Bill OBoyle: Protect seniors from high drug costs
Jul. 23—As people get older, their reliance on prescription drugs invariably increase.
Many of these seniors are on Medicare and supplemental plans and associated prescription plans.
Cost can be restrictive, if not in many cases, impossible for seniors to afford.
Some people I know refer to "health care" as a senior citizen's oxymoron phrase.
Well, according to information provided by U.S. Sen. Bob Casey's office, a recent report found health plans and pharmacy benefit managers are overcharging Medicare Part D beneficiaries for prescription drugs.
Casey says the "Protecting Seniors from High Drug Costs Act" prohibits this unfair practice.
So last week, Casey, a Democrat from Scranton, and Sen. John Cornyn, a Republican from Texas, introduced the Protecting Seniors from High Drug Costs Act.
They said the bipartisan bill would help bring down drug costs by prohibiting health plans and pharmacy benefit managers (PBMs) from charging Medicare Part D beneficiaries more in cost-sharing than the net cost of the drug.
"There is no reason why health plans and pharmacy benefit managers should be able to overcharge American seniors just because they're enrolled in Medicare Part D," Chairman Casey said. "The Protecting Seniors from High Drug Costs Act will end this unfair practice. We cannot allow corporate profiteering to continue getting in the way of our seniors being able to afford the prescription drugs they need."
Cannot allow? How will the good senator accomplish that? Big Pharma has big lobbyists and big money and that translates to big influence.
"Far too often, patients unknowingly pay a much higher insurance co-pay than the actual out-of-pocket cost of a prescription drug," SCornyn said. "This commonsense legislation would put an end to the harmful practice of 'co-pay clawbacks' and prevent third-party pharmacy benefit managers from cutting a profit at the expense of patients' pocketbooks."
All of this sure does makes sense, but getting it done is a big challenge.
The senators provided a lot of information on this topic:
—A recent report from the Medicare Payment Advisory Commission (MedPAC) found that almost 8% of total spending in the Part D benefit, the cost-sharing amounts set by plan sponsors (in many cases PBMs) exceeded net drug costs after deducting rebates from the original price of the drug.
This means that for that 8% of spending, the enrollee's cost-sharing paid to the PBMs was more than the cost of the drug itself.
The bill prohibits health plans and PBMs from engaging in this practice of charging patients more than the net price of the drug. It will lower cost-sharing for patients and help them afford all the prescriptions they need, while ensuring that PBMs and plans are not engaging in unfair practices.
Earlier this year, SCasey sent a letter highlighting how the Inflation Reduction Act has reduced drug costs for American seniors and families, due to provisions included from the Lowering Medicare Premiums and Prescription Drug Costs Act which he championed.
Casey says the Protecting Seniors from High Drug Costs Act will continue progress towards ensuring seniors can afford the prescription drugs they need.
We must ask why this fair treatment for senior citizens is such a struggle to achieve? Why can't our elected officials get behind this and pass this legislation and put the pressure on Big Pharma to do what is right?
Taking prescription drugs is, for sure, a matter of life and death. And taking the correct dosages is critical.
And seniors should be able to afford their medications and still be able to put food on their table, watch cable TV, go out once in a while for dinner and a movie and buy a birthday gift for their grandkids.
In other words, seniors should be able to live a good life without the worry of having to choose what not to have because the cost is prohibitive.
Good luck Sen. Casey and Sen. Cornyn.
This is something that is long overdue and seniors depend on the outcome.
Before you move on, we invite you to become a Times Leader Advocate. You'll receive some great benefits, including our Diamond Card with local discounts and deals, access to our E-Edition, a faster, reduced ad experience on timesleader.com, and more.
Click now to support or get more information.
Reach Bill O'Boyle at 570-991-6118 or on Twitter @TLBillOBoyle.
