Good Day BIO: Modernizing Medicare Part D

Congress is back—and drug pricing could be on the agenda. But here’s how we can modernize Medicare Part D without harming future cures. We also take a quick look at what happened during COP26 and President Biden’s pick for FDA Commissioner. (1,000 words, 5 minutes)

How we can modernize Medicare Part D

“Medicare Part D has some gaps in which seniors are asked to pay more than they would with other insurance options,” says Shawn O’Neail, VP of Government Affairs for Eli Lilly and Company. As Congress takes up drug price controls, he suggests “smart reforms” to address drug access without harming future cures.

It’s time to modernize Medicare Part D “in a way that provides greater affordability without eroding support for the research and innovation that is essential to providing new treatments that address the growing unmet needs of the next generation of Medicare beneficiaries,” writes BIO member Eli Lilly’s Shawn O’Neail in USA Today. 

But: “policymakers have been focused on legislation that would allow the government to dictate prices for medicines in Medicare to achieve a political soundbite,” he continues. “Such legislation would have a devastating effect on all patients—certainly to our older adult population—as the pipeline of tomorrow’s cures would slow to a trickle.” 

Congress should focus on Part D reforms to “improve affordability without disrupting innovation”:

1. Cap out-of-pocket costs. “There is currently no cap on spending in Part D,” causing “financial damage and a lack of predictability” for many seniors.

2. Reduce the coverage gap (a.k.a. “the donut hole”). 

3. Spread out-of-pocket spending over a longer period. “Families caring for sick loved ones can generally incur high costs for medical care and prescriptions, especially in the early months of the calendar year when deductibles reset,” he explains. “We should shift these health care costs back to the second quarter of the year to allow for more recovery time and breathing room for families.”

4. Share savings directly with patients. “The plans that administer Medicare Part D receive large rebates on branded medicines. These rebates have been growing but have not been used to lower out of pocket costs for patients.”

“These Part D reforms keep patients and their families front and center, ensuring they will continue to have access to groundbreaking therapies when they need them most—a vast improvement over the legislation currently being considered in Washington that promises to hinder innovation and severely limit patient access to medicines,” concludes O’Neail. 

The context: Congress returns from recess this week and the House is expected to take up the Build Back Better Act, President Biden’s social and spending policy agenda that includes a drug pricing “deal” that gives Medicare the power to set prices on certain drugs.

Visit www.SaveCures.com to learn why this provision would harm patients and future cures and contact your Members of Congress.

More Health Care News:

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National Journal: Rare-disease drug subsidy targeted in social-spending bill
“Democrats want to prevent drug companies from ‘gaming’ a tax incentive aimed at encouraging drug development for rare diseases.” 

The Mighty: Meet America’s strongest leaders, extraordinary advocates and heroes of 2021
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Recapping COP26

The UN’s consequential climate change conference ended Sunday—here’s what happened and why we’re more convinced than ever that biotech is the key to solving the climate crisis.

We have a deal. Nearly 200 countries (including the U.S.) agreed to the Glasgow Climate Pact, which includes a commitment to “accelerating efforts” to phase out fossil fuel subsidies and “phasing down” coal, explains New Scientist. 

The positives:It’s the first COP text to specifically address coal and countries agreed to “revisit and strengthen” 2030 plans by the end of next year. 

But: “Pledges at COP26 are expected to see Earth warm 2.4°C this century, better than the predicted 2.7°C predicted before the summit but still a rise that would bring extreme climate impacts and see countries overshoot their shared goals of 1.5°C and “well below” 2°C,” continues New Scientist. 

On methane: “More than 100 countries agreed to cut emissions of methane, a potent planet-warming gas, 30 percent by the end of this decade,” reports The New York Times. 

Read: How biotech’s battling methane 

On carbon markets: Negotiators came to an agreement on Article 6 of the Paris Agreement, which covers carbon markets. “Crucially, negotiators agreed to limit the use of pre-2020 credits from the UN's Clean Development Mechanism in the Paris architecture, avoiding a wholesale flooding of the market for carbon credits that could have sent their price plummeting,” explains S&P Global. 

BIO was front and center in the conversation—announcing our role as Knowledge Partner in the USDA’s Agriculture Innovation Mission for Climate (AIM), while Dr. Michelle joined international leaders across the supply chain to discuss how we can reduce emissions across the health care sector. 

The bottom line: If we want to achieve our climate goals, we need biotech—low-carbon and zero-carbon biofuels, fossil-fuel-free alternatives for plastics and chemicals, and agriculture technology that can reduce emissions, help farmers and landowners participate in carbon markets, and make our food supply more resilient.

Read: Biotech Solutions for Climate

President Biden’s Monday: Participating in a Tribal Nations Summit, then signing the infrastructure bill into law. This evening, he’ll meet virtually with President of China Xi Jinping. And finally, we have a nominee for FDA: Dr. Robert Califf, who BIO's Dr. Michelle McMurry-Heath calls "a proven leader whose on-the-job experience and deep understanding of the agency will allow him to hit the ground running." (Dr. Califf was FDA Commissioner from 2016-2017.) 

What’s Happening on Capitol Hill: Congress returns from recess. The House is expected to take up the Build Back Better Act, which includes drug price controls; Democrats are battling over the provision that would “penalize drugmakers if they hike prices of medicine faster than inflation,” which Republicans consider “a violation of the Senate’s parliamentary rules for considering the bill because it’s a non-budgetary item,” reports POLITICO. Meanwhile, the Senate is likely to focus on the National Defense Authorization Act (NDAA), reports The Hill.