers see lower costs, but savings would be plowed into other priorities such as dental coverage for retirees and lower premiums for people with plans under the Obama-era health law. (AP Photo/Phelan M. Ebenhack)

Negotiating Medicare drug prices is the linchpin of President Joe Biden's ambitious health care agenda. Not only would consumers see lower costs, but savings would be plowed into other priorities such as dental coverage for retirees and lower premiums for people with plans under the Obama-era health law.

Seniors vs. the poor? Democrats stare down stark tradeoffs in trying to fund health care expansion

  Seniors vs. the poor? Democrats stare down stark tradeoffs in trying to fund health care expansion Each of the expensive health care proposals in Democrats' spending package would help different people. So how do they choose?If they don’t extend recently expanded health insurance subsidies, premiums will rise for millions of Americans right before the 2022 midterm elections.

Retiree Donna Weiner, left, talks with her husband Norman Weiner at the kitchen table with the daily prescription medications that she needs and pays over $6,000 a year through a Medicare prescription drug plan at her home, Tuesday, Oct. 5, 2021, in Longwood, Fla. Weiner supports giving Medicare authority to negotiate drug prices. Negotiating Medicare drug prices is the linchpin of President Joe Biden's ambitious health care agenda. Not only would consumers see lower costs, but savings would be plowed into other priorities such as dental coverage for retirees and lower premiums for people with plans under the Obama-era health law. (AP Photo/Phelan M. Ebenhack) © Provided by Associated Press Retiree Donna Weiner, left, talks with her husband Norman Weiner at the kitchen table with the daily prescription medications that she needs and pays over $6,000 a year through a Medicare prescription drug plan at her home, Tuesday, Oct. 5, 2021, in Longwood, Fla. Weiner supports giving Medicare authority to negotiate drug prices. Negotiating Medicare drug prices is the linchpin of President Joe Biden's ambitious health care agenda. Not only would consumers see lower costs, but savings would be plowed into other priorities such as dental coverage for retirees and lower premiums for people with plans under the Obama-era health law. (AP Photo/Phelan M. Ebenhack)

To do that, Congress would have to change an unusual arrangement that's written into law.

When lawmakers created Medicare's Part D outpatient prescription drug program in 2003, they barred Medicare from negotiating prices. Republicans who controlled Congress at the time wanted insurers that administer drug plans to do the haggling. Medicare was sidelined, despite decades of experience setting prices for hospitals, doctors and nursing homes.

Democrats weigh changes to drug pricing measure to win over moderates

  Democrats weigh changes to drug pricing measure to win over moderates Democratic leaders are discussing changes to a signature bill to lower prescription drug prices in a bid to win over a handful of moderate Democrats needed for passage. © Greg Nash Democrats weigh changes to drug pricing measure to win over moderates House and Senate leaders have discussed a proposal that would remove one of the provisions moderates find most objectionable in Speaker Nancy Pelosi's (D-Calif.) bill, a cap on prices based on what other wealthy countries pay for drugs, and have pitched the proposal to moderates, sources say.

Retiree Donna Weiner, right, sits at the kitchen table with the daily prescription medications that she needs and pays over $6,000 a year through a Medicare prescription drug plan at her home, Tuesday, Oct. 5, 2021, in Longwood, Fla. Weiner supports giving Medicare authority to negotiate drug prices. Negotiating Medicare drug prices is the linchpin of President Joe Biden's ambitious health care agenda. Not only would consumers see lower costs, but savings would be plowed into other priorities such as dental coverage for retirees and lower premiums for people with plans under the Obama-era health law. (AP Photo/Phelan M. Ebenhack): Congress Budget Medicare Negotiations © Provided by Associated Press Congress Budget Medicare Negotiations

“I don't know of any other situation where the government has one hand tied behind its back when dealing with people like big pharma,” said Sen. Ron Wyden, D-Ore., who is leading efforts to draft the Democratic plan in the Senate.

Known as the “noninterference clause,” the ban has been unbendable. That's the way the pharmaceutical industry wants to keep it.

Former Medicare administrator Andy Slavitt recalls proposing a “modest experiment” on pricing. “You would have thought we had pressed the nuclear button and the country was going to blow up,” he said.

Drugs costing tens of thousands of dollars a month were rare when the prescription benefit was enacted nearly 20 years ago. Now they have become more common, and Democrats want to allow Medicare to negotiate over high cost brand-name drugs with little or no competition, as well as insulins.

Their legislation also would limit price increases for established drugs and cap annual out-of-pocket costs for Medicare recipients such as Weiner. Another part would overhaul the inner workings of the nearly $100 billion-a-year drug program to try to reduce costs for taxpayers.

