Sherri Williams may no longer see as many patients who don’t take their prescription medication because they can’t afford it. On Friday, the Miramar nurse practitioner applauded the Biden administration’s agreement with drugmakers to lower prices on the 10 costliest prescription drugs under Medicare. “I have seen patients come back and forth, in and out of the emergency department, due to the cost of their medication,” said Williams, who previously worked as an ER nurse.
“They simply just can’t afford it. So, guess what they do? They stop taking it.” In a news conference in Miramar Friday, local practitioners, pharmacists, and patients celebrated the federal government’s first-ever drug-pricing negotiations.
The Biden administration on Thursday unveiled the results of the landmark agreement between Medicare and pharmaceutical companies that could help ease the financial burden on an estimated 1 in 7 older adults in the U.S. struggling to pay for their medications.
The new lower prices, applicable for people on Medicare and Medicare Advantage plans, won’t take effect until 2026. Administration officials said the new negotiated prices are projected to save Medicare enrollees $1.5 billion in reduced cost sharing and out-of-pocket costs in the first year.
As part of the government’s negotiations, seniors are expected to see lower out-of-pocket costs for the 10 popular drugs used by millions of people on Medicare, including blood thinners, diabetes drugs and blood cancer medications. The reductions in cost range between 38% and 79%. Williams said at her South Florida office, she has had patients tell her about splitting pills to make them last longer or even sharing medications among family members because of high costs.
“When medications are not able to be prescribed because patients can’t afford them, that leads to so many problems,” she said. Miramar Mayor Wayne Messam , host of the Friday news briefing, said the country’s population is aging, and housing costs are rising. “Our seniors are trying to make ends meet, and that is exacerbated by out-of-control medication costs,” he said.
South Florida pharmacist Saskia Madison said those in her profession are on the front line, watching the fallout of high prescription drug costs. “One of the heartbreaking challenges we are faced with is observing our patients when they have to choose whether to pick up a medication or not due to cost,” Madison said. “Rising drug prices are a challenge for many, but our vulnerable populations must make really difficult decisions.
” Julie Kennedy, 38, and her mother, Faith Kennedy, 64, both from Miami, suffer from Crohn’s, an inflammatory bowel disease that causes chronic inflammation of the GI tract. In Miramar on Friday, Julie Kennedy, who has employer-sponsored insurance, said she commends the government’s success in lowering the cost of Crohn’s medications for Medicare recipients. “I’ve suffered from the unaffordable costs that come with having a disease.
The treatments that we have are incredible, but they’re not accessible,” she said. “The co-payments that you are faced with are terrifying. Anytime I’ve had a doctor change my treatment, it terrifies me because I know what’s about to come: The fight and begging the insurance company to allow me to have this medication so I can have a decent quality of life so I can get out of bed every day and go to work and contribute to society.
” Stelara, for Chron’s disease and arthritis, is one of the 10 medications that were part of the negotiations. A patient who pays $3,459 on the drug today for a 30-day supply would pay only $1,174 in 2026. Julie Kennedy said her mother will benefit from the new prices.
When the cost savings go into effect in 2026, Faith Kennedy will be eligible for Medicare. Christen Linke Young, adviser to President Joe Biden on Health Care, told the South Florida Sun Sentinel the lower prices are the result of months of heated negotiations between the federal government and drugmakers. “We target drugs that have been on the market for at least nine years.
These are not drugs new to the market,” Linke Young said. “All of the manufacturers get time to recoup their investment and benefit from research they have done.” Linke Young said because Medicare is such a large payer, the government had leverage, and the final cost savings is the result of meaningful back-and-forth with pharmaceutical companies.
Medicare recipients also benefit from previous government action, including a $35 monthly cap on out-of-pocket costs for insulin and a $2,000 annual cap on patient costs for drugs taken at home. The $2,000 limit will go into effect next year. Biden has called for Medicare to negotiate the prices of 500 drugs over the next decade.
Medicare will select up to 15 additional drugs for negotiation in 2025. “We are just getting started,” Linke Young said. South Florida Sun Sentinel health reporter Cindy Goodman can be reached at cgoodman@sunsentinel.
com. Prices are the maximum Medicare Part D plans and the patient will pay for a one-month supply starting in 2026 Eliquis, for preventing strokes and blood clots, from Bristol Myers Squibb and Pfizer, $231 Jardiance, for diabetes, heart failure and chronic kidney disease, from Boehringer Ingelheim and Eli Lilly, $197 Xarelto, for preventing strokes and blood clots, from Johnson & Johnson, $197 Januvia, for diabetes, from Merck, $113 Farxiga, for diabetes, heart failure and chronic kidney disease, from AstraZeneca $178 Entresto, for heart failure, from Novartis, $295 Enbrel, for autoimmune conditions, from Amgen, $2,355 Imbruvica, for blood cancers, from AbbVie and Johnson & Johnson, $9,319 Stelara , for autoimmune conditions, from Johnson & Johnson, $4,695 Fiasp and NovoLog insulin products, for diabetes, from Novo Nordisk, $119.
