Let’s talk about prescription drugs and specifically the ten (10) prescription drugs that President Biden, under the Inflation Reduction Act, wants to reduce the amount paid by the federal government to the drug companies. The Republicans in Congress are bound and determined to prevent the federal government from reducing the amounts paid to them and Trump and other Republican candidates have vowed that they will dismantle the program to negotiate with the drug companies.
In 2024, the federal government will spend $120 billion to fund Part D Drug Plans. That represents over 74% of the total cost of the program. Beneficiaries pay an additional 14% and states contribute 11%. The number one drug targeted by Biden’s effort to reduce drug costs paid by the federal government is Eliquis, a drug that is essential in the prevention and treatment of blood clots in many heart patients. Here are the numbers for Eliquis under the Medicare Part D drug plans*:
Number of Part D Enrollees in 2022/2023 taking Eliquis: 3,706,000
Average Covered Part D Prescription Drug Cost Per Enrollee: $4,448.00
Total Part D Gross Prescription Drug Costs in 2022/2023: $16,482,621,000
*A significant part of the data I use comes from the KFF.org website. Some of the data comes from the “FACT SHEET: Biden-Harris Administration Announces First Ten Drugs Selected for Medicare Price Negotiation” published by the White House.
Bristol-Myers Squibb charges the federal government almost $16.5 billion per year just for Eliquis. Because the Canada the government to control the prices of prescription drugs, a generic substitute for Eliquis (which you can’t buy in the U.S. until at least 2028) is available for a total cost of $78 per month. Eliquis is available in Canada for a total cost of $88 per month. Stated another way, the same drug that costs $1056 per year in Canada costs $4,448 per year to Medicare recipients in the U.S.
If a patient has private insurance or does not have insurance, Bristol-Myer Squibb has a co-pay program that reduces the total out-of-pocket cost to insured patients to $10 per month. It’s not surprising that this generous program is available to the 22% of population who take Eliquis but are either under 65 or covered by a private insurance plan but is not available to the 74% of Eliquis users who have a Medicare Part D drug plan.
An example of how this works is my Mother. She is a heart patient and needs Eliquis and a few other prescription drugs to keep her alive. She has a Medicare Part D insurance plan with a $500 annual deductible that is the best available coverage for the prescription drugs she uses. Because of her deductible, in January, 2024, she paid $551 for her 30 day supply of Eliquis. In February through December, she will pay between $150 and $160 per month for her 30 day supply of Eliquis for a total annual cost of over $2,200. If she had a private insurance drug plan or if she was uninsured, she would pay $120 for her entire annual prescription for Eliquis. . Of course, as a Medicare recipient, my Mother is not eligible for a private insurance plan and can’t go uninsured because of the other prescription drugs that she takes.
Because she has a Medicare Part D plan, my Mother will be paying at least $2,200 for her Eliquis prescription this year. Her Medicare Part D plan, which is subsidized by the federal government, will pay another $2,200 in 2024 for her prescription.
The Part D Drug Plan provisions of the Inflation Reduction Act are but another example of how most Democrats try to help common people and Republicans try to help the corporations that fund their political careers.
I once thought that people must be using drugs if they voted for Republicans. Now I know that if you vote for a Republican, you must not be using drugs. At least that’s true if you have any common sense.