These 27 drugs will be subject to Medicare rebates
The Department for Health and Humans Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced 27 drugs that will be eligible for rebates to lower out-of-pocket costs for Medicare beneficiaries
Medicare Prescription Drug Inflation Rebate Program will lower coinsurance for Medicare Part B beneficiaries, with savings between $2 and $390 per average dose starting April 1, depending on their individual coverage. The program came about under the Inflation Reduction Act, which was implemented at the end of 2022 and gave Medicare substantially more power to enact policies that could lower drug prices.
The rebate program requires companies to pay a rebate if they raise prices of certain drugs faster than the rate of inflation. CMS will begin billing drug makers for rebates on these costs beginning 2025, with the rebates going to Medicare. The program specifically establishes Part B prescription drug inflation rebates for single source drugs and biologicals with price spikes above inflation rates, and also offers Part B beneficiaries lower cost sharing on these drugs.
“The Biden-Harris Administration believes people with Medicare shouldn’t be on the hook when drug companies inexplicably jack up the prices of their drugs,” HHS Secretary Xavier Becerra said in a statement. “President Biden made lowering prescription drug costs for Americans a top priority and we’re using every lever we have to deliver results. With the inflation rebate program, we are fighting to ensure seniors can afford the treatments they need, taxpayers aren’t subsidizing drug company excess prices, and the Medicare program is strong for millions of beneficiaries now and in the future.”
Part B beneficiaries will see their cost sharing fall for certain drugs on the rebate program list beginning April 1, 2023. Part B Medicare helps cover medical services like doctors' services, outpatient care, and other medical services that Part A doesn't cover. It is optional coverage for which beneficiaries pay a monthly premium.
The 27 drugs on the list for the rebate program includes well-known medications, such as Humira, which is commonly used to treat arthritis, plaque psoriasis, ankylosing spondylitis, Crohn's disease, and ulcerative colitis. Cancer treatments are also on the list, as well as leukine, which aims to make white blood cells after chemotherapy, bone marrow transplant or stem cell transplant.
Here are the 27 drugs on the rebate program list:
- Abelcet
- Akynzeo
- Atgam
- Aveed
- Bicillin C-R
- Bicillin L-A
- Carnitor
- Cytogam
- Elzonris
- Fetroja
- Flebogamma DIF
- Folotyn
- Fragmin
- Humira
- Leukine
- Minocin
- Mircera
- Nipent
- Padcev
- Rybrevant
- Signifor LAR
- Sylvant
- Tecartus
- Winrho SDF
- Xiaflex
- Xipere
- Yescarta
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."