The Medicare rule, designed by the Trump administration to take money away from drug industry brokers and provide refunds to patients, has not been implemented. But budget analysts say if it were, it would cost the government money. So senators are pushing the rule aside and claiming to save billions of dollars, which they want to use instead on new projects.
Health plans’ coverage of the medication, branded as Wegovy — which has a $1,300-a-month price tag — is not a sure thing.
Missouri is the last state to create a monitoring program to help spot the misuse of prescription drugs. But some public health experts warn that the nation’s programs are forcing people addicted to opioids to seek deadlier street options.
The makers of Aduhelm, a drug approved last month despite concerns raised by experts about its effectiveness, have launched a website and ads designed to urge people who are worried about their memory to ask doctors about testing. But some health advocates say it is misleading because some memory loss with aging is normal.
Sen. Ron Wyden (D-Ore.), who is helping to negotiate the health care spending framework for the Democrats’ budget plan, said lawmakers may have to settle for very basic versions of programs deployed in the package. But the key, he added, is to get the “architecture of these changes, bold changes,” started and show people what is possible.
The July 9 directive addresses the importation of prescription drugs and broader efforts to reduce the high cost of medicines.
The plan from high-wire negotiations would affect five key areas of health, but there will be further tense negotiations among Democratic lawmakers about specifics of the $3.5 trillion in funding. And all Senate Democrats will need to be behind the plan, because Republicans oppose it.
In an interview for KHN’s “What the Health?” podcast, HHS Secretary Xavier Becerra says the administration is eager for Congress to make changes to Medicare that will provide more benefits and make more older adults eligible for the program. He also said a priority will be making permanent the enhanced premium subsidies for Affordable Care Act marketplace plans.
Aduhelm, approved by the Food and Drug Administration last month despite questions about its efficacy, could be prescribed to at least 1 million patients a year, for a price tag of about $56 billion. Experts suggest there might be better ways to spend that money.
As more independently owned community pharmacies close, a Colorado town is crowdsourcing ways of getting prescription medicines delivered to those who can’t travel the long distance to the closest pharmacy. But even those stopgap measures don’t always work.