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SCHUMER, STANDING WITH BUFFALO & WESTERN NY SENIORS GETTING LOWER PRESCRIPTION DRUG PRICES, ANNOUNCES NEXT PHASE WITH NEW $2,000 CAP ON MEDICATION COSTS COMING FOR 62,000+ IN WNY IN JANUARY; REVEALS NEXT STEPS SENIORS NEED TO TAKE TO TAP ADDITIONAL SAVINGS


  Earlier This Month Feds Announced – For First Time In History – 10 New, Negotiated Lower Drug Prices For Medicare Thanks To Inflation Reduction Act, Impacting Those With Cancer, Diabetes, Heart Disease & More

Senator Standing With Buffalo Seniors Who Take These Drugs Says We Need To Do More; Announces Next Phase For Seniors Coming In January And Details Steps Seniors Need To Tap Further Savings – Vows To Block Efforts To Roll Back

Schumer: Lowering Health Care Costs Is Just What The Doctor Ordered For Buffalo & Western NY Seniors!

On the heels of just announced newly negotiated, lower prices for 10 of the highest-spend drugs in Medicare, U.S. Senate Majority Leader Chuck Schumer stood with Buffalo & Western NY seniors who take these drugs to spotlight the importance of the tremendous cost-saving measures, a result of Schumer-secured provisions in the Inflation Reduction Act. Schumer revealed the next phase of lowering drug costs with a $2,000 annual cap on total out-of-pocket prescription drug costs for NY seniors on Medicare starting this January as well as a new tool that allows seniors to break their drug costs into monthly payments, which they will need to opt in for if they would like to participate.

“Come this January, Western New York seniors on Medicare will not have to pay more than $2,000 a year for prescription drugs, and this will help end the decision-making of choosing between buying life-saving medications and keeping food on the table. It means more money in the pockets of Buffalo seniors and less in the pockets of Big Pharma, a win-win and just what the doctor ordered,” said Senator Schumer. “Thanks to the Inflation Reduction Act, we’ve made record progress lowering prescription drug prices for older Americans on Medicare. Before, seniors often had to pay thousands upon thousands of dollars for a single drug. Now, we are taking on Big Pharma directly to negotiate prices, which is lowering costs of medication for cancers, diabetes, and heart diseases by as much as 79%.”

“At D’Youville University, we are committed to health equity and access. The new drug pricing policy aligns our mission and is critical to ensuring vulnerable populations receive the affordable medications they need. We thank Senator Schumer and other healthcare leaders who have championed this vital drug pricing reform,” said Dr. Lorrie Clemo, President of D’Youville University.

“Vital Pharmacy and the Health Proffessions HUB are committed to providing essential medical services to the Western NY community,” said Dr. Michael S. Mac Evoy, Pharm.D., Chief Health Services Officer at D’Youville University. “Any reduction in out of pocket expense is greatly beneficial to our patients. It is encouraging to see government action curtailing over pricing of essential medications. With the help of Senator Schumer, we continue to advocate for patient care, that supports patients and their local, small business independent pharmacies.”

“The $2,000 IRA Out-of-Pocket Cost Cap will be of tremendous benefit to many older New Yorkers, particularly those suffering with chronic conditions and high medication costs. Through our helpline we have seen countless consumers, who live on fixed incomes and who need multiple and expensive life-saving prescription drugs incurring thousands of dollars in out-of-pocket costs.  We applaud the administration for implementing this policy to ease the financial burden of so many vulnerable seniors,” said Maria Alvarez, Executive Director of the NY StateWide Senior Action Council.

“The patients Catholic Health caregivers serve at Sisters Health Center D’Youville will benefit from these important changes, and I thank Majority Leader Schumer for always fighting for affordable health care,” said Joyce A. Markiewicz, President and CEO of Catholic Health. “One reason we built this clinic, is to improve healthcare access for people in the surrounding neighborhood, but unaffordable medicine has remained a critical challenge.  Nearly 47% of residents and 80% of children in the 14201 zip code live below the poverty line. With a median income of $32,000 per year, you can understand how impactful capping out-of-pocket costs and low income subsidies will be.”

Schumer was joined by local seniors who benefit from the new lower-cost negotiated drugs. Schumer said seniors in America are paying higher prices than anywhere else in the world for commonly taken drugs. Nationally, one-in-five seniors recently reported forgoing medication, skipping doses, or cutting pills in half because they could not afford their drugs. This year, thanks to the IRA, Medicare selected the 10 highest spending drugs in Medicare Part D for negotiation. The new prices will go into effect in 2026 and, each year moving forward, Medicare will negotiate lower prices for even more drugs. The first ten drugs alone this year are expected to impact 660,000 in NY, and save seniors across America over $1.5 billion every year in out-of-pocket costs and taxpayers nearly $6 billion every year.

Drug Name

Commonly Treated Conditions

NY Seniors Taking Drug

Current Price Set by Drug Company For A 30 Day Supply

New Price Negotiated by Medicare

Discount Secured By Medicare

Eliquis

Blood clots

232,000

$521

$231

56%

Xarelto

Blood clots, heart disease

96,000

$517

$197

62%

Januvia

Diabetes

85,000

$527

$113

79%

Jardiance

Diabetes and heart failure

96,000

$573

$197

66%

Enbrel

Rheumatoid arthritis and Psoriasis

4,000

$7,106

$2,355

67%

Imbruvica

Blood cancers

2,000

$14,934

$9,319

38%

Farxiga

Diabetes, Heart failure and Chronic Kidney Disease

53,000

$556

$178.50

68%

Entresto

Heart failure

43,000

$628

$295

53%

Stelara

Psoriasis and Crohn's Disease

2,000

$13,836

$4,695

66%

Fiasp and NovoLog

Diabetes

50,000

$495

$119

76%

In addition, Schumer announced that while an out-of-pocket spending limit of roughly $3,100 has been in place for 2024, it is lowering to $2,000 in January 2025. Once a senior spends $2,000 next year, their prescription drugs for the remainder of 2025 will be free of charge. This will provide major protection to people with Medicare who currently have extremely high prescription drug spending. Before the Inflation Reduction Act, a single prescription could cost $10,000 out-of-pocket. AARP estimates that 261,000 New York seniors – the seniors who currently have the highest levels of drug spending – will benefit from the cap next year. By 2029, one in ten seniors nationally is expected to see savings because of the cap.

Schumer also spotlighted the provision he helped deliver that will be starting in January that allows Medicare beneficiaries to break their drug costs into monthly payments. For some seniors taking a very expensive drug, they could hit the $2,000 limit in January or February, which leads to a huge spike in costs for a short period of time that may be hard to budget for. With the monthly payment tool, that same senior could pay their $2,000 obligation in equal $167 monthly payments throughout the year, rather than facing a huge bill at the pharmacy counter in January or February.

The monthly payment tool requires patients to opt in. Schumer said that while he wrote into the IRA that insurance companies are supposed to target and reach out to beneficiaries likely to benefit, it is critical to build awareness among beneficiaries and pharmacists so that everyone can take advantage, and nobody falls through the cracks. Schumer said this new out-of-pocket limit will work in tandem with other major drug affordability provisions he secured in his Inflation Reduction Act, including making vaccines free for seniors and a $35 insulin cap for those on Medicare, to help make healthcare more affordable for more than 3.8 million New York seniors on Medicare.

Schumer said collectively these cost-saving measures will benefit thousands in Western NY. A county by county breakdown can be found below:

County

Enrollment

Cattaraugus

4,052

Chautauqua

7,984

Erie

42,214

Niagara

8,551

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