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CMS releases list of prescription drugs subject to price reduction program

Article

Patients will benefit by reductions in coinsurance payments

Drug capsules spilled on hundred-dollar bills ©Narak-stock.adobe.com

©Narak-stock.adobe.com

Some Medicare beneficiaries could see reductions in their coinsurance payments for certain prescription drugs beginning July 1.

The Centers for Medicare and Medicaid Services today released a list of 43 medications to which it will apply a provision of the 2022 Inflation Reduction Act designed to bring down the cost of prescription drugs. The provision, known as the Medicare Prescription Drug Inflation Rebate Program, requires drug manufacturers to pay rebates to Medicare for single-source drugs and biologicals covered under Part B whose prices rise faster than the inflation rate. Medicare passes on the rebates to beneficiaries in the form of reduced coinsurance payments for the drugs.

The lower payments will apply from July 1 through September 30. Savings to Medicare beneficiaries who take the drugs will range from $1 to $449 per average dose, depending on individual coverage.

“The Medicare Prescription Drug Inflation Rebate Program is a critical way to address long-term price increases by drug companies,” CMS Administrator Chiquita Brooks-LaSure said in the announcement. “CMS is working tirelessly to ensure timely implementation of the Inflation Reduction Act to strengthen Medicare now and in the future.”

Meena Seshamani, M.D., Ph.D., deputy administrator and director of the Center for Medicare, said that under the inflation rebate program, “people with Medicare will no longer have to worry about sudden out-of-pocket price increases when drug companies raise prices faster than the rate of inflation.”

CMS released information about the 43 drugs and biologicals as part of its normal quarterly public release of Average Sales Price files. The agency says the list may be updated either before or after the July 1-September 30 quarter if new data become available. 

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