Some Medicare recipients could save money on 34 prescription drugs

The Centers for Medicare & Medicaid Services announced the list of 34 prescription drugs that may have a lower cost for Part B beneficiaries between Oct. 1 and Dec. 31.

Some people with Medicare who take these drugs may save between $1 and $618 per average dose starting Oct.1, 2023, depending on their individual coverage, CMS said this week.

The price reduction is part of the Inflation Reduction Act passed in August 2022.

Prescription drug provisions in the Inflation Reduction Act include:

• For the first time, the federal government is required to negotiate prices for some of the highest-spending drugs covered under Medicare.
• Requires drug companies to pay rebates if prices rise faster than inflation for drugs used by Medicare beneficiaries.
• Eliminates the 5% coinsurance for catastrophic coverage in Medicare Part D in 2024, adds a $2,000 cap on Part D out-of-pocket spending in 2025 and limits annual increases in Part D premiums for 2024-2030.
• Limits monthly cost sharing for insulin products to $35 for people with Medicare.
• Expands eligibility for Medicare Part D low-income subsidy full benefits.
• Eliminates cost sharing for adult vaccines covered under Medicare Part D and improves access to adult vaccines under Medicaid and the Children’s Health Insurance Program.

By reducing coinsurance for some people with Part B coverage and discouraging drug companies from increasing prices faster than inflation, CMS’ action may lower out-of-pocket costs for some people with Medicare and reduce Medicare program spending for costly drugs, the agency said.

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 Oct. 1 to Dec. 31. The 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.

The list of drugs impacted by the coinsurance adjustment includes:

• Adcetris
• Aggrastat
• Akynzeo
• Atgam
• Bicillin CR
• Bicillin L-A
• Blincyto
• Chirhostim
• Cresemba
• Crysvita
• Fragmin
• Humira
• Hypertet
• Imlygic
• Infugem
• Leukine
• Lupron Depot-PED
• Minocin
• Nipent
• Nplate
• Oncaspar
• Padcev
• Panhematin
• Pemetrexed
• Romidepsin
• Rybrevant
• Signifor LAR
• Sotalol
• Sylvant
• Synribo
• Vabomere
• Vectibix
• Xiaflex
• Zemdri

In August, CMS announced the first 10 prescription drugs that will be subject to Medicare price negotiations under the Inflation Reduction Act.

Under the act, Medicare will be able to directly negotiate with drugmakers over prices for the costliest medications. The negotiated prices will go into effect in 2026.