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Morning Briefing

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Wednesday, Oct 21 2020

Full Issue

How The Next President Will Try To Lower Drug Prices

Read about the biggest pharmaceutical developments and pricing stories from the past week in KHN's Prescription Drug Watch roundup.

Biden's proposal would work to lower prescription drug prices within Medicare, create an independent commission to oversee and regulate the price of new drugs, and get rid of the tax breaks given to pharmaceutical corporations on advertising. ... Trump has attempted to usher through prescription drug reforms via a series of executive orders signed in July and September, though the timeline for seeing these policies implemented remains uncertain. A notable order would lower drug prices for those on Medicare parts B and D to comparable costs seen internationally. (Moore, 10/16)

Millions of Americans are struggling to afford their medications during Covid-19, including some with health insurance, the nearly 27 million who lost coverage due to a job loss and those who never had it. But there are quite a few ways to lower your prescription drug costs in the pandemic. The sticker shock is real. In July, according to the GoodRx site, 67 prescription drug prices rose an average of 3.1%; prices for 857 brand-name and generic drugs increased by an average of 6.8% from January 1 to June 30, 2020. Refills for common medications such as insulin for diabetes and Nexium for heartburn can cost around $300. (Flynn Jay, 10/18)

Insulin prices continue to dominate the national discussion and remain a divisive topic in the midst of the political debate over drug pricing policy reform. The common understanding is that U.S. insulin prices have been jacked up to an unconscionable level and that needs to change, but the details on how to address this problem are anything but clear. (Hoskins, 10/19)

Handicappers rate the House race in Arizona’s 6th Congressional District as a toss-up, with the edge going to the Republican incumbent, David Schweikert. The high cost of prescription drugs resonates in retiree-heavy Arizona and a major union backing Democrat Hiral Tipirneni in the race has taken Schweikert to task for his voting record on the issue. (Greenberg, 10/19)

And news about Medicare prices —

Medicare open enrollment started October 15 and will run through December 7. For many retirees, shopping for coverage during open enrollment is the best chance to keep medical costs down by choosing an insurance plan well-suited to their needs. But while choosing the right Medicare policy is essential, many seniors will still face at least some out-of-pocket expenses for prescriptions, regardless of what plan they have. (Bieber, 10/20)

On March 11, the Centers for Medicare and Medicaid Services (CMS) announced the Part D Senior Savings Model. Plans that provide Part D prescription drug coverage can choose to offer insulin for a maximum copayment of no more than $35. In 2020, a monthly copayment for insulin can range from $2 to $200 or more, depending on the medication, plan and place of residence. According to the CMS announcement, the Senior Savings Model could save beneficiaries who take insulin about $466 a year.  The opportunity to get insulin for $35 a month is a very good deal. However, this isn’t automatic and some diabetic beneficiaries may be left out in the cold. (Omdahl, 10/20)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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