In May, the Trump administration proposed a blueprint for lowering prescription drug prices. Some thought the administration would finally allow Medicare to negotiate drug prices, but that seems not to be happening anytime soon. Secretary of Health and Human Services, Alex Azar, said the Trump administration “does not believe in” Medicare drug price negotiations. The blueprint is falling short of campaign promises, and it could even raise out-of-pocket costs.
Some doctors are concerned about the impact this proposal would have on cancer drugs, most of which are covered by Part B. If these life-saving cancer drugs are moved to Part D as the blueprint suggests, they could become much more expensive. Cancer drugs are considered a protected class of drugs and must be “all or substantially all” covered by Medicare. However, there are often no generic alternatives for these drugs, which could exclude them from negotiations.
Jeffery C Ward, oncologist at the Swedish Cancer Institute in Edmonds, WA said, “Part D has been helpful lowering prices for seniors citizens when there are generic alternatives or lots of competing drugs from which to choose. But in cancer care, we often have few choices. You can’t exclude a drug if it’s the only right drug for a patient.”
Out-of-pocket cost increase
Shifting some drugs (like cancer drugs) from Part B to Part D is a major point of the Trump blueprint. The logic behind this proposal is that Medicare Part D is sold by private insurance companies that are already empowered to negotiate drug prices.
However, if this proposal were to go through, Medicare beneficiaries would have to pick up the slack. Under Part B, beneficiaries pay 20 percent for approved drugs and services. Under Part D, beneficiaries would be responsible for 30 percent or more of the cost of some drug prices depending on their drug plan.
Stay tuned to Medicare World for more updates on the Trump drug pricing blueprint.