Capping Medicare drug co-pays is not enough. Cap drug profits.

This week’s news that the FDA will approve a drug that treats Alzheimer’s was controversial.

Many medical experts question whether the FDA was rushed to judgement on a drug that costs $56,000 a year as well as raising questions about it’s usefulness.

Meanwhile shares of Biogen Inc. rocketed to a six-year high in trading Monday, as Wall Street analysts cheered the U.S. Food and Drug Administration’s approval of the biotechnology company’s Alzheimer’s drug.

This is a good time for drug companies and the pharmaceutical industry.

For the average American, it’s hard to be mad when a vaccine was created for COVID in less than a year.

While J&J, Moderna and Phizer vaccines were free to get, they got billions from the government.

What gets cloudy when a vaccine for COVID comes out or a drug for Alzheimer’s is released is the issue of how much profit should a drug company make off of it.

For the elderly like me on Medicare, the issue of drug costs and drug company profits has its unique issues.

In 2021, Medicare Part D enrollees must spend $6,550 out of pocket before they reach the “catastrophic” coverage phase, where they typically still have to pay 5% of a drug’s cost, without limit. For retirees taking pricier drugs, that 5% is often unaffordable. Medicare picks up 80% of the drug cost in the catastrophic phase, while Part D plans pay the remaining 15%, and the drug companies pay nothing. High prices for brand-name specialty drugs mean that a growing number of patients hit catastrophic coverage after filling a single prescription, and Medicare’s spending in the catastrophic phase, which more than quadrupled between 2010 and 2019, is expected to reach $88 billion by 2029, according to a report by Medicare’s trustees.  

There is federal legislation being considered, a bill in the House aims to cap out-of-pocket drug costs under Medicare.

The pharmaceutical companies support it and there is bipartisan support for caps on co-pays. Why?

Because capping patient co-pays without also capping drug prices directly through government controls on profits and pricing continues the writing of a blank check to Big Pharma.

One thought on “Capping Medicare drug co-pays is not enough. Cap drug profits.

  1. “The pharmaceutical companies support it and there is bipartisan support for caps on co-pays. Why?”
    Because pharmaceutical companies, through their lobbyists and Super PAC donations, legally bribe legislators.

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