Three Novel Ways Tested By CMS To Lower The Cost of Drugs

It has come to light that the federal health agencies have gone on to select three new models so as to lower the prices of the drugs and work on President Joe Biden’s executive order that targets the drug costs. These models are going to be tested through the CMS Innovation Center.

The president has directed his administration to lower drug prices in Executive Order No. 14087, which is referred to as Lowering Prescription Drug Costs for Americans. Tagged with the Inflation Reduction Act of 2022, CMS can go on to have substantial power to negotiate as well as lower the prices of drugs for many Americans. The IRA has given the CMS the ability to negotiate prices for Medicare for the very first time in history. The Department of Health and Human Services has released the timeline so as to implement the first round of drugs that will be targeted.

According to Xavier Becerra, the HHS Secretary, HHS is going to be using every tool that is available to lessen the healthcare cost and at the same time, elevate the access to high quality as well affordable healthcare. They are going all out to deliver the cost savings from the president’s rolled-out Inflation Reduction Act of 2022. Apparently, as per him, people on Medicare are already feeling the benefits. President Biden has however also made it clear that there has to be further action involved when it comes to building on the new prescription drug law and that is why HHS is executing these new projects so as to bring the drug cost down.  

The models selected by Becerra meet the standards when it comes to affordability, feasibility, and accessibility in terms of implementation. These models have in them the Medicare $2 Drug List, cell and gene therapy access, and an accelerating clinical evidence model. The Medicare $2 Drug List model takes care of chronic conditions like high blood pressure as well as high cholesterol. Many patients who happen to be facing such conditions experience a cost-sharing gap when it comes to generic medications, which can have significant benefits. The model will encourage Medicare Part D drug plans to give low and fixed co-payments across all the cost-sharing phases of the Part D drug benefit for generic drugs on a standardised list that treat chronic conditions.

The Cell and Gene Therapy Access model looks to lessen the huge costs involved in cell and gene therapies, which happen to be emerging areas of medicine that can cost more than $1 million. This model has state Medicaid agencies assign the CMS to partner with and administer multi-state agreements with manufacturers for certain set of cell and gene therapies. This goes on to help Medicaid beneficiaries have access to these life-saving treatments as well as high-cost specialty drugs.

Accelerating clinical evidence model enables the CMS to bring out payment methods for drugs that are approved under the accelerated approval and in-consultation with the FDA so as to encourage timely trial completion and enhance the access to the post-market safety as well as efficacy data.

These selected models are going to test the strategies to help make it easier for Medicare enrolees to afford as well as access the required prescriptions for $2 or even less and thereby help broaden the cutting-edge cell and gene therapy for people having Medicaid. They look forward to working on these listed models and help making the drug cost lower with the help of Medicaid and Medicare, says Liz Fowler, Deputy Administrator and Director of the CMS Innovation Center.