A continuing key priority of the Biden-Harris Administration is lowering prescription drug costs. The Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), announced the list of 43 prescription drugs for which Part B beneficiary coinsurances may be lower between July 1 – September 30, 2023. Some people with Medicare who take these drugs may save between $1 and $149 per average dose starting July 1, depending on their individual coverage. Through the Inflation Reduction Act (IRA), President Biden and his Administration are lowering prescription drug costs for American seniors and their families.

The Medicare Prescription Drug Inflation Rebate Program is one of the many important tools Medicare has to address rising drug costs. By reducing coinsurance for some people with Part B coverage and discouraging drug companies from increasing prices faster than inflation, this policy may lower out-of-pocket costs for some people with Medicare and reduce Medicare program spending for costly drugs. 

“The Medicare Prescription Drug Inflation Rebate Program is a critical way to address long-term price increases by drug companies, and CMS is continuing our work to make prescription drugs more affordable for people with Medicare,” said CMS Administrator Chiquita Brooks-LaSure. “CMS is working tirelessly to ensure timely implementation of the Inflation Reduction Act to strengthen Medicare now and in the future.”

CMS has released information about these 43 Part B drugs and biological products in the quarterly Average Sales Price (ASP) public files, available here. A fact sheet is available here.

“Under this provision, people with Medicare will no longer have to worry about sudden out-of-pocket price increases when drug companies raise prices faster than the rate of inflation,” said Dr. Meena Seshamani, Deputy Administrator and Director of the Center for Medicare. “This is just one of the many ways we are helping people with Medicare realize the impact of this law as CMS continues its thoughtful implementation.”

CMS’ normal procedure is to release the ASP public files several weeks before the quarter of which they will go into effect so the public can review and notify CMS of any potential discrepancies. From time to time, ASP public files need to be corrected or updated, generally referred to as a restatement, based on feedback received after the files are published. If CMS receives feedback that necessitates updates to this list of drugs with adjusted coinsurance amounts, CMS will update the list. The July 1 – September 30, 2023 files may be subject to updates either before the start of the quarter or after in the event updated data becomes available.

Under the Inflation Reduction Act, people with Medicare may pay a lower coinsurance for some Part B drugs if the drug’s price increases faster than the rate of inflation. The lower Part B coinsurance on the listed drugs announced today will be in effect from July 1, 2023 to September 30, 2023. This coinsurance adjustment applies to certain drugs and biologicals paid under Medicare Part B. The Part B drugs impacted by this coinsurance adjustment may change quarterly.

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LAS VEGAS (AP) — President Joe Biden on Wednesday said his administration was focused “intensely” on lowering health care costs and took aim at “MAGA” Republicans who he said are intent on dialing back Medicare coverage for millions of Americans.

Biden used a speech in Las Vegas where he was wrapping a three-day Western swing to make the case there are stark differences in how Democrats are tackling skyrocketing drug prices compared to their Republican counterparts.

The president sought to make the contrast as he gears up for an expected reelection announcement. The speech on Wednesday in Las Vegas could serve as an early preview of the campaign ahead as Biden aims to make his efforts at lowering drug costs central to his policy and political agenda.

Biden, speaking before a crowd of doctors and nurses at the University of Nevada, Las Vegas, vowed to protect Medicare and Social Security, while touting his administration’s successful efforts to press pharmaceutical companies to lower the costs of insulin for Americans suffering from diabetes.

“MAGA Republicans in Congress don’t think any of this is a good idea,” Biden said. “They think Big Pharma should be able to make the exorbitant profits at the expense of the American people”

The White House thinks it has a winning message in showcasing legislation passed last year that is expected to save taxpayers billions of dollars and lower the cost of drugs for the roughly 84 million Americans who rely on Medicare.

Ahead of the speech, White House officials made the case that issue is central to Americans lives and called on Republicans to work with them to lower prescription costs.

