The Department of Health and Human Services (HHS) has released a new list of Medicare Part B drugs that will have lower coinsurance rates from April 1 to June 30 if drugmakers raise their prices faster than the rate of inflation.
Under the Medicare Prescription Drug Inflation Rebate Program, some beneficiaries that use one or more of the 41 rebatable drugs on the list may save between $1 and $3,575 per average dose depending on their coverage, the HHS said. The agency estimates that 763,700 people with Medicare use one or more of the 41 drugs annually.
Last December, the agency released its first-quarter 2024 list of rebatable drugs under the program. There were 48 drugs in that list and Medicare coinsurance for certain Part B drugs on the list were expected to save some beneficiaries up to $2,786 per dose, HHS said at the time.
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Drug companies are required to pay the rebates for certain drugs to Medicare when prices increase faster than inflation as part of the Biden administration’s Inflation Reduction Act, which established the program.
HHS Secretary Xavier Becerra said in a statement that the administration “will continue to use every lever we have to lower healthcare costs for more Americans.”
Drug price talks continue
In addition, drugmakers participating in Medicare's price talks on the first 10 Part D drugs sent counteroffers to the agency earlier this month, following Medicare's initial offer in February.
The drugs, covered under Part D, are: Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara and Fiasp/NovoLog.
Negotiations are slated to end August 1. New negotiated prices for the drugs expected to be announced by September 1, with an effective date of January 2026.
Guidance on Medicare programs
The Centers for Medicare & Medicaid Services (CMS) provides a variety of guidance documents on the rebatable drugs, price negotiations with drugmakers, and other Medicare programs. For more information on reducing coinsurance for certain Part B rebatable drugs under the Medicare prescription drug inflation rebate program, see this CMS fact sheet.
HHS also has launched LowerDrugCosts.gov, a new website for Medicare beneficiaries with information related to the drug pricing provisions under the Inflation Reduction Act as well as resources for Medicare enrollees and other interested parties.
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