JustCare

Tag: Cost

  • Biden brought down the price of insulin significantly; a Trump presidency could undo that

    Biden brought down the price of insulin significantly; a Trump presidency could undo that

    Drug prices remain out of control, and there’s a lot that President Biden could still do to bring them down. But, Americans should give President Joe Biden credit for reducing the cost of insulin significantly, a huge achievement for which he has not gotten the credit he is due, writes Jonathan Cohn for Huffington Post. If Trump is reelected, he could undo this.

    In fact, President Biden is responsible for several new laws that are bringing down the cost of health care and making it a little more affordable. [Editor’s note: Not nearly enough, but far more than President Trump.]

    With insulin, which millions of diabetics rely on for their well-being to process sugars in their bodies, the list price can be hundreds of dollars. That price is insane. People in other developed countries pay as little as 10 percent of the amount we pay for their insulin. Their governments negotiate the price of insulin and every other drug on their behalf.

    About 25 percent of Americans with diabetes cannot afford insulin and other basic needs. In some cases, people forego insulin to the detriment of their health. They might not have health insurance and cannot afford the full cost of insulin. Fortunately, thanks to the Affordable Care Act, fewer Americans than ever are uninsured.

    As of 2023, because of the Inflation Reduction Act, older adults and people with disabilities should pay no more than $35 a month for an insulin prescription. If they have two prescriptions, it would cost them $70. Since the government has not yet negotiated the price of insulin, it’s not clear how much more everyone with Part D prescription drug coverage is paying in premiums as a result of the Inflation Reduction Act.

    Unfortunately, reports are that some Part D drug plans have stopped covering insulin in response to the $35 maximum copay. If you have diabetes, make sure that your drug plan covers your insulin prescriptions.

    As of January 1, 2024, people who do not have Medicare should also see lower insulin prices. The three major companies that manufacture insulin have reduced their prices to $35 a month voluntarily. One policy expert explains, however, that the price drop actually helps these companies maximize profits: “They’re lowering prices to avoid paying rebates to Medicaid programs and therefore maximize profits.”

    If President Trump is reelected in November, watch out. His administration would likely undo President’s Biden important legislation on insulin prices. And, many of the 8.4 million Americans who rely on insulin would again be struggling to afford it or, worse still, forced to go without it.

    Here’s more from Just Care:

  • Employer-based health care doesn’t work for people with lower incomes

    Employer-based health care doesn’t work for people with lower incomes

    About 60 percent of people who are not over 65 have employer-sponsored health insurance, reports the Kaiser Family Foundation. But, a significant portion of people eligible for employer coverage, primarily people with incomes under 200 percent of the federal poverty level, do not take it because of the cost.

    Nearly 165 million people or about half the US population has employer-based health insurance. More than four in five employers offer coverage. As health care costs continue to rise and insurers delay and deny care and narrow their health care provider networks, even with insurance it can be hard to get care.

    The high cost of health insurance and the ability of employers to charge their workers for it mean that our health care system discriminates against people with lower incomes even when they are eligible for employer coverage. Not even one in four (23.9 percent) people with incomes under 200 percent of the federal poverty level, who are eligible for employer-sponsored health insurance, elect it. Six in ten eligible (59 percent) people with incomes between 200 and 400 percent of the federal poverty level elect it. But, more than eight in ten (84,2 percent) people with incomes above 400 percent of the federal poverty level elect it.

    Similarly, people with incomes under 200 percent of the poverty level were far less likely to work at a job that offered employer-sponsored health insurance than people with incomes over 4oo percent of the poverty level, 60.6 percent versus 88.2 percent. Because employers do not have to offer health insurance to all their workers, people with lower incomes end up less likely to have a job that offers them health insurance. About half of workers (49.5 percent) with incomes under 200 percent of the poverty level were eligible for coverage as compared to 84.6% of workers with incomes above 400% of the federal poverty level.

    Employer-based health insurance also leads to racial discrimination, benefiting White individuals far more than non-White people. Black people, Hispanic people and American Indians are significantly less likely to take advantage of employer-based coverage than White people. Not even four in ten American Indians (39.6 percent) get employer-based coverage for which they are eligible, as compared to 68.4 percent of White people. Forty-five percent of Hispanic people and 52.6 percent of Black people get employer-based coverage.

