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Weekly Policy Update: Senate Finance Committee Advances Drug Pricing Package

On Thursday, the Senate Finance Committee advanced a major legislative package that includes substantial changes to Medicare and Medicaid drug reimbursement. The bill, the Prescription Drug Pricing Reduction Act, passed the Committee by a vote of 19-9 and will be considered by the full Senate in the fall.

Since learning about some of the provisions in the bill, CBSA has been coordinating with our members and industry partners to voice our concerns about the unintended consequences some policies may have on patient access and medical innovation. One of our objections is a provision to impose inflation rebates on Medicare Part D medicines, which would destabilize the market-based structure that had made the Part D program so successful.

CBSA has also expressed opposition to a provision that would require manufacturers to account for the value of coupons when calculating a drug’s average sales price, which is the basis for Medicare Part B drug reimbursement. If this proposal goes forward, the reduction in ASP would mean more and more therapies will be reimbursed less than cost, making it harder for providers to provide outpatient care – particularly those in rural and underserved areas. The last thing we want is for outpatient care to be shifted to the more expensive hospital setting, creating additional barriers to patient access. What’s worse, this policy could incentivize manufacturers to reduce or eliminate their assistance programs, which is certainly not in the best interest of patients.

While we have many objections to the policies in this bill and would like to see substantial changes, we appreciate that it includes an annual out-of-pocket cap for patients in Medicare Part D. Currently there is no cap on what a beneficiary has to pay for their prescription drugs in Part D, even after they have reached the catastrophic phase of coverage. This policy is an important step in lowering out-of-pocket costs for seniors, and as the bill moves forward, we are committed to working with our delegation to make sure they get it right.

Over the August recess, CBSA will continue to voice our concerns and weigh in with key offices to address the top priorities of our members.

 



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