– U.S. Senators Bob Menendez (D-N.J.), and Bill Cassidy, M.D. (R-La.) today reintroduced
the bipartisan Seniors Prescription Drug Relief Act to strengthen
Medicare Part D and make it easier for seniors to afford their medication.
“Our bipartisan bill would put patients and consumers first
by providing seniors with real financial relief at the pharmacy counter to
ensure that those who rely on expensive medications aren’t saddled with
insurmountable prescription drug bills at the start of every year,” said
Sen. Menendez. “Setting a cap on out-of-pocket expenses allows seniors
to prorate their share over the year into set monthly payments, giving them
more flexibility to cover their health care expenses. Policies like this, that
deliver savings to the consumers, must be central to our continued work on
making drugs more affordable for the American people.”
“If someone on Medicare cannot afford their medication,
they are going to get sicker or not get better. This bill takes on the root
causes of high drug prices because we want to make it easier for seniors to pay
for their prescriptions,” said Sen. Cassidy.
For seniors, the bill establishes a new out-of-pocket cap
on catastrophic coverage, so that beneficiaries would have no costs after
reaching $3,100 in out-of-pocket spending. Seniors who reach that limit early
in the calendar year could spread their payments over the course of the year,
to help those on fixed incomes or who would otherwise struggle to pay their
entire obligation in a lump sum. The bill would also reduce coinsurance from 25
to 20 percent in the initial coverage period, after patients meet their
deductible but before they reach the catastrophic cap.
The Seniors Prescription Drug Relief Act would also
redesign Medicare Part D’s benefit structure to realign these flawed incentives
and lower the cost of prescription drugs. Medicare Part D spending is growing
substantially, especially in the benefit’s catastrophic phase, which begins
once beneficiaries have spent more than $6,550 out-of-pocket. The legislation would
also encourage plans to better negotiate for lower drug prices and better
formulary placement, and ensure that when drug prices rise, so does the
drug-maker’s financial responsibility.
Organization supporting the legislation include the
Alliance for Aging Research and the Leukemia & Lymphoma Society.
“Senators Cassidy and Menendez continue to provide critical
leadership to ensure Medicare patients can afford and access needed care. The
Alliance for Aging Research thanks the Senators for their efforts to advance
patient affordability in Medicare Part D through this bill,” said
Alliance for Aging Research Vice President of Public Policy Michael Ward.
“The Seniors Prescription Drug Relief Act includes landmark
reforms that would dramatically lower prescription drug costs Medicare patients
experience far too often,” said The Leukemia & Lymphoma
Society Chief Medical Officer Dr. Gwen Nichols, M.D. “These reforms
would limit upfront costs for patients who rely on costly prescription drugs
and cap the amount enrollees pay over the course of the year—two changes that
will give a much-needed break to American seniors. Today, blood cancer patients
on Medicare Part D often pay more than $3,000 for their first prescription of
the year, with annual out-of-pocket costs sometimes higher than $15,000 for a
single cancer therapy. Under the Seniors Prescription Drug Relief Act, these
same patients would see their Part D costs reduced to less than $260 per month.
On behalf of the 1.3 million Americans living with a blood cancer diagnosis,
The Leukemia & Lymphoma Society applauds Senators Bill Cassidy and Bob
Menendez for their leadership on this critical issue, and we urge Congress to
pass these solutions this year.”
full text of the bill can be found here.