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Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation

CMS announces savings for some people with Medicare on 34 Part B prescription drugs

A continuing key priority of the Biden-Harris Administration is lowering prescription drug costs for seniors and families. Today, the Centers for Medicare & Medicaid Services (CMS) announced the list of 34 prescription drugs for which Part B beneficiary coinsurances may be lower between October 1 – December 31, 2023. Some people with Medicare who take these drugs may save between $1 and $618 per average dose starting October 1, 2023, depending on their individual coverage. Through the Inflation Reduction Act President Biden and his Administration are lowering prescription drug costs for millions of American seniors and their families.

The Medicare Prescription Drug Inflation Rebate Program is one of the many important tools Medicare has to address rising drug costs. By reducing coinsurance for some people with Part B coverage and discouraging drug companies from increasing prices faster than inflation, this policy may lower out-of-pocket costs for some people with Medicare and reduce Medicare program spending for costly drugs.

“Today, CMS announced certain drugs for the next quarter for which people with Medicare may save up to $618 per average dose,” said CMS Administrator Chiquita Brooks-LaSure. “This is one of many ways that the Inflation Reduction Act is making prescription drugs more affordable for people with Medicare.”

CMS has released information about these 34 Part B drugs and biological products in the quarterly Average Sales Price (ASP) public files, available here. A fact sheet is available here.

“CMS, through the prescription drug law, continues to lower out-of-pocket drug costs for some people with Medicare by protecting them from sudden out-of-pocket cost increases when drug companies raise prices faster than the rate of inflation,” said Dr. Meena Seshamani, Deputy Administrator and Director of the Center for Medicare. “This is just one of the many ways we are helping to strengthen Medicare now and in the future.”

CMS’ normal procedure is to release the ASP public files several weeks before the quarter of which they will go into effect so the public can review and notify CMS of any potential discrepancies. From time to time, ASP public files need to be corrected or updated, generally referred to as a restatement, based on feedback received after the files are published. If CMS receives feedback that necessitates updates to this list of drugs with adjusted coinsurance amounts, CMS will update the list. The April 1 – June 30, 2023 files and the July 1 – September 30, 2023 files have been updated. The October 1 – December 31, 2023 files may be subject to updates either before the start of the quarter or after in the event updated data becomes available.

Under the Inflation Reduction Act, people with Medicare may pay a lower coinsurance for some Part B drugs if the drug’s price increases faster than the rate of inflation. The lower Part B coinsurance on the listed drugs announced today will be in effect from October 1, 2023, to December 31, 2023. This coinsurance adjustment applies to certain drugs and biologicals paid under Medicare Part B. The Part B drugs impacted by this coinsurance adjustment may change quarterly.

See the initial guidance detailing the requirements and procedures for the Medicare Prescription Drug Inflation Rebate Program here.

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