Tester Fights to Lower Prescription Drug Costs for Montana Seniors

Senator Urges Administration to Cut Red Tape & Increase Transparency for Medicare Part D Recipients

(U.S. Senate) – U.S. Senator Jon Tester is pushing the Centers for Medicare and Medicaid Services (CMS) to increase transparency and lower prescription drug prices for Montana seniors.

“[I] write to urge the Department of Health and Human Services to move forward with a proposal to meaningfully address skyrocketing drug prices by specifically addressing pharmacy direct and indirect remuneration fees in the Medicare Part D program,” Tester wrote to Health Secretary Alex Azar.

Under the current system, when a Medicare Part D patient picks up a prescription the patient is charged a percentage of the drug’s cost and then the pharmacist works with a pharmacy benefits manager to collect the remaining payment from the patient’s insurance company. The patient’s co-pay is based on the drug’s price at the point of sale, but pharmacy benefits managers are allowed to come back to pharmacies well after a drug is sold and pay less than the patient was originally charged by applying a fee.

As a result, seniors pay more out of pocket than they need to and pharmacies are forced to absorb the loss. That’s why Tester is urging the Administration to implement its own proposal to stop these retroactive fees by requiring pharmacy benefits managers to disclose all fees up front when the drug is sold.

“We ask this Administration to require the reporting of all pharmacy price concessions in the negotiated price at the point of sale,” Tester wrote. “The administration has considered this type of policy several times over the past years, and the time to move forward is now.”

CMS estimates that the proposal will save Medicare beneficiaries over $10 billion dollars in lower cost-sharing for their prescription drugs.

Tester has led the charge on this issue, asking the Administration to finalize this proposal back in January, urging Medicare to adopt this proposal last month, and introducing a bill to prevent these pharmaceutical middlemen from charging retroactive fees on small pharmacies that serve seniors.

Tester’s letter to the Administration is available HERE. More information about Tester’s work to lower prescription drug prices is available HERE.