Achieving promised savings for government program will inevitably restrict patient access to decrease utilization of lifesaving medications
August 29, 2023 (WASHINGTON, D.C.) The Partnership to Fight Chronic Disease (PFCD) released the following statement today in response to the Centers for Medicare and Medicaid Services’ (CMS) release of the initial list of drugs subject to Medicare drug pricing authority under the Inflation Reduction Act (IRA):
“Millions of Americans living with chronic conditions like diabetes, cancer, and high blood pressure rely on access to lifesaving prescription drugs. The list of drugs subject to price setting notably includes several medicines that generate high spending for the Medicare program – not because they are expensive, but merely because of the number of people taking them. This means that cutting spending will also require cutting volume by restricting Medicare beneficiaries’ access to the medicines they need, are prescribed and upon which they rely to manage one and often multiple chronic conditions.
“There are better ways to lower prescription drug and other health care costs for Medicare without undercutting patient access to the medicines they need. PFCD and our partners are working hard to support policies that promote health, reduce the burden of illness, enhance access and lower out-of-pocket costs for consumers. These efforts cannot come at the cost of jeopardizing access to relied-upon medicines for chronic conditions. Instead, we should focus on efforts to ensure that negotiated savings are passed along to patients and to remove costly administrative hurdles that stand between patients, health care providers, and recommended care.
“The IRA includes some important reforms that support patient access under Medicare Part D, including capping out-of-pocket costs, lowering the eligibility threshold for low-income subsidies, and allowing beneficiaries to spread their out-of-pocket costs for drugs over the plan year. Those benefits, however, are overshadowed by the significant threat IRA implementation presents to accessing medicines upon which people living with chronic diseases rely and the innovation needed to address unmet medical needs.
“As the size of the Medicare-eligible population grows, costs are growing with it. Instead of attempting to control that growth by restricting beneficiary access to recommended care, policymakers should focus on lowering the key driver of spending: the growing burden of chronic illness. More than half of people with Medicare have three or more chronic conditions. The Administration should focus on improving people’s health by lowering the burden of chronic disease and increasing the affordability and accessibility of available treatment options instead of trying to position the IRA’s budget-balancing exercise as a win for Medicare beneficiaries.”
The Partnership to Fight Chronic Disease (PFCD) is an international coalition of patient, provider, community, business and labor groups, and health policy experts, committed to raising awareness of the number one cause of death, disability, and rising health care costs: chronic disease.