Sen. Ron Wyden, D-Oregon, said a key priority for Democrats this Congress will be to head off drugmakers from attempting to weaken new reforms like giving Medicare the power to negotiate for lower prices.
Wyden spoke Monday during an event sponsored by the advocacy group Protect Our Care on whether there could be any changes to the drug pricing provisions in the Inflation Reduction Act that passed last year.
“Anybody wants to water down the consumer protection provisions that we won after this titanic battle is gonna have to run over me,” he said.
Wyden, who is chairman of the Senate Finance Committee, added he has not seen any “groundswell” among Senate Democrats to change any of the consumer protections in the law.
The law included several drug price reform policies that the pharmaceutical industry fervently opposed, including installing an out-of-pocket cap on Part D drug costs and capping insulin for Medicare patients at $35 a month. The out-of-pocket cap of $2,000 a year goes into effect next year.
One of the biggest provisions was to give Medicare the power to negotiate prices for a small subset of drugs in Parts B and D.
The Centers for Medicare & Medicaid Services released a timeline for how the negotiations will work. It plans to announce the first Part D drugs subject to negotiation later this fall, with the negotiated amounts being applied by 2026. Wyden said that the goal is to identify the applicable highest-spending drugs first.
Certain drugs will not be eligible for price negotiation right off the bat. Any small-molecule drug gets nine years of exclusivity before it becomes subject to negotiation, and a biologic gets 13 years.
However, some in the industry have sought to make the small-molecule exclusivity limit the same as biologics, which Wyden appeared to shoot down Monday.
“This is pharma coming back with its regular game plan to water down consumer protections for senior citizens and consumers,” he said.
Legislative action appears highly unlikely with the Democrats in control of the Senate and White House and Republicans taking back control of the House.
However, House Republicans have signaled they will scrutinize drug price regulations.
For instance, during the first hearing of the House Energy and Commerce Committee’s health subcommittee last week, Republicans on the panel blasted the use of quality-adjusted life years in all government health programs such as Medicare and Medicaid. The metric is used to measure the value of medical interventions and treatments based on the severity of the disease of the patient.
“Such policies arbitrarily put a value on someone’s life and are especially discriminatory toward those living with disabilities,” said Subcommittee Chairman Rep. Brett Guthrie, R-Kentucky, during the hearing last week.