These 10 drugs will now be cheaper for people on Medicare; political debate continues over change
MILWAUKEE (CBS 58) -- The White House on Thursday announced the new prices for 10 prescription drugs that will be cheaper as part of a law allowing Medicare to negotiate the prices of select medicines with pharmaceutical companies.
At the Hayat Pharmacy near Mitchell Airport, Dr. Hashim Zaibak said he was very familiar with several of the drugs on the list.
"Every single day, seven days a week, there are patients who come and pick up these medications on a daily basis," Zaibak said. "Or we deliver it to them."
According to data released Thursday by the U.S. Department of Health and Human Services, three of the selected drugs are used by more than one-million Medicare enrollees. The most popular of those medications is Eliquis, which prevents and treats blood clots. Currently, a 30-day supply of the drug costs $521, but when the negotiated price takes effect in 2026, it will be $231.
Jardiance, which helps people with diabetes and chronic kidney disease, will go from a $573 monthly cost to $197. Xarelto, which also treats and prevents blood clots, will go from $517 per month to $197. You can see the full list of new prices here.
Zaibak said the lower prices will be a huge relief for Medicare enrollees when they get caught in what's known as the 'Medicare donut hole' -- when Part D users go past their initial coverage limit. At that point, they must pay their costs entirely out of pocket until they hit that limit and the program once again helps cover costs.
"That's when they get the price shock," he said. "When they come to pick up the prescription, and their co-pay, instead of it being $40, it's $400."
Dr. Hashim Zaibak, found of Hayat Pharmacy, says Medicare Part D users are often shocked by skyrocketing costs once they enter the 'donut hole' coverage gap.
On a virtual press call hosted by Democratic Sen. Tammy Baldwin and the liberal group, Protect Our Care, a Milwaukee retiree told reporters her husband was taking Eliquis, and it was a struggle for them to afford the medication he needed after suffering a heart attack.
"We couldn't afford that charge, plus paying for other meds," Pat Dunn said. "The only suggestions for help offered by sympathetic medical staff we could lower our cost by ordering meds from Canada."
The ability for Medicare to negotiate the price of certain prescription drugs is part of the $750 billion Inflation Reduction Act President Joe Biden signed into law two years ago.
Republicans maintain while some medicines will now cost less for seniors, their overall costs could still rise through higher premiums. At a hearing House Ways and Means Republicans held last month in Utah, GOP lawmakers also said the lower prices would discourage drug makers from spending as much money on research for new medications.
"The Congressional Budget Office's conservative estimates say that 13 fewer drugs will come to the market over the next 30 years," Rep. Nicole Malliotakis (R-NY) said. "With outside experts projecting the number will be around 135 new cures [not coming to the market]."
Baldwin told reporters she didn't buy that argument. She said the nation's biggest pharmaceutical companies could easily dip into their profits and maintain research without missing a beat.
"They get billions of dollars. They can choose to invest those $20 billion in profits back into [research and development]," Baldwin said. "And they can do those things instead of maybe big stock buybacks."
An analysis by the left-leaning group, Accountable.US, found the nation's five biggest pharmaceutical companies -- Eli Lilly, Johnson & Johnson, Merck, AbbVie and Pfizer -- reported combined earnings of nearly $82 billion in 2022. The report found the companies spent a combined $4.4 billion on stock buybacks while putting a total of $70 million into lobbying efforts against allowing Medicare to negotiate prices.
Zaibak said he believes it's possible the lower prices will somewhat stifle innovation, but overall, he does not think it's much of a concern. He pointed to what he sees elsewhere in the world.
"Other governments and other countries are not spending as much on their drugs, and they still have wonderful research," he said. "Whether in Japan, Europe and other countries."
Zaibak said he thinks the most impactful part of the new Medicare regulations are new cap on total out-of-pocket costs. Starting next year, Medicare beneficiaries will spend no more than $2,000 per year.