Kids could be the budget bill's big winners -- or losers

  Kids could be the budget bill's big winners -- or losers President Joe Biden and congressional Democrats are poised to channel historic investments into programs for kids -- if they can navigate around competing demands, particularly from programs for seniors, as they slim down the massive public investment and social safety net bill now under intense negotiation on Capitol Hill. © Andrew Caballero-Reynolds/AFP/Getty Images The US Capitol at dusk in Washington on October 1, 2021.


Video: Rep. Hinson attempts to block IRS from monitoring transactions over $600 (FOX News)

Politicians including former President Donald Trump and House Speaker Nancy Pelosi, D-Calif., have supported Medicare negotiations. But it's Biden, with Pelosi doing much of the lifting, who's come closest to getting it done.

And it still might not happen.

Similar to the rest of Biden's massive agenda, authorizing Medicare to negotiate hinges on a few Democratic holdouts. During committee deliberations in the House, three Democrats were opposed. In the Senate, a couple are seen as unconvinced.

Amid a furious lobbying and advertising campaign, the AARP, consumer groups, and health insurers are pressing for Medicare negotiations.

Business groups and the pharmaceutical industry are opposed. Drug companies have spent $171 million so far this year on lobbying, far above any other industry, according to the watchdog group OpenSecrets.

The industry says weakening the ban on negotiations would stifle investment in innovative ideas that can lead to lifesaving cures.

“The United States simply put is the bio-pharmaceutical engine for the world,” said Lisa Joldersma, a top executive of the lobbying group Pharmaceutical Research and Manufacturers of America, or PhRMA. “The investments that our companies make are what allow things like multiple vaccines and therapies to address a global pandemic to come to market in an unprecedented amount of time.”

Half a loaf? Low-income seniors only get one thin slice of Medicare dental benefit

  Half a loaf? Low-income seniors only get one thin slice of Medicare dental benefit Congress has a simple choice. Provide a meager dental benefit to all Medicare patients, rich and poor alike, or provide low-income seniors with a comprehensive affordable dental benefit that will significantly help those in need. Let's hope that Congress makes the right choice. Daniel J. Klemmedson, D.D.S., M.D., of Tucson, Ariz., is the 157th president of the American Dental Association (ADA). Dr. Klemmedson is a fellow of the American Board of Oral and Maxillofacial Surgery, as well as a member of the Academy of Dentistry International, American Cleft Palate-Craniofacial Association and American Medical Association.

PhRMA opposes constraints on launch prices for new drugs, as well as limitations on price increases for existing medicines. It says the government has other ways to shield Medicare recipients from high out-of-pocket costs and blames insurers for not passing manufacturer rebates directly to patients.

Joldersma points to research by the nonpartisan Congressional Budget Office to support the industry argument that fewer drugs would come to market. The CBO found an approach similar to the legislation would lead to a slight reduction in new drugs in the first 10 years, growing with time to 8% fewer new drugs in the third decade.

PhRMA says the chilling effect would be deeper.

“If you are the patient ... it is certainly not a marginal issue,” said Joldersma.

Others say it's unlikely that drug development would shrivel. Valuable medicines would go forward, but ones with fewer benefits would have a harder path, said biotethicist said Dr. Steven Pearson, head of the nonprofit Institute for Clinical and Economic Review, or ICER, in Boston. The research organization recommends prices based on effectiveness.

“The big argument is at if the government lays a finger on the process, somehow that is going to stifle innovation,” said Pearson. “We can get even better innovation by being smart in how we pay."

Responded industry official Joldersma: “I’m not aware that Steve Pearson of ICER has ever been in the business of discovering or bringing to market any treatment or cure."

Juliette Cubanski, a Medicare expert with the nonpartisan Kaiser Family Foundation, says "the level of hyperbole that we are hearing in this present drug debate suggests the industry is quite concerned.”

One of the biggest industry objections is that the House bill would use lower prices in other advanced counties as a yardstick for Medicare. The Trump administration tried a similar idea with a different set of Medicare medications. Drugmakers say U.S. patients may have to wait longer than they're used to for new medications if that goes through.

A recent RAND Corporation study found that linking the cost of top U.S. drugs and insulins to prices abroad could reduce spending here for those drugs by about half.

Other countries try to balance incentives for research and development with prices that reflect the value to patients and society, said study author Andrew Mulcahy.

“If we just wrote a huge check to drug companies, would they do more research?" Mulcahy asked. “Probably some. But is that the socially optimal thing to do? Probably not.”

How Government Could Make the Inflation Problem Worse .
With politically damaging price increases showing no signs of easing, it may be tempting to take counterproductive measures.Ben: The inflation news we got yesterday isn’t ideal. The price of seemingly everything in America, from rent to furniture to cars, is still rising, with an overall 5.4 increase from a year ago — the highest yearly spike since 2008. This has dashed consumers’ (and the Biden administration’s) hopes that such price increases, which are directly connected to Covid economic aftershocks, would fade quickly.

usr: 1
This is interesting!