The White House budget released Monday includes a number of ideas for lowering the cost of prescription drugs:
- Passing on discounts and rebates negotiated by pharmacy benefit managers to seniors enrolled in Medicare Part D. Seniors would see out-of-pocket savings, but insurers could hike their premiums.
- Reducing Medicare Part B reimbursements for drugs administered in a hospital.
- Switching reimbursement for some drugs administered in doctor’s offices or hospitals and paid for under Medicare Part B to Medicare Part D, allowing the price of those drugs to be negotiated.
- Capping out-of-pocket costs for Medicare beneficiaries affected by the insurance program’s coverage gap, and ensuring that low-income seniors in Medicare don’t pay for generic drugs.
- Creating a pilot project that gives up to five states the ability to band together and negotiate Medicaid drug prices with manufacturers and provides greater flexibility to the states in choosing which drug would be included in their formularies.
The bottom line: The budget proposals, which come days after the White House Council of Economic Advisers issued a report about lowering drug prices, suggest that the administration may be starting to focus on keeping President Trump’s oft-repeated promise to bring drug prices “way down.” The election-year timing may add some political incentive to make progress on the issue.
The proposals involve some difficult tradeoffs. Some Medicare beneficiaries would likely face higher prices, but those who now pay the most overall for their drugs could save thousands of dollars annually. Still, Allan Coukell, senior director of health programs at the Pew Charitable Trusts, told Kaiser Health News that while several of the proposals have price-lowering potential, “none of it changes the overall trajectory” of prescription prices.