“These kind of savings will give people a little bit more breathing room, more comfort as they decide to go to the grocery store to buy their food, more ability to pay their rent, or maybe it’s just to do something decent for their families,” Health and Human Services Secretary Xavier Becerra told reporters on Tuesday as he previewed the Democratic president’s remarks.

Biden talked up how his administration is rolling out several parts of that law, passed in a Democratic-controlled Congress last year, that cap the price of insulin, make most vaccines free and allow the federal government to negotiate deals on a handful of pharmaceutical drugs for Medicare enrollees.

The federal government expects to see significant savings from those negotiations and to make money from a rule that requires drugmakers to send Medicare a check when they raise drug prices higher than inflation.

“Let’s finish the job,” Biden said. “Let’s protect the lower prescription drug costs for everyone”

Already, the legislation caps the price of insulin at $35 for disabled and older Americans who rely on Medicare.

Biden has proposed extending that cap to all Americans, but that plan faces an uphill battle. Efforts to pass laws capping the price of insulin for uninsured Americans or those with private insurance failed in the Democratic-controlled Congress last year.

Biden, however, has still championed last year’s bill as a success for the millions of Americans who aren’t on Medicare. Drug companies, facing public pressure after tripling their prices for the life-saving drug over the last two decades, have started to voluntarily lower the cost of insulin. Drugmaker Novo Nordisk announced Tuesday it was cutting the cost of insulin to about $72 a vial, on the heels of an announcement from rival Eli Lilly that it would start selling its generic for $25.

“This builds on the important progress we made last year when I signed a law to cap insulin at $35 for seniors,” Biden said in a statement on Tuesday on Novo Nordisk’s announcement. “I urge all other manufacturers to follow suit and Republicans in Congress to join us and cap insulin at $35 for all Americans.”

Another part of the law that the administration hopes will have ripple effects for Americans: the requirement that pharmaceutical companies pay a rebate to Medicare when they raise the cost of drugs faster than inflation.

The Centers for Medicare and Medicaid Services won’t send a bill to drug companies until 2025, but the federal agency has already started tracking drug prices. The agency on Wednesday identified 27 drugs whose prices were increased too fast, a move that will limit the price that Medicare enrollees have to pay for them. The administration hopes that will motivate drugmakers to lower the cost of those medications.

Biden has sought in recent weeks to draw a stark contrast between how his party and Republicans handle health care affordability, repeatedly raising concerns that the GOP will seek to undo the Medicare cost-savings provisions or try to make cuts to the program.

Last week, Biden promised to fend off financial challenges facing Medicare by instead raising the Medicare tax rate from 3.8% to 5% on those with annual incomes of $400,000 or more.

Republicans leaders — who have publicly disavowed accusations that they’ll the cut the program — have yet to coalesce around a plan to address Medicare’s impending shortfalls. Last year, the House Republican Study Committee proposed raising the eligibility age for Medicare from 65 to 67.

Senate Minority Leader Mitch McConnell, R-Ky., told reporters last week that Biden’s plan to raise taxes for Medicare “will not see the light of day.”

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President Biden on Friday will sign an executive order directing administration officials to consider further actions to lower prescription drug costs, the White House announced.

Why it matters: With less than a month before the midterms, Biden is focusing on health care costs to help position Democratic candidates.

The big picture: Biden’s order would compliment the Inflation Reduction Act and specifically, the provision allowing the federal government to negotiate some prescription drug prices.

• However, polls show that while the public is familiar with the law, they are unaware of its key health provisions.

• Still, many of the law’s goals have strong public support, including limiting out-of-pocket prescription drug costs for people on Medicare and capping monthly out-of-pocket insulin costs for Medicare recipients.

State of play: The executive order directs the Department of Health and Human Services to “explore additional actions” it can take to lower prescription drug costs.

• HHS will have 90 days to submit a report on how it will use new models of health care payment and delivery to lower drug costs “and promote access to innovative drug therapies for beneficiaries enrolled in the Medicare and Medicaid programs.”

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