New abilities for Medicare to negotiate prescription prices mean certain drugs should be 50% to 70% cheaper for many Floridians in 2026.
That’s according to an analysis by AARP.
“That’s real relief for older adults who have been stretched to the breaking point by high drug prices for far too long,” said AARP Executive Vice President Nancy LeaMond in a media briefing.
The study looked specifically at how negotiated prices impact customers in five states with a high number of Medicare users: Florida, California, New York, Pennsylvania and Texas. Medicare has selected 25 drugs so far to start price negotiations.
The AARP study shows out-of-pocket costs for the first 10 Medicare-negotiated prescription drugs, which are used by 9 million Medicare seniors to treat diabetes, heart disease, autoimmune disorders and cancer, will drop by more than half for those on standalone Medicare Part D plans.
AARP attributes those savings to a law signed by former President Joe Biden in 2022 and backed by the AARP for years.
LeaMond said it’s especially valuable now, at a time when upward of 95% of Americans age 65 and older have at least one chronic condition, and close to 80% are dealing with two or more.
“The law now requires Medicare to identify high-cost drugs and negotiate lower prices on behalf of beneficiaries and the taxpayers who help fund the program,” she said.
“The law also stops price gouging by requiring rebates when companies raise prices faster than inflation. It caps insulin at $35 per month for people on Medicare, makes vaccines for things like shingles free, and limits what folks in Medicare drug plans pay out of pocket for their prescriptions. And today’s new AARP analysis shows that the 2022 law will continue to make a big impact, helping older Americans save money on their prescriptions.”
Medicare Part D currently provides prescription drug coverage for nearly 56 million Americans, according to Leigh Purvis, the AARP Public Policy Institute’s Prescription Drug Policy Principal and the author of the report.
“Rising drug prices have placed an immense burden on many of these enrollees, leading far too many to make difficult choices like not filling prescriptions or skipping doses to make ends meet,” Purvis told press. “This is particularly troubling for those on fixed incomes, where every dollar counts.”
But AARP cautioned that the policies could also draw reaction from pharmaceutical companies.
“Beware: big drug companies are spending millions to delay negotiation and keep prices sky high — while lining their own pockets,” LeaMond said. “As the voice for 125 million Americans age 50 and over, AARP will keep fighting any attempts to undermine Medicare’s ability to negotiate prescription drugs.”
In total, the change should provide a collective $1.5 billion in out-of-pocket costs to Medicare enrollees in 2026, based on figures available from the Centers for Medicare & Medicaid Services.
AARP has also supported state policies, like giving the ability to import cheaper drugs internationally. Florida in January 2024 received a long-sought approval to import certain prescription drugs, making it the first state to win such an approval.
Megan O’Reilly, AARP Vice President of Public Affairs, stressed that AARP supports importation efforts.
“We know there’s a number of states in different processes and discussions with the federal government,” she told Florida Politics. “As we talk about AARP support across the board for all the different levers that we think can have an impact on lowering drug prices and the costs that seniors pay, importation has been one of those issues we’ve been strongly advocating on.”
But Purvis cautioned that the process for such approvals is a lengthy one. Florida’s request to the federal government was pending for two years.
“Most of the states that have engaged in this still have not fully completed that process,” Purvis said. “But one really important criteria is that they have to be able to demonstrate savings, and so should a program be finally approved and implemented? The expectation is yes, they should see savings from having that program in place.”
The study came out as Congress debates health care reforms and the best way to address health care costs. The U.S. House on Wednesday passed a Republican-crafted plan that leadership said should reduce insurance premiums for most Americans, but which notably included no extension of pandemic-era tax credits tied to the Affordable Care Act insurance marketplace.
Will that change impact drug costs? AARP officials noted that the legislative package included a pharmacy benefit manager (PBM) policy. The senior advocacy organization has yet to take a public stance on that specific measure, but said it broadly supports reforms to the PBM system.
AARP has backed Senate language in a bipartisan health care proposal from U.S. Sens. Mike Crapo, an Idaho Republican, and Rob Wyden, an Oregon Democrat. LeoMand said the organization will ultimately support any proposal with proven opportunity to “bring relief and efficiencies to prescription drug pricing and make improvements in the drug supply chain.”