Michigan’s Medicaid program is proposing to fire the pharmacy benefit managers that handle its prescription drug claims and negotiate prices. The state would manage drug coverage itself, starting Dec. 1.
The big picture: More state Medicaid agencies have determined that outsourcing all negotiations and operations of prescription drugs to PBMs has not produced the dramatic savings they were promised.
Details: Michigan officials said in a bulletin the state could extract bigger rebates from pharmaceutical companies and cut administrative costs if the state handled all Medicaid medication benefits, instead of the current private contractors.
via Axios.
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#politics #medicaid #health care #rx drugs #prescription drugs #seniors #elderly #older americans #retirement #retirees #retirement crisis #healthcare #drug pricingMore you might like
Retirement in America is growing less secure, physically and financially, given the omnipresent threat and cost of serious illness or disease.
Why it matters: Qualifying for Medicare does not guarantee that older adults will skirt potentially ruinous medical bills. Millions of seniors have also come to rely on the taxpayer-funded program for lower income people — Medicaid — and there’s no indication that will slow down.
- “I can’t tell you how many times people talk about how unaffordable the costs are, how it wipes away life savings in short order,” said Tricia Neuman, a Medicare policy expert at the Kaiser Family Foundation.
via Axios.
Related Reading:
It’s time to let Medicare to negotiate drug prices.
If we truly want to lower prescription drug prices for all Americans, the number one solution is allowing Medicare to negotiate directly with Big Pharma. While it’s true that there are several commendable proposals to address the problem — including greater transparency, regulating Pharmacy Benefit Managers, promoting more generic competition, and importing drugs from Canada – Medicare must be empowered to engage in price negotiations with drug-makers. It’s an idea President Trump supported during the 2016 campaign, but has yet to embrace in office.
Medicare spent $97 billion on prescription drugs in 2014, accounting for more than a quarter of the nation’s spending on prescription medicines. Those numbers are expected to continue rising in coming years, as spending on the Part D benefit accelerates. Policymakers have put a number of proposals on the table to reduce the growth in Medicare drug spending and costs for beneficiaries, including a controversial proposal that would change the way Medicare pays for Part B drugs administered by doctors.
Related Reading:
Options for Implementing Medicare Drug Negotiation.
Letter to Senate Finance on High Drug Costs.
A divided Congress probably won’t be able to agree on much over the next two years. But that vacuum could bode well for one vexing problem both parties say they want to solve: the high cost of prescription drugs in the United States.
Hope is strong among health-care advocates and lawmakers that 2019 could be the year Congress and the executive branch finally make significant moves against the powerful prescription drug industry, after long acknowledging a need for action but doing little about it.
via Washington Post.
Related Reading:
Trump Administration Drug Proposal Puts Burden on Beneficiaries.
Instead of taking big, bold steps to lower prescription drug prices, the Trump administration has rolled out yet another incremental measure that merely nibbles at the edges of the problem – while at the same time putting additional burdens on beneficiaries.
Options for Implementing Medicare Drug Negotiation.
At a time when policymakers are seeking ways to lower the federal deficit and overall health care spending, proposals that reduce Medicare prescription drug costs cannot be overlooked.
Seniors could save 28% on Medicare prescription drugs if we paid the same prices as Canada. Compared to Denmark, we would save 65%!
Senate Finance Committee Chairman Chuck Grassley (R-Iowa) is working on a bipartisan plan to cap seniors’ expenses for prescription drugs in Medicare as part of a broader effort to lower drug prices.
Grassley told The Hill on Wednesday that one idea he is working on with Sen. Ron Wyden (Ore.), the top Democrat on the panel, is “some sort of maximum amount that one person would have to pay” for drugs.
via The Hill.
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Pharmacists finally will be free to disclose lower prices for prescription drugs, thanks to a new law introduced by Senator Debbie Stabenow (D-MI), which was endorsed by the National Committee to Preserve Social Security and Medicare.
The passage and signing of Senator Stabenow’s legislation proves that Congress and the president are indeed capable of coalescing around common sense solutions to lower prescription drug prices. This law will particularly help seniors on fixed incomes struggling to afford the medications they need.
Read more from this press release by clicking here.
According to AARP, the annual average cost of prescription drugs overall increased nearly 60% between 2012-2017, while Oregonians’ income increased only 14.8%. In 2017, nearly one quarter of the state’s residents rationed pills or skipped medications altogether. Oregon seniors who have suffered the consequences of soaring drug prices shared their stories at the Portland town hall.
Nobody should have to choose between paying their bills for basic costs of living and taking their medication.
We applaud Rep. Lloyd Doggett’s efforts to keep prescription drugs affordable for the seniors who depend on them. We thank you for your tenacious efforts on this vital issue.
via twitter.
Related Reading:
Prescription drug prices are out of control – and older Americans are feeling the financial pain at the pharmacy counter. Prices for the most commonly prescribed drugs for seniors have increased ten times the rate of inflation since 2013. Medicare beneficiaries pay thousands of dollars a year in out-of-pocket drug costs they can’t afford.
You can sign our petition by clicking here.


Rep. Alexandria Ocasio-Cortez made a plea for expanding Social Security benefits on Tuesday… in support of Rep. John Larson’s Social Security 2100: A Sacred Trust bill. Read more here: https://www.ncpssm.org/entitledtoknow/rep-larson-introduces-social-security-2100-a-sacred-trust-bill/. #Secure2100 #SocialSecurity








