Medicare Could Negotiate Drug Prices Under Democrat Proposal

WEDNESDAY, Nov. 3, 2021 (HealthDay News) -- A measure designed to lower prescription drug costs for seniors has been added to President Joe Biden's social safety net and climate change bill that Democratic leaders hope to bring to a House vote this week.

For the first time, the measure would enable the federal government to negotiate prices for medications covered by Medicare, The New York Times reported. Under the proposal, negotiations could begin in 2023 on the most expensive drugs -- anticoagulants, as well as cancer and rheumatoid arthritis treatments. Before negotiations could start, most drugs would be given patent exclusivity for nine years, but that would be extended to 12 years for biologics, according to. After those periods, Medicare would be able to step in, even if drug makers get patent extensions or take other measures to safeguard their patents.

The prescription drug measure forced Democrats to overcome an onslaught of lobbying by the pharmaceutical industry, which succeeded in weakening their initial proposal, The Times said. The final deal includes a $2,000 annual cap on out-of-pocket expenses by older Americans facing catastrophic health issues, a strict $35 monthly cap on insulin expenses, and automatic rebates on drugs whose prices rise faster than inflation.

There were concessions: The inflation rebates initially would have weighed rebates on drug prices that began to soar as far back as 2012. And some Democrats wanted to grant Medicare price-negotiating authority immediately, with no patent exclusivity periods. Still, the bill grants Medicare the broader negotiating powers that Democrats have been pushing for decades.

Republicans are unanimously opposed to the social safety net and climate change bill, so Democrats would have to get the support of all 50 of their senators and all but a few of their members in the House for it to pass, The Times reported.

The New York Times Article