Fact Check: New Provisions Could Raise Drug Costs for Seniors with Cancer and Rare Diseases
What We Know
Recent announcements from the U.S. Department of Health and Human Services (HHS) indicate that Medicare has selected 15 additional drugs for price negotiations under the Inflation Reduction Act. These negotiations aim to lower costs for some of the most expensive prescription drugs, which are often used by seniors, including those with cancer and rare diseases (HHS). Between November 2023 and October 2024, approximately 5.3 million Medicare Part D beneficiaries used these drugs, which accounted for about $41 billion in total gross covered prescription drug costs, representing about 14% of the total costs under Medicare Part D during that time (HHS).
However, the context of rising drug prices cannot be ignored. A report indicated that the median annual list price for new drugs has more than doubled in the past four years, with many new drugs for rare diseases exceeding $370,000 (Reuters). This trend raises concerns about the affordability of medications for seniors, particularly those who rely on these high-cost treatments.
Analysis
The claim that new provisions could raise drug costs for seniors is Partially True. On one hand, the HHS's initiative to negotiate drug prices is designed to lower costs for seniors, particularly those with serious health conditions like cancer and rare diseases. The negotiations are expected to yield discounts ranging from 38% to 79% off list prices, which could significantly reduce out-of-pocket expenses for Medicare beneficiaries (HHS).
On the other hand, the broader context of rising drug prices presents a counter-narrative. The doubling of median prices for new drugs, especially those targeting rare diseases, suggests that while negotiations may lower costs for some existing drugs, the overall trend in drug pricing remains upward. This could potentially lead to higher costs for new drugs that are not included in the negotiation process, thereby affecting seniors who may need these newer, often more expensive treatments (Reuters, NPR).
The reliability of the sources is generally high, with HHS being a government agency responsible for health policies, while Reuters and NPR are established news organizations known for their reporting on healthcare issues. However, it is essential to consider that the negotiation process will not cover all drugs, particularly new treatments that may emerge after the negotiations are finalized.
Conclusion
The claim that new provisions could raise drug costs for seniors with cancer and rare diseases is Partially True. While the Medicare Drug Price Negotiation Program aims to lower costs for many existing high-cost drugs, the overall trend of rising drug prices, especially for new medications, poses a risk of increased costs for seniors in the future. Therefore, while some seniors may benefit from lower prices, others may still face challenges due to the escalating costs of new treatments.