Drug Pricing
The Alliance for Aging Research believes that all people should have access to high-quality healthcare. One of the most significant healthcare issues for older adults is being unable to afford their physician-prescribed medications. The Alliance for Aging Research is advocating for older adults in the drug pricing debate through our below initiatives.
Project Lower Out of Pocket (LOOP) – The Alliance for Aging Research is advocating for two policy changes to the Medicare Part D program to make prescription drugs more affordable for older adults. We are advocating for a cap in the drug benefit design for Part D plans that would set a ceiling on the total out-of-pocket costs a beneficiary would pay in a calendar year. Secondly, we are advocating for a “smoothing” mechanism in Part D that would allow patients to pay for their high-cost medication over a year over the course of the benefit year rather than all at once.
Related Alliance Resources:
- Patient Advocacy Groups Call for Bipartisan Action to Alleviate Older Americans’ Undue Medicare Part D Cost Burden
- Opinion: “Why drug costs for older Americans should be capped in pandemic’s wake,” by Susan Peschin (The Hill)
- New Survey Shows Older Adults Are Willing to Pay More in Monthly Medicare Premiums to Ensure a Cap on Out-Of-Pocket Prescription Drug Costs
- Opinion: “Smoothing Medicare Beneficiaries’ Out-of-Pocket Drug Costs,” by Susan Peschin and Marc Boutin (Morning Consult)
- Blog: Addressing Out-Of-Pocket Prescription Drug Costs for Older Adults
Opposition to the Methodology of the Institute for Clinical and Economic Review (ICER) – ICER is an organization that creates reports known as “cost-effectiveness analyses” or “value assessments” that estimate how much a new medical treatment should cost. The reports use metrics, known as Quality-Adjusted Life Year (QALY), that value treating younger, healthier individuals over treating older adults and people with disabilities. These reports can persuade healthcare payers from covering treatments for older adults and dissuade pharmaceutical companies from developing drugs for rare diseases. Visit www.icerfacts.org to learn more.
Related Alliance Resources:
- Opinion: “How Much Say Should Specialty Providers Have in Medicare Coverage Decisions?,” by Susan Peschin (Morning Consult)
- National Pharmaceutical Council Blog: “Considering the Needs of Older Patients in Value Assessments” by Susan Peschin
- Letter to the Editor: “Drug Pricing and the Broader Quality of Life,” by Susan Peschin (Wall Street Journal)
- Opinion: “Discrimination has no place in American prescription drug coverage,” by Sue Peschin (The Tennessean)
- Opinion: “Governors should reject unscientific and discriminatory approaches to drug pricing,” by Susan Peschin (The Hill)
- Opinion: “Cost-Effectiveness in Health Care Is Racist,” by Susan Peschin (Morning Consult)
Opposition to the International Pricing Index (IPI) – IPI is a policy idea first proposed by U.S. Health and Human Services in the fall of 2018 for Medicare Part B drugs, and was expanded in U.S. House of Representative’s drug pricing plan to allow the federal government to negotiate the cost of 250 prescription medicines that aren’t facing market competition and extends the negotiated price to insurers and the commercial market at large. The IPI approach would require United States drug prices to be based on an international average of prices from mostly European countries. This policy would have a negative effect on newer and more innovative medical products on the market and would require the United States to effectively adopt the discriminatory cost-effectiveness standard used by foreign governments. The implementation of an IPI policy can mean that some patients and people with disabilities have diseases that are too expensive to receive care, and will likely result in healthcare rationing as it has in other countries.
Related Alliance Resources: