Medicare Part B Drugs | Case For Controlling Prices

By: Edward Neeman
Published: Monday, March 11 2019
Last Updated: 3 years ago

If you’re currently being prescribed medication, or have at any point in your life, then you understand how expensive prices have gotten. In fact, experts are projecting a significant spike in drug spending by 2021, which is expecting to hit $610 billion.

For Medicare beneficiaries, unplanned costs can lead to financial devastation, which is why the government may soon do something about the rising cost of prescription drugs. President Trump and his administration are trying to identify possible areas where they can reduce the cost of Medicare Part B prescription drugs, which provide a much needed relief for so many.

What The Us Government Is Suggesting

The US government is providing suggestions that could lower the cost of Medicare Part B drugs. The ambitious proposal is undoubtedly to mirror that of other developed countries. In a way, those who naturally have Medicare would essentially be paying less for their necessary Part B drugs.

The potential savings would be driven down in that the specific charge with the lifesaving Part B drugs would not be as much as they are today. The conscious consumer would undoubtedly have a lower copay.

What Are Recognizably Medicare Part B Drugs?

Traditional Medicare typically consists of Medicare Part A and Part B. Medicare Part A covers the economic cost of necessary hospitalization. Medicare Part B will include the recipient's costs at the physician's office. Medicare Parts A and B do not typically cover the cost of prescription drugs.

Typically, Medicare Part B does not cover the cost of medications. It is left up to Part D for prescription drug coverage. However, Part D will only provide coverage for medication dispensed at a pharmacy. When you have medications administered by a doctor, this is not covered by your Part D, it is covered by your Part B.

Medicare Part B drugs are the drugs administered in a physician's office. Examples of these drugs include injections for illness such as rheumatoid arthritis or macular degeneration.

How Would I Be Affected by the Price Change?

The price change would reduce the cost to the physician. The doctor would pay a comparable price which is paid in other developed countries, like those found in Europe. Since the physician would pay a reduced cost, you would, as well.

The savings are passed on to the consumer. The program would only be for Medicare Part B drugs. Unfortunately, there is not yet talk of a plan to control the pharmacy dispensed drugs. The plan to control the cost of Part B drugs would be phased in over 5 years time.

What Are Details About The New Plan?

The plan was unveiled in October 2018. The plan is titled the MedPAC deal. MedPAC would reduce already high drug prices for many on Medicare. MedPAC will be voted on during spring 2019. If it passes, it would be phased in over 5 years time.

The 5 years time would begin during spring 2020. At which time you would begin seeing a reduction in the high drug prices you currently pay. By this we mean the prices you currently make for the copay on your Medicare Part B drugs.

What is the "Target Price" of Part B Drugs?

Part B drugs are to have a target price that is comparable to the prices of international drugs. What this means is that Part B drugs would now be comparable to the same drugs internationally. What that will mean to you, the consumer, is you would pay lower copayments.

The reason your copayments would be lower is that the doctor would pay less for the prescriptions. The savings would then be passed on to you. It is a win, win situation for the physician and the consumer.

Currently, the doctors will buy Medicare Part B medicine from a vendor. The vendor charges the doctor accordingly. The physician then makes a charge to you when they administer the medication. You make a copayment based on what Medicare does not cover.

Are There any Concerns About The New Plan?

Of course, there are some critics who think the consumer is going to be shortchanged. When these people talk they voice their concerns that the consumer will spend less and get less quality of medications. These concerns are crucial to getting the bill passed.

When Is The New Plan Supposed To Be Phased In?

The plan is supposed to be phased in over a 5 years span. The plan will begin in spring 2020. Over the five following years, consumers can expect to see major changes in their healthcare. These changes will give the consumer substantial savings on their Part B drugs over the 5 year period.