U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra joined members of the Michigan Pharmacists Association and local pharmacists in Flint on Wednesday to highlight President Joe Biden’s commitment to health care.
Pharmacists praised the Biden administration’s proposals in the Controlling Inflation Act, which would cap insulin copays for Medicare Advantage and Part D beneficiaries at $35 and eliminate costs for vaccines covered by Medicare Part D. Vaccines for diseases such as shingles and whooping cough previously cost seniors $200 to $400.
“There are a lot of older adults in America who can’t afford $400 to get the vaccine. So what do they do? They just have to cross their fingers and hope they don’t get shingles,” Becerra said.
John Gross, owner of JGross Pharmacy Group and executive director of the Michigan Association of Independent Pharmacies, spoke of his personal experience listening to seniors decide which medications they can afford based on cost, and called the reduction in the insulin cap and the 2025 out-of-pocket drug cost caps “exciting.”
Currently, out-of-pocket drug costs for Medicare beneficiaries are capped at $3,500. That cap will be reduced to $2,000 in 2025. DHHS estimates that the 2024 out-of-pocket cost limit will save Michigan Medicare Part D enrollees approximately $113 million.
“$2,000? Some people will say that’s still a lot of money. If you’re a cancer patient, if your patient has cardiovascular disease, if you’ve had a stroke, you know that your medications can cost tens of thousands of dollars. Starting next year, your out-of-pocket costs will be less than $2,000. This will be a huge savings for millions of Americans,” Becerra said.
Becerra said HHS also plans to announce the results of price negotiations within two months for the 10 most expensive drugs in the Medicare program, which cost Medicare beneficiaries $46 billion a year.
Becerra said many Americans are saving money on their medications, cutting their doses in half to stretch out the time between refills or skipping doses to make their medicine last a month, and he stressed that the cost-saving programs are aimed at giving people peace of mind as well as improving health.
Biden has delivered on his promises to reduce health care costs, expand access to more Americans and provide better benefits, but Becerra said there is still much work to be done.
Eric Roth, director of government relations for the Michigan Pharmacists Association, pointed to recommendations in a recent Federal Trade Commission interim report. Pharmacy Benefits ManagerThis will lead to reduced drug costs.
The report, released Tuesday, highlights practices by pharmacy benefit managers, who act as intermediaries between insurers and drug companies, that allow them to profit by inflating drug costs and imposing unfair, arbitrary and harmful contract terms on local pharmacies.
“We urge members of Congress and the Administration to continue the good work of examining the underlying causes that are limiting access to the critical medicines our citizens need,” Roth said.
“Our pharmacies strive for every opportunity to deliver services in an accessible and sustainable way for patients. Ultimately, this means improved access to essential health services, including medicines, for all our citizens, especially our most vulnerable patient populations,” Roos said.
Brian Homberg, pharmacy manager at Flint Family Pharmacy, said independent and community pharmacies are under attack, with many at risk of closing. He expressed concern about the negative impact pharmacy closures will have on patients. Michigan Rite Aid pharmacy closes The company filed for bankruptcy, Walgreens closing stores nationwide.
“This is a travesty on patient access to health care that must be addressed, and I look forward to working with all of the leaders in this and the incoming administration to resolve these issues for the American people,” Homberg said.
Roth also emphasized the role pharmacies play in providing health care, offering vaccinations and participating in infectious disease testing, as has been made clear during the COVID-19 pandemic.
“I want to remind everyone that if you go into a pharmacy and want to find out more about the medical services that are available to you, there will be no out-of-pocket costs. As the saying goes, prevention is better than cure,” Roth said.
Becerra said the Biden administration has put a lot of taxpayer money into supporting pharmacies, which are on the front lines of the COVID-19 response. The administration is also working on policy changes that will make it harder for independent pharmacies to compete with large pharmacy chains.
“We want to eliminate the middleman that’s really creating a difficult situation for some independent pharmacists. Right now, these PBMs (pharmacy benefit management companies) essentially control the market,” Becerra said. “I say, somewhat metaphorically, that they control the market in how these drugs are dispensed and how they are priced.”
“We believe that middlemen who are siphoning money out of the system that isn’t actually being used to provide health care and medicines are a real disservice to everyone, including taxpayers,” Becerra said.
