A key fact the White House is reluctant to admit

Today, President Biden delivered remarks that touch on recent drug pricing reforms included in the Inflation Reduction Act. While the law is deeply flawed and government price-setting is the wrong approach for patients, don’t be confused by any political talking points: The biopharmaceutical research industry has long supported capping what seniors in Medicare Part D pay out of pocket for lifesaving medicines.

For years, PhRMA has been urging Congress to pass this commonsense solution and have said repeatedly we’d do our fair share to make it happen. For example, in April 2021, PhRMA released a set of policy solutions to help lower drug costs for patients. A core pillar of these solutions was capping seniors’ out-of-pocket costs in Part D.

As the 2021 proactive agenda noted:

“Part D could work better and be made fairer by improving affordability and predictability for beneficiaries who face high out-of-pocket costs for their medicines. Improvements to Part D must be done the right way, with targeted and measured reforms. … We need to cap annual out-of-pocket costs in Part D.”

Here’s PhRMA President and CEO Steve Ubl on the plan in 2021:

"Changes to Medicare Part D, the Medicare prescription drug benefit program — such as capping annual out-of-pocket payments for prescription medicines, lowering cost sharing and making those costs more predictable — could dramatically reduce out-of-pocket costs for seniors."

And our strong support for limiting seniors’ out-of-pocket costs goes beyond 2021. Here is PhRMA’s Steve Ubl in an op-ed published by STAT in 2019:

“Let’s focus on practical affordability reforms, such as capping out-of-pocket costs … ensuring predictable monthly out-of-pocket costs …”

We could provide more examples, but you get the point. We’ve long supported this smart change to an important program millions of seniors rely on. The change helps address insurance practices that shift the cost of care onto vulnerable patients. What’s unfortunate is that it took policymakers so long to deliver this commonsense solution for patients.

Of course, the law in its entirety will do more harm than good. But we’re pleased to see the president tout an out-of-pocket cap that our industry has long supported (even if the White House is reluctant to admit it).