    Disparities in access to health insurance also exist by profession. People working in different industries have significantly different access to employer-sponsored health insurance. People working in fishing, farming and forestry are least likely to be offered employer-sponsored health insurance. Only 41.4 percent of them had access to coverage. In stark contrast, more than 85 percent of people working as professionals or in finance, business and other management positions had access to employer-coverage.

    Here’s more from Just Care:

  • Dozens of drug companies owe Medicare rebates from raising prices higher than the inflation rate

    Dozens of drug companies owe Medicare rebates from raising prices higher than the inflation rate

    The Biden Administration just announced that dozens of drug companies owe Medicare rebates from raising prices higher than the rate of inflation. As a result , hundreds of thousands of people with Medicare will save as much as $2,786 per dose of their prescription drugs.

    The Inflation Reduction Act (IRA) prevents drug price gouging–defined as price increases greater than the rate of inflation–by pharmaceutical companies. The IRA also caps out-of-pocket costs for each insulin drug at $35 a month and limits total out-of-pocket drug costs for people with Medicare through Medicare Part D to $2,000 a year beginning in 2025. Yet, Republicans are trying to repeal the IRA.

    In total, the Administration reports that pharmaceutical companies raised prices on 64 drugs more than inflation. For example, the price of Signifor, which treats an endocrine disorder, went up so much that people who use it could see a savings of $311 for a monthly dose of the drug beginning in January.

    President Biden is also heralding his Administration’s decision to allow the government to “March-in” and help bring down the price of drugs developed with federal funding, if the price is unreasonable. This march-in right has always existed but prior administrations have been reluctant to take the position that the government could step in if a pharmaceutical company charged an excessive for the drug.  Of course, the proof of this Administration’s commitment here is in determining that the price of a drug developed with federal money is too high and taking action. Time will tell.

    Meanwhile a story in Becker’s exposes extreme drug price increases for eight drugs, according to ICER.  The story suggests that insurers spent more than $1.3 billion in these drugs in one year. It’s not clear if that means that individuals paid higher premiums to cover the cost of the drugs, but presumably so. The question left unanswered is whether the insurers recouped that money they spent for these drug, through rebates, and left their enrollees’ holding the bag, a likely scenario.

    Herre’s more from Just Care:

  • Insurers overcharge Medicare enrollees for generic drugs

    Insurers overcharge Medicare enrollees for generic drugs

    The biggest health insurers and Pharmacy Benefit Managers (PBMS) offering Part D prescription drug coverage are overcharging Medicare for generic drugs, according to a new JAMA study by researchers at UC San Diego, West Health and the University of Washington. More than 40 million people with Medicare have Part D drug coverage for their outpatient drug needs. As a result of these overcharges, their out-of-pocket coinsurance costs are likely signficantly higher than they should be.

    The researchers find that part of the reason that older adults and people with disabilities face high out-of-pocket drug costs with Medicare Part D is that Rite Aid, Cigna, Centene, CVS Health Humana, and UnitedHealth, which offer Part D coverage, and the Pharmacy Benefit Managers they own or contract with are inflating the costs of some drugs significantly. Pharmacy Benefit Managers or PBMs buy drugs from manufacturers and design the Part D drug formulary–list of covered drugs–that an insurer offers.

    What’s happening? The insurers and/or the PBMs maximize profits by paying pharmacies (often the pharmacies they own and operate) many times the pharmacies’ acquisition cost of a drug. The insurers or the PBMs eventually clawback that overpayment. But, because they pay a high price to the pharmacies, the Part D insurers can charge a much higher copay to their enrollees–based on the inflated price of the generic drugs–driving up enrollees’ costs.

    The researchers found that sometimes, insurers or PBMs pay pharmacies markups of 6,000 percent or 7,000 percent. For example, insurers paid pharmacies $126 for a cancer tablet that costs $4.20 a tablet.

    In 2022, a USC Schaeffer paper also reported generic drug price padding by the PBMs. The authors call for drug pricing transparency. But, that proposal still gives a role to the PBMs and does not fix the system. It would continue to allow PBMs and insurers to keep low-cost generics off their formularies in order to benefit from big rebates they receive from brand-name drug manufacturers for putting their drugs on formulary. And, it would not stop the padding of generic drug prices.

    The simplest way to address inflated drug prices in the US is to open our borders to drugs from verified pharmacies around the world and require insurers to cover them.

