Negotiated Medicare drug costs could aid 36K Iowans

DES MOINES — Roughly 36,000 Iowans on Medicare pay an average of $650 each year to take the blood thinner Eliquis, according to federal data, but that copay could fall in future years under a new federal law being celebrated by President Joe Biden’s administration and Iowa Democrats.

The measure, part of the so-called Inflation Reduction Act, allows the federal government to negotiate prices with prescription drugmakers. The goal is to reduce the price of the prescription drugs for the government, and also to lower out-of-pocket costs for Medicare participants.

This week, the Biden administration highlighted potential cost savings for the first 10 drugs whose prices the administration plans to negotiate in the coming years. However, any lower prices won’t take effect for three years, and the path forward could be further complicated by litigation from drugmakers and heavy criticism from Republicans.

The administration this week published state-level data that shows how many Iowans receive the drugs through Medicare, and the average out-of-pocket costs annually.

In addition to the 36,000 Iowans on Medicare who paid an average of $650 in 2022 on Eliquis, 15,000 paid an average of roughly $640 for another blood thinner, Xarelto, according to federal data. And 12,000 paid roughly $470 for the diabetes treatment medication Jardiance.

Iowa’s average out-of-pocket costs for those three most commonly used drugs are among the highest in the country, according to the federal data. In 2022, Iowa had the fifth-highest average annual out-of-pocket cost for Eliquis, Xarelto and Jardiance.

In all cases, the only states with higher out-of-pocket costs were Nebraska, North Dakota, South Dakota and Wyoming — all of which had fewer Medicaid recipients receiving the drugs than Iowa.

“The question that I get asked the most often as CMS administrator is from people wanting to know why their prescription drugs are so expensive,” federal Centers for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure said Wednesday during a conference call with reporters.

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“It's no exaggeration to say that allowing Medicare to directly negotiate the prices of covered prescription drugs is helping to change the system for the better,” Brooks-LaSure added. “Negotiation will improve access to lifesaving drugs by making those drugs more affordable, helping to get medications into the hands of those who need it by ensuring that the price doesn’t keep it out of reach. And it will help lower costs for Medicare and strengthen the program for current and future generations.”

The list of drugs the administration plans to first negotiate costs also included the diabetes treatment Januvia and the autoimmune disease treatment Enbrel and Entresto, which is used to treat heart failure, the Associated Press reported.

The law also calls for a $2,000 annual cap on how much people with Medicare have to pay out of pocket for drugs starting in 2025. In addition, it already caps out-of-pocket costs for insulin at $35 a month for Medicare patients.

The Inflation Reduction Act passed Congress on Democrats’ support; all six Iowa Republicans voted against the legislation. Republicans argue, in part, that drugmakers might pull back on introducing new drugs that could be subjected to future negotiations under the Medicare program.

In a statement, Iowa Democratic Party Chair Rita Hart called on Republican presidential candidates who have been campaigning in Iowa to make clear their position on the legislation and the measure that allows the federal government to negotiate Medicare drug prices.

The Associated Press contributed.

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