10 Things to Know About US Medicare Negotiations
The US Medicare program is the largest health insurance program in the world, covering over 65 million people. For years, Medicare has been prohibited from negotiating drug prices with pharmaceutical companies. This has allowed drug prices in the US to skyrocket, far outpacing inflation.
In 2021, the US Congress passed the Infrastructure
Investment and Jobs Act, which included a provision that would allow Medicare
to negotiate drug prices for the first time. The provision is set to go into
effect in 2023.
Here are
10 things to know about US Medicare negotiations:
- What
is Medicare drug price negotiation?
Medicare drug price negotiation is the process by which
Medicare negotiates with pharmaceutical companies to lower the prices of
prescription drugs. This is similar to how other countries, such as Canada and
France, negotiate drug prices.
- Which
drugs will be eligible for negotiation?
The first round of Medicare drug price negotiations will
focus on 10 high-cost drugs. These drugs are expected to account for about $50
billion in Medicare spending in 2023. The drugs that are eligible for
negotiation will be selected by the Centers for Medicare & Medicaid
Services (CMS).
- How
will Medicare negotiate drug prices?
CMS will use a variety of factors to negotiate drug prices,
including the cost of research and development, the price of the drug in other
countries, and the clinical value of the drug. CMS will also consider the
impact of any price reductions on innovation and access to care.
- What
are the potential benefits of Medicare drug price negotiation?
Medicare drug price negotiation has the potential to save
billions of dollars for Medicare beneficiaries and taxpayers. It could also
lead to lower drug prices for everyone in the US.
- What
are the potential challenges of Medicare drug price negotiation?
The pharmaceutical industry has opposed Medicare drug price
negotiation, arguing that it will stifle innovation and access to care. They
also argue that it will be difficult for CMS to negotiate fair and reasonable
prices.
- What
is the timeline for Medicare drug price negotiation?
The first round of Medicare drug price negotiations will
begin in 2023. The negotiated prices will go into effect in 2026.
- What
are the next steps for Medicare drug price negotiation?
CMS is currently working on the details of how Medicare drug
price negotiation will work. The agency is also working on developing a process
for appeals by pharmaceutical companies that are not satisfied with the
negotiated prices.
- How
can I stay informed about Medicare drug price negotiation?
You can stay informed about Medicare drug price negotiation
by following the news and by visiting the websites of the Centers for Medicare
& Medicaid Services (CMS) and the Pharmaceutical Research and Manufacturers
of America (PhRMA).
- What
can I do to support Medicare drug price negotiation?
You can support Medicare drug price negotiation by
contacting your elected representatives and urging them to support this
important policy. You can also sign petitions and join advocacy groups that are
working to lower drug prices.
- What
is the future of Medicare drug price negotiation?
The future of Medicare drug price negotiation is uncertain.
The pharmaceutical industry is likely to continue to oppose this policy, and it
is possible that the Trump administration could take steps to weaken or
eliminate it. However, the momentum for Medicare drug price negotiation is
strong, and it is likely that this policy will eventually become a reality.
