CMS names 10 drugs under new price controls, but advocates warn of ‘cruel’ side effects

The Centers for Medicare and Medicaid Services released on Tuesday the list of 10 medications that will be part of the price-setting Drug Price Negotiation Program through the Inflation Reduction Act, affecting an estimated 8.2 million patients with a range of illnesses, including heart failure, blood clots, diabetes, and arthritis.

“We took on Big Pharma and special interests, overcoming opposition from every Republican in Congress, and the American people won,” President Joe Biden said in a statement on the announcement, calling the Inflation Reduction Act “one of the most significant laws ever enacted.”

SMALL BUSINESSES HELPLESS OVER SPIKE IN RETAIL THEFTS, SAY THEY FEEL ABANDONED BY LAWMAKERS

The most expensive drugs on the list include Eliquis, to prevent blood clots, and Jardiance, for diabetes and heart failure.

The other medications on the list include Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and the various products associated with diabetes medications Fiasp and NovoLog.

These 10 drugs accounted for $50.5 billion in Medicare Part D spending between June 2022 and May 2023, or about 20% of total Part D gross covered prescription drug costs, according to HHS.

The Medicare provision of the Inflation Reduction Act grants the HHS secretary the authority to negotiate with drug companies a maximum fair price for Medicare Part D coverage of the most expensive medications without generic or biologic alternatives.

“For far too long, pharmaceutical companies have made record profits while American families were saddled with record prices and unable to afford life-saving prescription drugs. But thanks to the landmark Inflation Reduction Act, we are closer to reaching President Biden’s goal of increasing availability and lowering prescription drug costs for all Americans,” Health and Human Services Secretary Xavier Becerra said in a statement.

The first round of maximum fair prices set by Becerra will be finalized by September 2024 and go into effect on the market as of 2026. By 2029, HHS will select 20 drugs for the negotiation program that will be applicable to Medicare Parts B and D.

Senior Biden administration officials told reporters on Tuesday morning that CMS followed the strict protocols set in the Inflation Reduction Act in selecting the drugs listed despite the fact that competitor pharmaceuticals or biosimilars may be on the market before the maximum fair price would take effect in 2026.

CMS data indicate that out-of-pocket costs for the 10 selected drugs cost seniors anywhere between $261 per month to over $6,000 per month.

A recent survey conducted by Morning Consult and the advocacy group Medicare Today, however, found that 81% of Medicare Part D enrollees said their necessary medications are covered by their supplemental insurance plan. A total of 76% of respondents said their co-pay or co-insurance amounts for on-brand prescriptions were financially manageable.

The effects of the medication price controls, however, could have more deleterious effects for those with rare conditions, the costs of which are offset by patients who use less expensive drugs to treat more common illnesses.

Tom Schatz, president of Citizens Against Government Waste, told the Washington Examiner the Medicare pricing provision of the Inflation Reduction Act has already had a negative impact on pharmaceutical research, creating “an invisible graveyard of patients” who will not be able to benefit from new drugs being brought to market.

“Manufacturers have already stopped [research and development] as a result of the IRA,” Schatz said.

“The U.S., by far, is the global leader on research and development, in large part because pharmaceutical manufacturers are permitted to recover the money they invested in not just the pharmaceuticals that reach market, but those that don’t,” Schatz added. “It’s not a cheap or easy process.”

Patient advocate John “CZ” Czwartacki, founder and chairman of Survivors For Solutions, told the Washington Examiner that “government encouraging innovation gave me a chance at a life” in helping find a cure for the neurological disorder multiple sclerosis, or MS.

“Due to a bipartisan consensus to actively keep government out of the way, my disease went from having zero treatments to slow its progression in 1993 to more than a dozen today,” Czwartacki said. “I’ve required four different of these cutting-edge tools over the 30 years since my diagnosis. I can say with confidence that the pipeline of treatments I needed wouldn’t have been available had the disincentives of the IRA been in place then. I would have spent my life in a government nursing home instead of the happy and productive life I’ve had.”

For those battling complex, rare diseases such as MS, Czwartacki said the price negotiation program will hinder access to treatment.

CLICK HERE TO READ MORE FROM THE WASHINGTON EXAMINER

“It’s cutting the spigot of innovation, causing researchers to be redirected, and now political science replaces real science. So those like me — who are battling diseases without a cure and require a plan B, C, and D to fight the disease — our chances to survive just got worse,” Czwartacki said. “The formerly healthy spigot of treatments and cures will reduce to a trickle.”

“In short, this robs those who face the most cruel diseases of their hope,” Czwartacki said.