    Here’s more from Just Care:

  • The challenges of caring for aging parents in the US

    The challenges of caring for aging parents in the US

    An article in The New York Times by Reed Abelson and Jordan Rau captures the plight of family members caring for aging parents in the US. The journalists profile several individuals who are managing care for parents and grandparents, with cancer, dementia and other complex conditions. One woman sums up the situation with these words: “The health care system for the elderly is neglected, broken and inadequate to meet any demands, even the basic needs.”

    To be clear, if you are not eligible for Medicaid, your long-term care costs could be exorbitant. Medicare does not cover long-term care. For many people, long-term care costs are unaffordable. Even with Medicaid, it can be hard to get long-term care.

    Medicaid should be picking up the costs of long-term care for people with low incomes. But, eligibility requirements are restrictive, and even when people meet them, there can be long waits to get needed care. There are not enough health aides, so agencies will hire anyone who is willing to take on this role. When aides don’t show up, replacement aides are hard to come by.

    To keep costs down, often children of aging parents bring their parents in to live with them. And, while that makes it easier to ensure they are getting needed care, it can keep them from working outside the home. In some cases, older adults cannot be left alone. To make ends meet, adult children are forced to institutionalize their parents so they can work outside the home.

    Single adults, living alone and needing to care for aging parents, are in a particularly difficult bind. They lack a partner to share the work of caring for aging parents, while earning an income to sustain themselves. Unless they are wealthy, they have few options when their aging parents develop dementia or otherwise need ongoing help with activities of daily living and are in need of fulltime care.

    A 60-year old actor from Topeka, Kansas explains that it cost $8,000 a month to provide just eight hours a day of care for her mom. That cost is not sustainable for the vast majority of Americans with limited savings. Then, her mom fell, broke her sacrum, got 100 days of Medicare rehab and was once again left without a viable care plan. Her daughter and her siblings cashed out her life insurance policies to pay $65,000 for a year of nursing home care. Medicaid eventually picked up some of those costs after her mom spent down more of her assets. Now, her mom has died and the state is asking for almost $20,000 back.

    A California professor and his wife had a plan for his mom, one that would not destroy his own retirement savings. But, his mom lost some cognition after a stroke. The least expensive way to care for her was at an assisted living facility, costing $4,500 a month. His mom only gets $1,500 a month from Social Security and has no other funds to cover these costs. He negotiated with the assisted living facility and launched a GoFundMe campaign. But, in his 60’s, he’s figuring out what new work he can do to pay the balance of his mom’s monthly bills.

    A 60-year old retiree from Greenville, South Carolina explained that her mom, was getting terrible care in an independent living facility. No one was engaging with her. Before long, her mother got sick and needed a wheelchair to get around in her assisted living facility. The assisted living facility cost $8,000 each month and was quickly depleting her $120,000 in savings. She had no additional financial support beyond $2,500 a month in retirement income. Her daughter and son-in-law were unable to get away until she died.

    A 55-year old college professor from Vermont found a new home for her family so that she could move her mom in to live with them. Her mom had been in California, where she could not drive any longer or otherwise adequately care for herself. Her mom had dementia. Adult care was extremely costly. Moreover, her mom became violent. No nursing home would take her. She was sent back to live with her family, who had to give her drugs to calm her. She died soon after.

    Here’s more from Just Care:

  • Could weight-loss drugs ultimately reduce health care spending?

    Could weight-loss drugs ultimately reduce health care spending?

    Bruce Japsen reports for Forbes that weight-loss drugs are costing employers $324 per worker each year. These costs will only increase as more workers take these prescription drugs, if the government does not step in to rein in drug prices. They will also drive up Medicare costs a lot if Medicare decides to cover drugs for weight loss. (Medicare covers weight-loss drugs for people with diabetes.) Ideally, weight-loss drugs will reduce the prevalence of diabetes, heart disease and other costly conditions, driving down overall health care spending.

    Right now, Wegovy, Rybelsus and Saxenda as well as Ozempic are responsible for ever higher insurance premiums, deductibles and copays. Their costs likely will keep going up, as more people take them and their manufacturers raise prices. When will our government step in to negotiate prescription drug prices for everyone or, at the very least, open our borders to prescription drugs from verified pharmacies abroad, which are significantly cheaper than in the US and have been shown to be safe.

    In 2021, weight-loss drugs contributed to $96 of insurance costs for each worker. In two years, health insurance costs for these weight-loss drugs are projected to rise to $500 per worker.

