Biden Admin Temporarily Lowers Cost of 54 Medicare Drugs

Bottles of prescription drugs are filled as they move along an automated line at the central pharmacy of Intermountain Heathcare on Sept. 10, 2018, in Midvale, Utah. George Frey/Getty Images

Some people with Medicare will pay less out-of-pocket for prescription medications for the fourth quarter of this year, the U.S. Department of Health and Human Services (HHS) said.

The federal agency on Monday identified 54 drugs that had price increases faster than inflation. Under the Inflation Reduction Act (IRA) of 2022, coinsurance rates for these drugs will be adjusted to reflect the inflation rate, and pharmaceutical companies will be penalized in the form of rebates paid to Medicare, the taxpayer-funded federal health care program for seniors.

The selected drugs will have a lowered Part B coinsurance rate from Oct. 1 to Dec. 31, with HHS estimating that some patients could save between $1 and $3,854 per day, depending on the medication. For example, a Medicare enrollee taking Kymriah, a cancer drug, could save as much as $3,000 during the period.

HHS noted that more than 822,000 Medicare enrollees rely on these drugs each year for the treatment of conditions such as cancer, osteoporosis, and pneumonia.

In July, HHS implemented similar price controls for 64 drugs under the IRA’s inflation rebate program. The lower prices for those drugs were in effect during the third quarter of 2024 and expire on Monday.

“No one should have to choose between paying for their health care or putting food on the table,” HHS Deputy Secretary Andrea Palm said at an event announcing the latest quarterly list of Part B medications subjected to coinsurance rate adjustments.

President Joe Biden also touted the rebate program created under his signature piece of legislation, blaming pharmaceutical companies for high drug costs.

“While Big Pharma made record profits, Americans footed the bill for the industry’s price hikes. Not anymore,” Biden said in a statement on Monday.

“Thanks to my Inflation Reduction Act, companies that increase the price of prescription drugs faster than inflation now must provide a rebate to Medicare.”

Medicare is also negotiating, for the first time under the IRA, to lower the prices of selected prescription drugs with manufacturers. In February, the Biden administration kicked off the first round of negotiations involving 10 high-cost drugs, marking a major milestone for both Biden and Democrats who have championed drug pricing reforms.

Republicans, however, have argued that leveraging the government’s purchasing power to rein in prices will stifle the development of new drugs and hurt patients in the long run.

The constitutionality of the IRA’s Medicare negotiation program remains a point of contention, with ongoing litigation between the HHS and the U.S. Chamber of Commerce, whose members include drugmakers such as AbbVie and Eli Lilly.

In a decision issued Sept. 29, a federal judge in Ohio allowed the program to continue while the case proceeds in court, stating that the challengers failed to make a compelling argument that the program violates the due process clause of the Fifth Amendment.