Medicare beneficiaries are struggling to afford their medicines. Out-of-pocket costs have risen, but solutions that both preserve seniors’ access to medications and reduce their financial burden have been tough to find. Fortunately, the Medicare agency has proposed a key change for lowering out-of-pocket costs for medication.
It’s called the “rebate rule,” and it would give Medicare seniors the discounts pharmaceutical companies offer on their products. This is a shift from today’s reality, where the Medicare drug plan sponsors and administrators take those rebates for themselves, simply to boost their profits.
For example, a medication priced at $300 usually costs a Medicare beneficiary $75 out of pocket. They would pay just $30 under the rebate rule — a savings of more than half.
A senior’s savings on certain insulin products alone are expected to reach $800 per year, and over 3 million Medicare Part D Medicare beneficiaries are insulin-dependent.
The beneficial effects are not just financial. Lowering the out-of-pocket costs seniors pay for insulin will reduce the number of people who are unsafely stretching their supplies and too often suffering harmful, expensive-to-treat complications, such as diabetic seizures.
Medicare prescription drug plans and their middlemen should be ashamed of taking rebates intended for patients, while keeping seniors’ own out-of-pocket costs artificially high. Since basic decency has failed to compel them to change, a Medicare rule update is in order. The Medicare agency should side with seniors and help them afford vital medicines by enacting the rebate rule right away.
Marcus Garong
Roy