    Competition from new weight-loss drugs should contain costs some. And, indeed, Gina Kolata reports for the New York Times that more weight-loss drugs are coming to market. Eli Lilly’s Zepbound, tirzepatide, is the latest to receive FDA approval. But, even if these drugs bring down prices a little, these new drugs are sure to drive up demand. Obesity is rampant in the US, affecting 100 million adults.

    Time will tell the extent to which these new weight-loss drugs affect the overall cost of health care in the US. Zepbound’s initial list price for a four-week dose is $1,060, somewhat less than the price of Wegovy, which is $1,349. But, these drugs are expected to drive down people’s weight by as much as 20 percent, helping to reduce their risk of diabetes, heart disease and other chronic conditions people develop as a result of being overweight. We can only hope that the cost of these drugs will be offset by savings from a reduction in the prevalence of some costly chronic conditions.

    Here’s more from Just Care:

  • The cost of weight-loss drugs is driving up our insurance premiums

    The cost of weight-loss drugs is driving up our insurance premiums

    Gina Kolata reports for The New York Times that the cost of weight-loss drugs is not what it seems. People must take them throughout their lives, and weight-loss drugs have list prices of as much as $1,300 every four weeks. Ozempic, Wegovy and drugs like them could literally mean a huge increase in people’s health insurance premiums.

    One epidemiologist projects that if prices for these weight-loss drugs are not controlled, they could increase health care spending by 50 percent! What’s interesting is that it is not only the drug manufacturers that are raking in the profits from these drugs. The health insurance companies and pharmacy benefit managers are profiting wildly from them as well.

    The weight-loss drug manufacturers pump up the list price of the drug so that they can then give a major rebate to the pharmacy benefit managers and insurers as a financial incentive to promote and cover them. The insurers and PBMs pocket these rebates or most of the rebates rather than pass them along to consumers.

    Net prices for the weight-loss drugs are, according to the conservative American Enterprise Institute, AEI, much less than the list prices. The AEI believes that the net price for Ozempic is just $300, $650 less than its list price. Similarly, AEI believes the net price for Wegovy is $700 or $650 less than its list price.

    The weight-loss drugs are unaffordable to many Americans because they cannot afford the copays even with insurance, they have no health insurance, or their insurance does not cover them. Medicare does not cover weight-loss drugs for weight-loss. However, it does cover the drugs for people with diabetes. Medicaid rarely covers the drugs.

    Novo Nordisk, a Danish company, expects to generate $11 billion in revenue this year from Ozempic and another $4 billion from Wegovy. Some might argue that the price for these drugs is fair because treating obesity, with its risk of diabetes, kidney failure, heart attacks and strokes, can be very expensive. No other wealthy country pays prices anywhere near as high as Americans.

    Here’s more from Just Care:

  • Dental care is increasingly unaffordable

    Dental care is increasingly unaffordable

    The cost of dental care has become prohibitively expensive for the vast majority of Americans. In a new study by Synchrony, more than nine in ten Americans say that they would consider putting off getting dental care because of the cost, reports Pete Grieve for Money.

    Medicare does not cover dental care. And, people with Medicare should note that when Medicare Advantage plans offer dental benefits , the benefits tend to be extremely limited. As a result, many people in Medicare Advantage plans that claim to offer dental benefits are still not able to get dental care. In some cases, there are only a small number of in-network dental providers and it can be hard to see them. In other cases, the out-of-pocket costs for dental care are limited and unaffordable. Do not join a Medicare Advantage plan because of its dental benefits before checking closely to see what those benefits are.

    Note: Even though Traditional Medicare does not cover dental care, people in Traditional Medicare get dental care at the same rate as people in Medicare Advantage plans.

    The problem in getting dental care for most people is the cost; the price of dental care keeps rising, faster than inflation. Dental care costs are up 5.6 percent this year. The American Dental Association Health Policy Institute claims that costs are up because supplies and materials cost more, as do lab fees and labor.  It wold not be surprising if private equity firms buying up dental practices are driving up dental costs as well.

    The Synchrony researchers found that more than half (58 percent) of the 1,335 respondents surveyed said they could not afford dental care, even though many of them had dental insurance. Of course, when people do not have dental insurance,  it’s all the harder for them to afford critical dental care.Three in four people without dental coverage said they could not afford dental care.

