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The driving force behind Medicare Part B’s price increase was blunted—the price hike should be, too

Nearly 64 million Americans rely on Medicare for their health care coverage, the majority of whom pay monthly Part B premiums to access potentially lifesaving medications through the nation’s largest health care provider. Earlier this year, nearly 56 million of those beneficiaries suddenly faced a 14 percent price hike in their monthly premiums — creating newfound expenses that further stretched many seniors’ already tight budgets.

As the global pandemic rages on and prices rise in many sectors of the economy, our nation’s seniors simply cannot afford this sudden and unnecessary increase in their health care costs. As Democrats in Congress, we promised our constituents that we would fight on their behalf in Washington to lower the cost of health care and prescription drugs. And now, following the single largest dollar increase in Medicare’s long history, it’s time to make good on that promise.

It’s important to understand why Medicare announced this unprecedented premium hike in 2022. Last summer, the FDA approved a long-awaited drug to slow cognitive decline in patients with Alzheimer’s disease — a treatment called Aduhelm, which could be in high demand with our nation’s seniors. The manufacturer of this drug, Biogen, priced this new product at $56,000 per patient per year, an astronomical price that outraged patients, medical professionals, and advocates all across the country.

While Medicare actuaries pointed to a number of factors that led to increased monthly premiums in 2022, they stated that a significant and new factor to be accounted for was the exorbitant cost of Aduhelm. You see, in order to ensure that eligible beneficiaries could access this new, expensive treatment without negatively impacting the program’s long-term financial outlook, Medicare was forced to dramatically increase the monthly premium rates for all of its beneficiaries.

The story of Aduhelm and Medicare is far from over, however. On Dec. 20, 2021, Biogen announced that it would cut its price for the drug from $56,000 per year per patient to $26,200 — a price reduction that would significantly change Medicare’s financial calculations in 2022. And barely two weeks later, Medicare issued draft guidelines that would limit which beneficiaries could be approved for clinical trials of Aduhelm, limiting Medicare’s financial exposure even further.

These updated guidelines, coupled with Aduhelm’s price decrease, meant that the financial impact of the drug’s approval would be far less drastic than the actuaries estimated back in the fall of 2021.

Taken together, these developments demanded urgent action by the Department of Health and Human Services — as well as a recalculation of the 2022 Medicare Part B premium. Fortunately, Health and Human Services Secretary Xavier Becerra was in agreement. Last month, Secretary Becerra ordered his department to conduct a reassessment of the monthly price increase — a directive that could save American seniors hundreds of dollars annually.

As members of Congress concerned about the many costs facing older Americans, we know that we must do more to lower the soaring cost of prescription drugs in this country. Right now it’s clear that American seniors are overpaying for the cost of Part B services — a surcharge that many can hardly afford during these challenging economic times. That’s why, together, we’re leading efforts to urge the secretary and CMS Administrator Chiquita Brooks-LaSure to reverse course and deliver much-needed relief to our nation’s seniors.

We cannot break our promise to the American people. Let’s get this done.

U.S. Rep. Joe Courtney represents Connecticut’s 2nd District. U.S. Rep. Angie Craig represents Minnesota’s 2nd District.

Tags Aduhelm Alzheimer's disease Joe Courtney Medicare Xavier Becerra

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