Medicare patients to pay less for 64 rapidly rising-cost drugs

The US Department of Health and Human Services (HHS) recently identified 64 drugs available through Medicare Part B that had their prices increased at rates exceeding inflation. As a result, manufacturers of these medications will be required to pay rebates to Medicare. Additionally, patients using these drugs will benefit from lower coinsurance rates starting July 1, which will continue until the end of September. The typical coinsurance rate stands at 20%, but the new inflation-adjusted rates for these medications vary between 4% and 19%.

This initiative aims to provide financial relief to patients, potentially saving them up to $4593 per day on prescription costs, according to HHS estimates. Among the drugs flagged for price hikes are Padcev (enfortumab vedotin-ejfv) from Astellas, an antibody-drug conjugate approved for bladder cancer treatment, and Crysvita (burosumab-twza) from Ultragenyx Pharmaceutical, used for treating X-linked hypophosphataemia and osteomalacia.

The Centers for Medicare & Medicaid Services (CMS) plans to start invoicing the drug manufacturers for the required rebates by the fall of 2025.