    For the typical adult between 20 and 79 years old, dental insurance can cost as much as $51,000 during a lifetime. In addition, if people need dental implants or other complex dental care, dental procedures can cost tens of thousands of dollars.

    Consequently, 92 percent of adults studied said they were thinking about holding off getting dental care because of the cost. Even for emergency dental care, more than four in five adults (83 percent) were thinking about not getting care.

    The older you are, the harder it is to afford dental care. Two in three older people said that dental care was unaffordable as compared to 51 percent of young adults.

    Here’s more from Just Care:

  • 2023: Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan

    2023: Five things to think about when choosing between traditional Medicare and a Medicare Advantage plan

    The Annual Medicare Open Enrollment period begins October 15 and ends December 7. If you have Medicare, you are likely to see endless ads and receive lots of mail from an assortment of insurers chomping at the bit to get you to sign up with one of their Medicare Advantage plans. That’s how they rake in the big bucks, tens of billions of dollars a year. Unfortunately, our government does a poor job of helping you to understand differences between traditional Medicare, which is administered by the Centers for Medicare and Medicaid Services (CMS), and Medicare Advantage plans, which are administered by corporate health insurers that contract with the government. And, you can’t trust the corporate health insurers or their sales agents to tell you what you need to know.
    There are five basic differences between Traditional Medicare and Medicare Advantage that you need to understand.
    1. Coverage:
    Traditional Medicare. With traditional Medicare, you are covered for the medicallyreasonable and necessary care your providers believe you need. An insurance company is not second-guessing your doctors.
    Medicare Advantage. Medicare Advantage plans are supposed to cover the same benefits as traditional Medicare, but they cover significantly fewer, as has been documented over and over again. They often engage in widespread inappropriate delays and denials of care and generally require you to get approval before they will pay for most costly services. That’s how they maximize profits. If you think you might get sick or need costly health care at some point, even if you don’t need it now, think twice before signing up with a Medicare Advantage plan. No one provides you with the information you need to know to distinguish the good Medicare Advantage actors from the bad ones. And, there appear to be a lot of bad ones.
    2. Health care providers:
    Traditional Medicare. With traditional Medicare, you can see almost all doctors and use virtually all hospitals anywhere in the United States. Almost all take Medicare and more than 90 percent “take assignment,” accept Medicare’s approved charge as payment in full. The most they can charge is 15 percent above that amount.
    Medicare Advantage. With Medicare Advantage, your care is generally only covered when you use “in-network” providers. They can be few and far between and are often only located in your community. If you travel or spend time away from your primary residence, a Medicare Advantage plan usually will not cover your care, except in emergencies, Also, you might find that the providers in their directories are not taking new patients or have left the network. So, if you are thinking of joining a Medicare Advantage plan or are in one now, talk to any of the doctors you know you want to continue seeing to confirm that you will still be able to have your care covered when you see them. Keep in mind that a lot of the Medicare Advantage plans have lower quality providers in their networks and might not have a cancer center of excellence as part of their network.
    3. Costs:
    Traditional Medicare. With traditional Medicare you must pay your Part B monthly premium. You are generally liable for a hospital deductible and 20 percent of the cost of your medical care, unless you have supplemental coverage, either Medigap, which you buy in the individual market, Medicaid, or retiree coverage from a former employer. If you have supplemental coverage, most if not all of your costs will be covered. Traditional Medicare does not have an out-of-pocket maximum.
    Medicare Advantage. With Medicare Advantage, you pay your Medicare Part B premium and you might have no additional premium, but your out-of-pocket costs can be sky high. You cannot buy supplemental coverage to pick up your out-of-pocket costs. Your costs turn on the Medicare Advantage plan you choose, the care you need, and what the Medicare Advantage plan charges you for your care. You generally will have to pay a copay when you are hospitalized or need medical services. Your out-of-pocket costs can be over $8,000 for in-network care alone if you need costly care. But, each Medicare Advantage plan has its own out-of-pocket maximum. If you go out-of-network for your care, you will be liable for the full cost of your care, unless you are in a PPO (preferred provider organization), in which case you generally will be liable for 40 percent of the cost.
    4. Drugs:
    Traditional Medicare. With traditional Medicare, you will need to buy Medicare Part D prescription drug coverage if you want drug coverage. That typically costs about $55.50 a month.
    Medicare Advantage. With Medicare Advantage, your drug coverage is usually included in your plan’s monthly premium.
    Whether you’re in traditional Medicare or a Medicare Advantage plan, be sure to look at differences in your drug costs among Medicare Part D drug plans. And, keep in mind that it is possible, even likely, that you might spend less getting some of the drugs you take from Costco or another mail-order pharmacy than paying the copay for them through your Part D plan. Part D plans can have higher copays than the total cost of the drug from a low-cost pharmacy.
    5. Quality:
    Traditional Medicare. If you want control over the quality of your health care providers, you probably want to be in Traditional Medicare, where you choose the providers you see.
    Medicare Advantage. In a Medicare Advantage plan, the plan restricts your access to providers. And, even when you see a provider you want to see, the Medicare Advantage plan might not let your physician or hospital provide the care that they think is best for you. For example, if your doctor thinks you need 50 days of inpatient rehab therapy, your Medicare Advantage plan still might decide you only need 10 and will only cover 10 days.

