Medicare drug price negotiations will lower costs, save lives

Photo by Joe Raedle/Getty Images.

Last week, the Biden-Harris administration celebrated a huge milestone in making health care more affordable.

For the first time, Medicare is allowed to use their purchasing power to negotiate drug prices. The first round of negotiated drug prices will lower costs for ten of the costliest and most popular medications that treat conditions like diabetes , heart failure, blood clots, and autoimmune disorders.

This huge victory for seniors is decades in the making and part of the historic Inflation Reduction Act, which is lowering costs of health care for Minnesotans in all walks of life.

The Medicare Drug Price Negotiation Program will save seniors and taxpayers billions — including bringing relief to the 119,000 Minnesotans on Medicare who are currently taking one or more of those drugs. And these first ten drugs are just the beginning of efforts to use Medicare’s bulk-purchasing power to bring down costs.

I have taken one of the first ten drugs, Enbrel, for 25 years to treat my rheumatoid arthritis. Enbrel was miraculous for my symptoms, and allowed me to live free from pain and stiffness. Unfortunately, like so many other Minnesotans, I was priced out of Enbrel.

Under private-pay insurance, my Enbrel copay was $65 a month. When I moved to Medicare three years ago, my copay skyrocketed to $2,000 a month for my dose — a price out of reach for my family.

Thankfully, my husband found a nonprofit organization that helped lower my copay to $10 a month. Instead of taking my doses as prescribed, I skipped doses to stockpile the medication while I could afford the copays, worried that the cost would rocket up again.

Unfortunately, the cost relief didn’t last. The nonprofit ran out of funding, and once again I was faced with an exorbitant $2,000 monthly price. I could no longer afford Enbrel, and because it was mid-year, I wasn’t able to switch to a different health plan.

I ran out of my Enbrel doses when I was caring for my dying mother, and my disease flared when I was helping pack up and clean out her home. I was only able to regain access to this drug when my husband got a new job with the federal government. On his health coverage, this prescription is now in reach and my symptoms have abated.

Prescription drugs don’t work if people can’t afford them. And for too long, pharmaceutical companies have charged Americans far more than residents in other countries.

People in their 70’s shouldn’t have to go back into the job market to be able to access affordable prescription drugs. Medicare’s new drug prices —coupled with the $2,000 out-of-pocket limit that goes into effect next year — will help people like me access our medications and breathe easier.

For people with Medicare, the Inflation Reduction Act, which celebrated its second anniversary last week, also caps monthly insulin costs at $35;  provides free recommended vaccines; and, penalizes drug companies that increase prices faster than inflation. Starting next year, seniors’ drug costs are capped at $2,000 annually, which will help families like mine. And for Minnesotans who buy their health coverage on the MNSure marketplace, the Inflation Reduction Act significantly lowers monthly premiums.

The Biden-Harris administration and leaders like Gov. Tim Walz, Sen. Amy Klobuchar, Rep. Angie Craig and other Democrats in Congress have taken bold steps to reduce health costs. They want to extend these savings to all Americans and make premium tax credits permanent.

On the other hand, Republicans unanimously voted against the Inflation Reduction Act, and Trump and his MAGA allies are working behind the scenes to repeal the Inflation Reduction Act, including all of the measures to lower prescription drug and health care costs. In particular, Project 2025 would move us backward by giving more tax breaks to drug and insurance companies, leaving hardworking families across the nation to foot the bill.

This year, we are at a crossroads on health care. Are leaders going to side with seniors like me, and build upon the Inflation Reduction Act and the Affordable Care Act so that everyone — no matter who they are or where they live — can get the care they need? Or will they side with Big Pharma and giant insurance companies, as MAGA Republicans have promised?

I urge everyone to learn more about the health care priorities for leaders on the ballot this November.

My health is on the line, and so is yours.