November 29, 2021
United States Senate
Washington, DC 20515
I am writing on behalf of the National Committee to Preserve Social Security and Medicare’s millions of members and supporters to ask that you strengthen — not weaken — the drug pricing provisions in the House-passed budget reconciliation bill. Medicare beneficiaries need more robust drug price reform, now more than ever, given the extraordinary increase in Medicare Part B premiums driven substantially by the exorbitant cost of the Alzheimer’s drug Adulhelm. The Centers for Medicare and Medicaid Services attributes about half of the $21 or 14.55 percent spike in 2022 Part B monthly premiums to a “contingency reserve” they created to pay for Aduhelm if the agency decides to cover it under Part B.
At $56,000, Aduhelm is “Exhibit A” for what is wrong with drug pricing in the United States. It is an outrage that a drug that hasn’t even been covered by Medicare yet is already set to exact punishing costs from American seniors and people with disabilities. In addition to the increased burden in Part B premiums, Medicare beneficiaries who take Aduhelm will shoulder extraordinary costs. Beneficiaries in traditional Medicare without supplemental insurance and an estimated 90 percent of Medicare Advantage (MA) plan enrollees pay at least 20 percent coinsurance for Part B drugs (coinsurance can be much higher if beneficiaries use out-of-network providers). MA enrollees will be responsible for their share of Aduhelm until they reach the out-of-pocket cap of anywhere from $7,550 to $11,300 depending upon whether their provider is in or out of network. Those in traditional Medicare without supplemental coverage would be responsible for paying $11,200 in coinsurance for Aduhelm.
We are disheartened that the pharmaceutical industry has already further weakened the drug provisions in the Build Back Better Act by delaying the applicability of negotiation to biologics by one year and that attempts to limit the inflation rebate provision are under consideration. Instead, we urge you to amend the House-passed bill by allowing Medicare to negotiate with pharmaceutical manufacturers for the price of any drug – like Aduhelm — that significantly increases the Part B or Part D premiums.
We urge Congress to resist efforts to weaken the drug pricing provisions in the budget reconciliation legislation and to instead broaden pricing reforms to allow for negotiation of new drugs like Aduhelm. Seniors and people with disabilities can’t afford anything less.
President and CEO