    Bottom line: With traditional Medicare, your doctors and hospitals have every incentive to provide you with all the care they think you need and traditional Medicare will cover it. Medicare Advantage plans receive a fixed amount from the government to cover your care regardless of how much they spend on your care. Consequently, they have an incentive to withhold needed care and to incentivize their physicians to limit the care they provide you. The less money a Medicare Advantage plan spends on your care, the more money the Medicare Advantage plan has for its shareholders. Since there’s no good data to distinguish the good Medicare Advantage actors from the bad ones, you are gambling with your health and well-being when you enroll in a Medicare Advantage plan. To learn more, read this blog post by Diane Archer and Theodore Marmor on the fundamental difference between traditional Medicare and private insurance.

    Here’s more from Just Care:

  • Which outpatient drugs are costing Medicare the most?

    Which outpatient drugs are costing Medicare the most?

    In a little more than a month, we will know which ten outpatient prescription drugs will be subject to Medicare price negotiation under the Inflation Reduction Act in 2025. (That’s if the pharmaceutical companies do not prevail in their lawsuits aimed at stopping Medicare drug price negotiation.) The drugs whose prices will be negotiated will be those, covered under Medicare Part D, that are costing Medicare the most.

    In 2026, Medicare will negotiate prices for 10 additional drugs. In 2027, Medicare will negotiate prices for 15 additional Part D drugs. In 2028, Medicare will negotiate prices for yet another 15 Part D drugs.

    Beginning in 2029, Medicare will negotiate prices for 20 drugs covered under Part D and Part B, which covers inpatient drugs. Under the law, Medicare can only negotiate the prices of single-source brand-name drugs, which have been on the market for at least seven years, or biologics that do not have biosimilar options, which have been on the market for at least 11 years.

    A small number of drugs are responsible for a significant portion of Part D prescription drug spending. Medicare spent $48 billion on the ten drugs with the highest spending in 2021. Half of those drugs are treatments for diabetes: Trulicity, Januvia, Jardiance, Lantus Solostar, and Ozempic. The other half include Imbruvica, a cancer treatment and Humira Citrate-free (Cf) pen, a treatment for rheumatoid arthritis.

    Prescription drug prices are soaring, especially for the drugs that Medicare is spending the most on. In the three years between 2018 and 2021, the price of these ten drugs more than doubled. Spending jumped from $22 billion to $48 billion. Total Medicare Part D spending rose from $166 billion to $216 billion.

    Twenty-two percent of Medicare Part D spending results from just ten drugs out of a total of 3,500 (0.3 percent) that Medicare covers under Part D. Sixty-one percent of total spending results from just 100 drugs (3 percent of covered drugs).

    In 2021, Medicare spent $2.6 billion on Ozempic, to treat diabetes for 500,000 Medicare patients, $5 billion on Revlimid, to treat multiple myeloma, and $12.6 billion on Eliquis, a blood thinner.

    Not all of these drugs will be eligible for drug price negotiation: Ozempic, Revlimid, Humira and Lantus are not eligible. Ozempic has not been on the market long enough and the other three have biosimilars.

    The Congressional Budget Office estimates that, as a result of drug price negotiation, Medicare will save $100 billion on prescription drugs costs in the five years beginning in 2026. That’s a beginning, but hardly enough. If Congress would only permit prescription drug importation from verified pharmacies abroad, it would help drive down drug prices considerably.

    Here’s more from Just Care: