09/03/2024 | Press release | Distributed by Public on 09/03/2024 17:37
Earlier This Month Many Cap Region Seniors Found Out New Negotiated Lower Drug Prices For 10 Of Most Common Drugs For Medicare, Impacting Those With Cancer Diabetes, Heart Disease & More - But Extremists And Far Right Now Want To Take Away Medicare's Ability To Negotiate Drug Prices
Senator Says We Need To Be Doing More To Address Drug Costs And Announces $2,000 Annual Cap On Medication For Seniors Coming In January; Vows To Block Rollbacks That Could Drug Costs For Thousands Of Cap Region Seniors
Schumer: We Need To Be Moving Forward Not Backward. And Lowering Health Care Costs Is Just What The Doctor Ordered!
On the heels of just announced new, lower, and fairer negotiated prices for 10 of the highest-spend drugs in Medicare, U.S. Senate Majority Leader Chuck Schumer stood with Capital Region seniors who take these drugs to spotlight the importance of these tremendous cost saving measures, a result of Schumer secured provisions in the Inflation Reduction Act. Schumer said this comes amid extreme new proposals, including in Project 2025 to roll back these cost-saving measures, which could increase costs for up to 1,145,400 older New Yorkers. Schumer said we need to be moving forward not backward on lowering drug costs, and vowed to these efforts while announcing the next phase soon to come with a $2,000 cap on total out-of-pocket prescription drug costs for NY seniors on Medicare starting this January.
"Thanks to the Inflation Reduction Act, we've made record progress lowering prescription drug prices for older Americans on Medicare. Before, seniors often had to pay thousands upon thousands of dollars for a single drug. Now, we are taking on Big Pharma directly to negotiate prices, which is lowering costs of medication for cancers, diabetes, and heart diseases as much as 79%," said Senator Schumer. "It's outrageous that extremists in Washington could want to take this all away and are proposing removing these cost-saving measures. We need to be moving forward on lowering drug costs not backwards and I am here with our seniors in the Capital Region to say I will fight to block any and all efforts to roll these provisions back."
In addition to the new lower negotiated prices for 10 drugs thanks to Medicare's ability to negotiate, Schumer secured other measures in the Inflation Reduction Act that are lowering healthcare costs for seniors. Schumer announced that while an out-of-pocket spending limit of roughly $3,100 has been in place for 2024, it is lowering to $2,000 in 2025. Once a senior spends $2,000 next year, their prescription drugs for the remainder of 2025 will be free of charge. This will provide major protection to the set of seniors on Medicare who currently have extremely high prescription drug spending. Before the Inflation Reduction Act, a single prescription could cost $10,000 out-of-pocket. AARP estimates that 261,000 New York seniors - the seniors who currently have the highest levels of drug spending - will benefit from the cap next year. By 2029, one in ten seniors nationally is expected to see savings because of the cap.
Schumer added, "Come this January, New York seniors will not have to pay more than $2,000 for prescription drugs, and will help end the decision making like choosing between buying life-saving medications and keeping food on the table. It means more money in the pockets of New York seniors and less in the pockets of Big Pharma, a win-win and just what the doctor ordered."
In addition, Schumer also spotlighted the provision he also helped deliver that will be starting in January tool that allows Medicare beneficiaries to break their drug costs into monthly payments. For some seniors taking a very expensive drug, they could hit the $2,000 limit in January or February, which leads to a huge spike in costs for a short period of time that may be hard to budget for. With the monthly payment tool, that same senior could pay their $2,000 obligation in equal $167 monthly payments throughout the year rather than facing a huge bill at the pharmacy counter in January or February.
The monthly payment tool requires patients to opt into it. Schumer said that while he wrote into the IRA that insurance companies are supposed to target and reach out to beneficiaries likely to benefit, it is critical to build awareness among beneficiaries and pharmacists so that everyone can take advantage, and nobody falls through the cracks. Schumer said this new out-of-pocket limit will work in tandem with other major drug affordability provisions he secured in his Inflation Reduction Act, including making vaccines free for seniors and a $35 insulin cap for those on Medicare, to help make healthcare more affordable for more than 3.8 million New York seniors on Medicare.
Maria Alvarez Executive Director NY StateWide Senior Action Council, "The $2,000 IRA Out-of-Pocket Cost Cap will be of tremendous benefit to many older New Yorkers, particularly those suffering with chronic conditions and high medication costs. Through our helpline we have seen countless consumers, who live on fixed incomes and who need multiple and expensive life-saving prescription drugs incurring thousands of dollars in out-of-pocket costs. We applaud the administration for implementing this policy to ease the financial burden of so many vulnerable seniors."
Schumer explained that Project 2025 proposes reversing many of the provisions he fought for in the Inflation Reduction Act including eliminating the $2,000 out-of-pocket drug cost cap, and preventing Medicare from negotiating lower prices of prescription drugs, which would increases costs for up to 1,145,400 older New Yorkers, including thousands in the Capital Region on Medicare Part D.
Drug Name |
Commonly Treated Conditions |
NY Seniors Taking Drug |
Current Price Set by Drug Company For A 30 Day Supply |
New Price Negotiated by Medicare |
Discount Secured By Medicare |
Eliquis |
Blood clots |
232,000 |
$521 |
$231 |
56% |
Xarelto |
Blood clots, heart disease |
96,000 |
$517 |
$197 |
62% |
Januvia |
Diabetes |
85,000 |
$527 |
$113 |
79% |
Jardiance |
Diabetes and heart failure |
96,000 |
$573 |
$197 |
66% |
Enbrel |
Rheumatoid arthritis and Psoriasis |
4,000 |
$7,106 |
$2,355 |
67% |
Imbruvica |
Blood cancers |
2,000 |
$14,934 |
$9,319 |
38% |
Farxiga |
Diabetes, Heart failure and Chronic Kidney Disease |
53,000 |
$556 |
$178.50 |
68% |
Entresto |
Heart failure |
43,000 |
$628 |
$295 |
53% |
Stelara |
Psoriasis and Crohn's Disease |
2,000 |
$13,836 |
$4,695 |
66% |
Fiasp and NovoLog |
Diabetes |
50,000 |
$495 |
$119 |
76% |
Schumer vowed to block this proposal and focus on new measures to lower healthcare costs. The total Medicare Part D enrollment for the Capital Region this month is 69,635. A county by county breakdown can be found below:
County |
Enrollment |
Albany |
18,976 |
Columbia |
6,330 |
Greene |
4,184 |
Rensselaer |
9,055 |
Saratoga |
14,779 |
Schenectady |
7,805 |
Warren |
4,890 |
Washington |
3,616 |
Schumer said seniors in America are paying higher prices than anywhere else in the world for commonly-taken drugs. Nationally, one-in-five seniors recently reported forgoing medication, skipping doses or cutting pills in half because they could not afford their drugs. This year, Medicare selected for negotiation the 10 highest spending drugs in Medicare Part D that do not have generic versions of their drugs but are eligible for such competition, the new prices will go into effect in 2026 and each year moving forward, Medicare will negotiate lower prices for even more drugs. The first ten drugs alone this year are expected to impact 660,000 in NY, and save seniors across America over $1.5 billion every year in out of pocket costs and taxpayers nearly $6 billion every year.
"This regulation will provide critical support for patients reliant on life-saving medications, especially when more affordable alternatives are unavailable. We commend Senator Schumer for his commitment to supporting our seniors and the most vulnerable members of our community," said Jaget Patel, owner of Crestwood Pharmacy.
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