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Inflation Reduction Act brings Medicare negotiation for prescription drugs

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GREAT FALLS — Crucial action stemming from the Inflation Reduction Act signed in 2022 took effect earlier this week.

Montanans and millions of other Americans who rely on Medicare for prescriptions will likely find their options become much more affordable in time. As of Tuesday, August 29th, Medicare now has the ability to negotiate prices with drug manufacturers to help in lowering the price. This will apply to some of the costliest Medicare Part B and Part D drugs.

On behalf of the patients, prescription drugs included in Medicare negotiation are Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and insulin manufactured by Novo Nordisk. These are ten of the most commonly used drugs by seniors in Montana.

The first-round of price capping is expected to be complete by September of 2024. By 2025, a yearly cap of $2,000 for out-of-pocket prescription drug costs in Medicare will be applied.

Price cuts on the drugs listed above will take effect in 2026. Insulin will be available at $35/month per covered prescription.

Also included in the Inflation Reduction Act are inflation rebates in Medicare. The new law requires drug companies to pay Medicare a rebate if they raise drug prices faster than the rate of inflation.

Shelbi Witt, the owner of Montana Apothecary & Compounding in Great Falls, said of prescription drug prices: “It's a constant discussion in our world, especially as a pharmacist. You get calls every single day on drug prices. ‘What's your price on this? How do I get my insurance to pay for this?’”

She noted, “I think it's important for the patient to be educated about drug prices. That's the number one thing as the patient, having that gumption to go and ask what is the price?”

Numerous pharmaceutical companies have already filed lawsuits, citing the interference as unconstitutional.

"Today’s announcement is the result of a rushed process focused on short-term political gain rather than what is best for patients," said the Pharmaceutical Research & Manufacturers of America in a statement. "Many of the medicines selected for price setting already have significant rebates and discounts due to the robust private market negotiation that occurs in the Part D program today. Giving a single government agency the power to arbitrarily set the price of medicines with little accountability, oversight or input from patients and their doctors will have significant negative consequences long after this administration is gone."



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