Protect Seniors Not Drug Companies

rrocio

Right now, PhRMA is trying to convince Congress to rescind a provision of the bipartisan budget agreement that lowers drug costs for seniors struggling to afford their medicine.

Medicare Part D beneficiaries who have high prescription drug expenses currently have to pay more once the total cost of their medicines reaches the coverage gap, or doughnut hole. The doughnut hole has been narrowing each year since the Affordable Care Act (ACA) was passed in 2010. The gap was scheduled to close in 2020, when beneficiaries would be expected to pay 25 percent of the cost of all their prescriptions while they were in the gap.

Under the recent budget deal, the doughnut hole will now close next year. Beginning in 2019, Part D enrollees will pay 25 percent of the cost of all their prescription drugs from the time they enter the gap until they reach catastrophic coverage.

In addition to closing the doughnut hole a year earlier, the budget deal requires certain drug manufacturers to pay more of the costs for enrollees who are in the coverage gap. Currently, drug companies pay 50 percent of enrollees’ drug costs while they are in the coverage gap. Under the recent budget law, they will now pay 70 percent.

The higher discount that drug manufacturers now have to provide to beneficiaries will help to lower out-of-pocket costs by helping beneficiaries exit the doughnut hole faster. That’s an important protection because a patient’s out-of-pocket costs go from 25% to 5% once they exit the doughnut hole and enter catastrophic coverage.

Drug companies are lobbying Congress to reduce their share of the cost to close the doughnut hole a year earlier, which would lead to higher out-of-pocket costs for beneficiaries who get stuck in the doughnut hole for longer.

What to do about it:  AARP supports the important Part D doughnut hole reforms that were included in the recently enacted Bipartisan Budget Act of 2018. This includes closing the doughnut hole one year earlier and providing beneficiaries with a higher discount on their prescription drugs when in the coverage gap.

The higher discount will enable beneficiaries to move more quickly through the donut hole and help to lower their out-of-pocket costs. AARP opposes efforts that would roll back this progress and shift costs back onto beneficiaries.

The rising cost of prescription drugs is a key priority for Americans, including older Americans. Those age 65 and older use prescription drugs more than any other segment of the U.S. population, typically on a chronic basis.  However, older Americans continue to struggle to afford the drugs they need, and the cost of prescription drugs continues to rise.  In 2015, the average price of brand-name drugs widely used by older Americans increased by 15.5%.

Stand with AARP and oppose drug companies’ attempts to break the deal in the March 23^rd agreement and lower drug costs for seniors.