Senate Finance Committee Proposes Capping Medicare Patients’ Out-of-Pocket Prescription Drug Costs in Drug Pricing Bill

July 25, 2019

Washington, D.C.—Today the Senate Finance Committee is marking up the Prescription Drug Pricing Reduction Act (PDPRA) of 2019, which includes a provision to cap Medicare beneficiaries’ out-of-pocket prescription drug costs in Medicare Part D, among several other proposed changes intended to bring down patient costs. ACS CAN will continue to evaluate proposed provisions in the package to determine potential impact on cancer patients and survivors.

A statement from Lisa Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN) follows:

"We’re pleased the Committee is taking bipartisan action to address the high out-of-pocket costs for prescription drugs. For cancer patients, in particular, expensive drug therapies are their only option to treat their disease. The proposed cap for Medicare Part D enrollees has the potential to provide some important financial relief to these patients. However, we have concerns that the $3,100 threshold may still be too high of a cost burden for those patients on a fixed income. We urge the Committee to consider those that are most impacted by these costs and adjust the cap accordingly.

“We would also ask lawmakers to consider ways to address those sometimes overwhelming upfront costs Medicare patients face when it comes to reaching the catastrophic coverage phase of the current drug benefit. Patients taking high-cost drugs can face several thousand dollars in cost-sharing simply trying to fill their first prescription. These costs have been shown to prompt some cancer patients to never fill their prescriptions and abandon treatment. We welcome the opportunity to work with the Committee as they examine ways to address these significant upfront costs and make it more financially feasible for a patient to access often a life-saving therapy.

“Medicare provides essential health coverage to millions of Americans with a history of cancer. These patients need to have access to the best available therapies at costs they can afford. ACS CAN looks forward to continuing to review the package and working with the Finance Committee to address changes to Part D as well as other proposals that would directly affect cancer patients.”

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