Many steps remain before older adults see the benefit of the Centers for Medicare and Medicaid Services' upcoming talks with drugmakers.
However, Medicare patients will see some relief from drug prices before 2026. Starting in 2025, another provision in the Inflation Reduction Act will cap a beneficiary’s Medicare Part D out-of-pocket costs at $2,000 a year.After the prices on the 10 drugs are finalized, standalone Part D and Medicare Advantage plans are required to put the drugs on their formularies at the negotiated rate.Companies have until Oct. 1 to decide whether to participate in the talks.
CMS plans to send an initial price offer to companies by Feb. 1, and the drugmakers have 30 days to either accept the offer or decide to leave Medicare and Medicaid. Through spring and summer of 2024, CMS is going to hold up to three meetings with each company to hammer out a price.CMS must explain its decision on the final price by March 1, 2025.The IRA allows CMS to select only 10 drugs for the first round of negotiations.
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