Even as the federal government on Thursday touted the billions of dollars in savings seniors can expect to see from newly negotiated, lower drug costs, pharmacies that supply long-term care facilities are warning of dire consequences.
The Centers for Medicare & Medicaid Services announced Thursday morning that it had reached an agreement with drug makers to lower the list prices Medicare would pay for 10 of the most expensive drugs that are frequently prescribed to seniors by 38% to 79%.
The Senior Care Pharmacy Coalition (SCPC), the leading national voice for the long-term care pharmacy community, and the new Save Senior Rx Care campaign released a statement today in response to the new drug pricing announcement:
“Today, the Biden Administration released the negotiated 2026 prices for the ten most expensive Medicare Part D drugs, as required by the Inflation Reduction Act (IRA). Lowering drug prices for seniors – and for all Americans – is an important goal, and today’s announcement is a positive sign for seniors.
Many of the nation’s long-term care pharmacies are going to fall below “break-even” and may be forced out of business without additional support when drug-pricing policy changes kick in, sector advocates warned Wednesday.
The Senior Care Pharmacy Coalition is launching a new campaign for federal payment reform as the White House finalizes lower prices on 10 drugs widely used by Medicare beneficiaries and Congress toys with legislation that could loosen pharmacy benefit managers’ grip on most other US drug pricing.
America’s long-term care (LTC) pharmacies are launching Save Senior Rx Care, a new campaign urging Congress to protect access to life-saving medications and services for the millions of Americans who need long-term care.
The campaign will raise awareness of the unintended but potentially devastating consequences of new drug pricing policies on LTC pharmacies and the vulnerable patients they serve.
Firms that manage drug benefits, which promise to keep a lid on high drug costs, instead steer patients away from less expensive medicines and overcharge for cancer therapies, Federal Trade Commission investigators found.
The FTC, in a report released Tuesday, detailed a number of actions that it said large pharmacy-benefit managers use to boost their profits and increase the spending of the health plans and employers that hired them to control costs. The actions can also lead to higher outlays for patients at the pharmacy counter, the agency said.
Americans are paying too much for prescription drugs.
It is a common, longstanding complaint. And the culprits seem obvious: Drug companies. Insurers. A dysfunctional federal government.
But there is another collection of powerful forces that often escape attention, because they operate in the bowels of the health care system and cloak themselves in such opacity and complexity that many people don’t even realize they exist. They are called pharmacy benefit managers. And they are driving up drug costs for millions of people, employers and the government.
Nursing home patient access to prescription drugs is being squeezed as several market and regulatory factors have combined to increase the power pharmacy benefit managers have over long-term care pharmacies, an advocacy group warned federal officials last week.
Pharmacy benefit managers, or PBMs, serve as a go-between between insurers, pharmacies and drugmakers. They have been long villainized in the commercial insurance world, but their influence over those who serve nursing homes and other aging services providers has grown amid fresh political and financial scrutiny.
