Cut Inflation Act Offers Prescription Drug Relief to Florida Medicare Beneficiaries – State of Reform

More than 4.8 million Floridians enrolled in Medicare will benefit from new federal prescription drug pricing policies Inflation Reduction Act of 2022. President Biden signed the $750 billion bill into law on Tuesday, guaranteeing lower prescription drug prices, capping insulin co-payments at $35 a month and providing continued medical coverage through subsidies.

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“Seniors in Florida and seniors across the country face real challenges when it comes to paying for their prescription drugs on a monthly basis,” said Zayne Smith, advocacy director at AARP. Florida at State of Reform. “They really have to deal with all these increases in the cost of living that you see on all levels, whether it’s housing, utilities, groceries or gas, and then prescription drugs are there, grouped together. [AARP has] has been struggling for years to find ways to give people who depend on prescription drugs some kind of respite.

Drug prices in the United States are 2 to 3 times higher than in other countries, according to a July report analysis of the Office of the Assistant Secretary for planning an evaluation. One of the main provisions of the law allows Medicare to negotiate prescription drug prices for expensive drugs. The law would also cap annual drug spending in Medicare Part D at $2,000 starting in 2025, resulting in savings of more than 113,000 Floridians who would otherwise have spending above the cap, according to estimates by the Kaiser Family Foundation.

Some provisions of the law will come into force much earlier, at the beginning of next year. The first is to provide certain vaccines for free to Medicare beneficiaries, such as the shingles vaccine, which Smith says costs an average of $350 out of pocket. The second is to cap insulin co-payments at $35 per month, though this provision is also limited to Medicare beneficiaries. In 2020, approximately 232,000 Florida Medicare enrollees used insulin.

Another unique provision, Smith said, was that drug companies can now be penalized for raising drug prices above the rate of inflation.

“All kinds of different prescription drugs towards the end of the year are skyrocketing, but yet inflation is also skyrocketing,” Smith said. “It is costing people, once again, at all levels. The gas goes up, the prescription drugs go up. So now it’s going to penalize those pharmaceutical companies for making these huge increases above the rate of inflation. This will be a savings that will be immediately recognized and received by Medicare beneficiaries.

Despite the provisions of the law, AARP Florida believes more can be done to continue to lower prescription drug prices for Floridians. For example, the insulin cap was supposed to apply more broadly across all areas, but the process of changing it was limited to Medicare beneficiaries. According to Smith, individuals will often compromise on purchasing groceries or household utilities in order to afford insulin costs.

Florida is still awaiting federal approval for its Canadian Prescription Drug Import Programwhich the state legislature first passed in 2019. The program would allow the Agency for Healthcare Administration to import certain drugs from Canada that would treat chronic conditions such as asthma, COPD, diabetes and HIV/AIDS.

“The savings are literally hanging in front of us as soon as we get that approval, but implementation would be key,” Smith said. “Florida State has been planning this for 3 years now and waiting to get that go-ahead. We have the money, it’s been earmarked. The players are in place, we just need to get the go-ahead to do it as a that state.

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