Medicare Benefits Would Change for Millions Under New Senate Bill
Summary
A new Senate bill aims to lower prescription drug costs for about 56 million Medicare Part D users by requiring plans to cover cheaper generic and biosimilar drugs instead of more expensive brand-name ones. The bill intends to stop pharmacy benefit managers from using pricing strategies that make generics cost more than brand-name drugs at the pharmacy counter.Key Facts
- The bill is called the Ensuring Access to Lower-Cost Medicines for Seniors Act.
- It was introduced by Republican Senator James Lankford and Democratic Senator Maggie Hassan.
- Starting in 2028, Medicare Part D plans must include generics and at least one lower-cost biosimilar when available.
- Currently, some cheaper generics are placed on higher cost tiers, causing seniors to pay more out of pocket.
- Medicare Part D beneficiaries often pay coinsurance, a percentage of drug prices, so small price differences lead to big savings.
- The bill addresses rebate practices by pharmacy benefit managers (PBMs) that can raise the cost of generics.
- The legislation currently has only two sponsors and is in the Senate Finance Committee.
- Changes from this bill would only take effect starting in 2028 if it becomes law.
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