The agreement will allow Medicare to negotiate prices for certain expensive drugs administered at doctors’ offices or purchased at the pharmacy, according to a document circulated by Schumer’s office. Drugs would not be eligible until they were outside their original periods of exclusivity – nine years for many, 12 years for others.
Medicare would negotiate up to 10 drugs, starting in 2023, with prices coming into force in 2025. The number will increase to up to 20 drugs from 2028. This is a far more limited proposal than the Democratic leaders in Parliament have supported.
And it would redesign Medicare’s Part D medication plans so seniors and people with disabilities do not pay more than $ 2,000 for medications purchased at the pharmacy.
The senator welcomes a new agreement on a historic, transformative Medicare drug negotiation plan that will reduce their own costs for seniors – and ensure that drug prices cannot rise faster than inflation – save taxpayers’ dollars, and protect innovation to secure Arizona and “Americans continue to have access to life-saving medicines and new cures and therapeutic agents,” Sinema’s office said in a statement.
Despite the agreement’s narrower parameters, the pharmaceutical industry’s main lobby group said it would “repeal the same innovative ecosystem that brought us life-saving vaccines and therapies to combat Covid-19.”
“Under the guise of ‘negotiation’, it gives the government the power to dictate how much a medicine is worth, leaving many patients facing a future with less access to medicine and fewer new treatments,” says Stephen J. Ubl, CEO of PhRMA. .
The agreement is not as broad as the original measure, which is supported by many, but not all, Democrats in the House.
“While not nearly as expansive as we originally proposed, I hope the agreement’s new inflation rebate and equity cap for seniors will work with Medicare’s bargaining authority to lower the cost of prescription drugs for Americans meaningfully,” said Energy and Commerce Committee chairman Frank Pallone. , Jr., a Democrat from New Jersey.
House Speaker Nancy Pelosi, who has been pushing to allow Medicare to negotiate, said she was “satisfied” with the compromise.
The deal is likely to provide lower savings than Parliament’s proposals, which lawmakers said could offset as much as $ 700 billion in spending.
The original proposal called for the Secretary of Health and Human Services to negotiate maximum reasonable prices for at least 50 and as many as 250 expensive drugs lacking competition, including insulin. The award would have been available to Medicare recipients and to individuals enrolled in group health schemes.
Although Democrats now lead both chambers, not all members have agreed on what would be a historic change to Medicare.
The response to the announcement of the agreement was mixed across patient advocate groups, with some calling it a major step forward and others only a step forward.
“Preventing prices from rising faster than inflation and adding a hard cover to Part D will provide real relief for seniors with the highest drug costs,” said AARP CEO Jo Ann Jenkins, about the limit on pharmacy spending.
But Robert Weissman, president of Public Citizen, said the new deal does not fully allow Medicare to negotiate prices.
“This deal is short of what Americans want and deserve to stop Big Pharma price spills, but it is nonetheless a positive step forward,” Weissman said, based on terms reported earlier Tuesday.
This story has been updated with further developments.
CNN’s Morgan Rimmer and Manu Raju contributed to this report.