December 05,2019

Washington Post: Prescription Drug Pricing Reduction Act “Drug Pricing Bill with the Best Chance of Passing Congress”

Bipartisan Grassley-Wyden Legislation “The Most Viable Drug Pricing Bill in Congress”
The Most Viable Drug Pricing Bill in Congress is Getting a Makeover
By Paige Winfield Cunningham
Thursday, December 5, 2019
The drug pricing bill with the best chances of passing Congress is getting a makeover, as its authors and the White House try to make it more attractive in a last-ditch effort to notch a win on lowering drug costs before the 2020 election season.
Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) are poised to unveil a 2.0 version of their Prescription Drug Pricing Reduction Act of 2019, which caps out-of-pocket costs for Medicare enrollees and requires drugmakers to pay rebates if they hike prices faster than inflation. The revisions, which the White House says it supports, are expected to bring further cost relief to seniors, and aides predict the bill could win much-needed support from more GOP lawmakers.
“The skeleton is the same, but we do believe it will be much more popular with members and their constituents,” an aide working on the legislation told The Health 202.
Grassley and Wyden's measure could be the only realistic venue at this point…the senators are expected to smooth out when seniors pay the $3,100 out-of-pocket cost maximum they must pay before full coverage kicks in. For seniors with expensive drug needs, those costs can be burdensome at the beginning of the year before the cap has been reached. Senate aides are looking at ways to include a monthly cap so those out-of-pocket expenses are more spread out throughout a plan year.
A senior White House official confirmed to The Health 202 that’s a change it is seeking. “The White House would like to cap out of pocket costs for seniors on a monthly basis,” the official said.
The measure already includes a provision curbing costs for Medicare enrollees with a first-ever annual cap on their out-of-pocket spending. Under current law, seniors must still cover 5 percent of the cost of drugs after their spending is enough to reach what’s known as the “catastrophic” phase of coverage. That leaves some seniors on extremely expensive medications vulnerable to steep costs.
Skyrocketing drug costs have thrown the problem into sharp relief. Now, more than 1 million Medicare patients now have such high out-of-pocket costs that they hit that “catastrophic” phase of coverage. That’s up from 380,000 such patients a decade ago. Some patients must pay $10,000 or more every year for a single drug.
Patient advocate groups have endorsed the Grassley-Wyden measure as well as a Democratic-backed drug pricing bill from House Speaker Nancy Pelosi (D-Calif.), which includes a $2,000 out-of-pocket cap…