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August 29, 2023

“A huge victory for Americans,” King Celebrates Historic Step to Lower Costs of Prescription Drugs

For the first time, Medicare will directly negotiate drug prices helping to reduce the cost for prescription drugs used by thousands of Maine people

BRUNSWICK, ME – U.S. Senator Angus King today celebrated the Biden administration’s historic step to lower the cost of prescription drugs. Authorized by the Inflation Reduction Act that passed Congress last August, Medicare will now begin direct negotiations with drug companies on the prices of ten drugs under Medicare Part D. Tens of thousands of Maine Medicare enrollees currently take the ten drugs; paying annual out-of-pocket costs up to nearly $5,000 in 2022.

The drugs treat common conditions such as diabetes, heart failure, blood clots, and arthritis. Allowing Medicare to negotiate drug prices has been among Senator King’s top priorities for years, and one he fought to include in the Inflation Reduction Act.

“One of the first bills I ever cosponsored in the Senate was the Medicare Prescription Drug Price Negotiation Act. As we said at the time, it was a commonsense way to lower drug prices while saving taxpayer dollars. Years later, I’m beyond excited that the Inflation Reduction Act and President Biden have finally made this vision a reality,” said Senator King. “Today’s announcement is a huge victory for Americans – especially older Americans on a fixed income – who are struggling with the high costs of healthcare. These price negotiations will result in significant savings for taxpayers and will hopefully reduce the financial strain on the 30% of Maine people enrolled in Medicare. There is still more work to be done, but this is a truly important, game-changing step in our efforts to lower costs for Maine people.”

“For too long, big drug companies have price-gouged America’s seniors to pad their profits,” said Noël Bonam, AARP Maine State Director. “Today’s announcement is a monumental step toward allowing Medicare to negotiate prices for 10 of the most widely used prescription drugs, so millions of older adults can finally feel financial relief. No one should ever have to choose between paying for lifesaving medications or other necessities like food or rent.”

The selected drugs and the conditions they treat for the first round of negotiation are:

  • Eliquis – Blood clots
    • 21,000 Maine enrollees
    • $413 average annual out of pocket cost
  • Jardiance – Diabetes; Heart failure
    • 7,000 Maine enrollees
    • $262 average annual out of pocket cost
  • Xarelto – Blood clots; coronary or peripheral artery disease
    • 6,000 Maine enrollees
    • $432 average annual out of pocket cost
  • Januvia – Diabetes
    • 4,000 Maine enrollees
    • $228 average annual out of pocket cost
  • Farxiga – Diabetes; Heart failure; Chronic kidney disease
    • 2,000 Maine enrollees
    • $223 average annual out of pocket cost
  • Entresto – Heart failure
    • 1,000 Maine enrollees
    • $338 average annual out of pocket cost
  • Enbrel – Rheumatoid arthritis; Psoriasis; Psoriatic arthritis
    • Less than 1,000 Maine enrollees
    • $940 average annual out of pocket cost
  • Imbruvica – Blood cancers
    • Less than 1,000 Maine enrollees
    • $4,994 average annual out of pocket cost
  • Stelara – Psoriasis; Psoriatic arthritis; Crohn’s disease; Ulcerative colitis
    • Less than 1,000 Maine enrollees
    • $1,783 average annual out of pocket cost
  • Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; and NovoLog PenFill – Diabetes
    • 4,000 Maine enrollees
    • $89 average annual out of pocket cost

These selected drugs accounted for $50.5 billion in total Part D gross covered prescription drug costs, or about 20%, of total Part D gross covered prescription drug costs between June 1, 2022 and May 31, 2023. Of these ten drugs, eight are among the drugs with the top 25 highest list prices within Part D. The Centers for Medicare & Medicaid Services (CMS) will publish any agreed-upon negotiated prices for the selected drugs by September 1, 2024; those prices will come into effect starting January 1, 2026. In future years, CMS will select for negotiation up to 15 more drugs covered under Part D for 2027, up to 15 more drugs for 2028 (including drugs covered under Part B and Part D), and up to 20 more drugs for each year after that, as outlined in the Inflation Reduction Act.

Senator King has consistently worked to reduce healthcare costs for Maine people. The Inflation Reduction Act has laid the groundwork for—and in some cases already implemented—long-term changes in federal policy that will keep people healthier and deliver higher quality care at a lower cost to patients. These benefits are delivered while simultaneously reducing the deficit by finally allowing Medicare to negotiating bulk discounts on the price it pays for prescription drugs. This will save taxpayers hundreds-of-billions.

Impacts Already Being Seen

  • Extends Affordable Care Act premium subsides. The Inflation Reduction Act makes a three year extension of premium subsidies for American’s who receive their healthcare through the Affordable Care Act – more than 100,000 Maine people – Congress extended enhanced premium assistance for ACA marketplace plans through 2025; 80 percent of Maine ACA enrollees saved on insurance, and average savings per enrollee were more than $600 in 2022.
  • Provides free vaccines for seniors. The Inflation Reduction Act makes all vaccines free in Medicare for seniors, the only population for which vaccines were not already free. 
  • A new “inflation rebate” under Medicare. Drug companies should not be allowed to make arbitrary and rapid price increases on products that are not changing year-to-year. The Inflation Reduction Act requires drug companies rebate back the difference to Medicare if they raise prices higher than inflation. 
  • Limits insulin copays to $35/month. For too long, Maine seniors have faced uncertainty when paying for insulin which could costs hundreds of dollars out of pocket. The Inflation Reduction Act ensures no senior will pay more than $35/month for this life-sustaining medication.

Impacts Beginning in 2024

  • Caps Medicare Part D Premium Growth. For seniors on fixed incomes, increasing Medicare premiums can be a massive burden; the Inflation Reduction Act, in 2024, will prohibit premiums increasing more than 6% per year.
  • Expand premium and co-pay assistance on prescription drugs for low-income individuals. Currently, the low-income subsidy program (LIS) under Medicare Part D is fully available to all seniors earning less than 135% of the federal poverty level, and partially available to seniors earning less than 150% of the federal policy level. The Inflation Reduction Act eliminates the partial subsidy status, giving those seniors the full low-income subsidy under Medicare Part D. 

Impacts Beginning in 2025

  • Cap Medicare patients’ out of pocket costs at $2,000 per year. Today, there is no cap on spending for prescription drugs seniors buy from pharmacies. The Inflation Reduction Act caps Medicare’s out of pocket prescription drug costs at $2,000 a year, ensuring that devastating diagnoses, like cancer, will never again mean paying tens of thousands for just one drug.


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