Posted on 06/17/2016 6:53:34 AM PDT by Lorianne
Calling the rising cost of drugs "unsustainable," congressional advisers on Wednesday recommended major changes to Medicare's popular outpatient prescription program, now 10 years old.
The proposal from the nonpartisan Medicare Payment Advisory Commission, or MedPAC, steers clear of calling for the government to negotiate drug prices directly, an option both presidential candidates advocate. For beneficiaries, the plan is a mixed bag. All seniors would get better protection from extremely high costs, but some may have to spend more.
The recommendations are unlikely to gain traction in Congress during an election year, but they will get a serious look from staff experts on key House and Senate committees overseeing Medicare.
MedPAC is a congressional agency charged with making regular recommendations on Medicare, the government's premier health insurance program, with about 57 million elderly and disabled beneficiaries. Echoing widespread concerns about drug costs, MedPAC said spending for Medicare's prescription program grew by nearly 60 percent from 2007 through 2014, from $46 billion to $73 billion.
That was driven by spending on high-cost beneficiaries who tend to use the most expensive medications, such as the recent breakthrough cures for hepatitis C infection. Congress should re-examine the program's design "to better ensure financial sustainability," the commission said.
The MedPAC proposal would protect all seniors by setting an annual limit on how much they can be required to pay for medications, a new safeguard.
However, it would also raise costs by about $1,000 for some beneficiaries who land in the widely loathed coverage gap known as the "doughnut hole." And MedPAC also proposed restructuring modest copayments that low-income beneficiaries may face, in order to encourage greater use of generic and preferred brand name drugs.
Insurance companies, the middlemen who deliver coverage to some 39 million beneficiaries in the prescription program, aren't likely to be pleased.
(Excerpt) Read more at hosted.ap.org ...
Is anyone surprised by this? Just turn the damn thing over to the market.
We are seeing major medicare changes; it’s called the Obamacare nightmare.
Let me guess. The answer is to cap drug prices, or have the government buy drugs at a capped price and then dole them out based on need.
Of course this is no surprise! Obamacare was written by a combination of special interests and drug-addled 22 year old Obamabots.
Trust me. Whatever they do (how much cash has Clinton taken from the pharmaceutical industry?) it won't hurt the drug companies or the insurance companies. At most, they will shift the cost from the people benefiting from the drugs to the people picking up the tab.
I’m just glad there’s no law in place forbidding the government from negotiating lower drug prices in order to save the taxpayers a few bucks. /s
Anyone who complains that drug prices are cheaper abroad should realize that foreigners can get a free ride off of American companies’ development expenditures by either refusing to respect drug company patents or effectively nullify them via price controls.
Perhaps you are right.
Perhaps drug companies recoup all their R&D costs from American customers, while giving the rest of the world a free or reduced-price ride due to regulation. Perhaps if we join the rest of the world in regulation they will close-up shop and quit developing new drugs.
I have the sneaking suspicion we are going to find out.
The federal government has CREATED the problem.
It's just like higher education costs: if the government makes it possible (through student loans) for people to spend nearly unlimited amounts of money on something, they'll do it. And, the universities respond to the demand by raising prices (tuition). You can't change the law of supply and demand.
The same thing is happening with prescription medications. They are raising prices because people are insulated from the actual cost -- their insurance will pay for it, after a small co-pay. Medicare Part D is just the largest payer.
Drug companies do this because it literally costs a billion dollars to develop a new drug, get FDA approval, and bring it to market. They have to recoup their cost and make some profit before the patent expires, and anyone that can mix chemicals can manufacture it (i.e. generics).
The new biologic medicines (like Enbrel, etc.) are actually manufactured by genetically modified bacteria. Those are incredibly expensive (like $1,000 per week), but it's unlikely there will ever be a generic version. The manufacturer isn't going to hand out their bacterial cultures, and it will be difficult for another manufacturer develop and get approval for one on their own.
Drugs are cheaper in foreign countries because they can’t be sued. I heard a pharmacy guru on radio say 90% of the cost of drugs in the US is for legal reasons.
And it’s nearly impossible for your drug to not be ‘proven’ to have ‘side effects’ at some point in time. Heaven help the pharmacorp being sued for side effects caused by people being on their stuff for far longer than they could test-run for them, because the lawyers will have no regard for how bad the economy sucks for you at the present.
Look at the Tv ads for “join a class action suit if you were hurt by baby powder!”. Complete and utter bilge but not only is there a good chance the suit wins, literally any other drug is now vulnerable because what is milder than talcum powder?
Bingo! Almost all products in the US factor in the cost of future litigation. Tort reform would help this issue. But how are we going to get real tort reform when the people writing the laws are lawyers?
I took Nexium for a long time. My kidney is damaged pretty bad. Now lawyers are asking for people to join the class action suit against Nexium. Yet Nexium is still being sold.
I don’t know if it’s what damaged my kidney. I also had dye injected in me twice in 4 days when they say there should be 6 months between injections. So, which one did the damage?
We face a choice of high-priced drugs or none at all. If the government puts a price cap on drugs, they will disappear off the shelf just as surely as food has disappeared in Venezuela.
When you have doctors pushing the latest, highest cost, most side effect riddled drugs just out, of course you will see a spike in cost. They wanted hubby on Crestor, high side effects and cost, he takes a low cost older cholesterol drug that has a generic at a much lower cost that works as well and has less side effects. Slick ad campaigns made it the #1 cholesterol drug. Not that it works better than older less side effect riddled ones.
My DUMB PCP wants me on Lyrica 375 MG several times a day. I’ve already had a bad reaction to a lower doses. I’ll stick with my CHEAP, less addictive Valium for my Fibromyalgia and
Peripheral Neuropathy pain. Works, no side effects.
Then you have the fact she doesn’t listen, doesn’t follow proper testing guidelines, and writes scripts for full blown diabetes med based on a glucose reading taken after 1000 MG of Vit C. No meter to test, no A1C1, no Keytone testing. Made her give me a meter. 1 test strip per day. I’ve a Type 2 diabetic son. So I know what has to be done. If you suspect I have a ‘sugar’ issue send me to my ENDOCRINOLOGIST who treats my Hypothyroid. You Dr are NOT QUALIFIED to diagnosis the issue. Which is NOT a real health issue. Just a Vit C issue.
Then you have the $60 BILLION in fraud in Medicare to contend with. And Illegals being put on it to boot.
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