Sanders to Biden: Cut back looming Medicare premium hike

[Omaha Steve]

Marta and I are both just joining Medicare on January 1.



FILE - Sen. Bernie Sanders, I-Vt., speaks during a news conference on Capitol Hill, Nov. 3, 2021, in Washington. Sanders is asking the White House to cut back a big Medicare premium hike set to take effect in weeks and tied to a pricey Alzheimer’s drug whose benefits have been widely questioned. (AP Photo/Alex Brandon, File)

By RICARDO ALONSO-ZALDIVAR December 3, 2021

WASHINGTON (AP) — Sen. Bernie Sanders is asking the White House to cut back a big Medicare premium hike set to take effect in weeks and tied to a pricey Alzheimer’s drug whose benefits have been widely questioned.

In a letter Friday to President Joe Biden, the Vermont Independent called on the president to act immediately to prevent the portion of an “outrageous increase” in Medicare premiums that’s attributable to Aduhelm, a newly approved Alzheimer’s medicine from drugmaker Biogen, priced at $56,000 a year.

If Biden agreed and found a way to do it, a planned January increase of $21.60 a month to Medicare’s “Part B” premium for outpatient care would be slashed closer to $10. The monthly premium for 2022 would drop from $170.10 to about $159.

Biden’s massive social agenda legislation takes significant steps to curb prescription drug costs, but Democrats are running the risk that seniors smarting from one of the biggest increases ever in Medicare premiums will turn against them in the 2022 midterm elections. That increase would claw back a big chunk of next year’s Social Security cost-of-living allowance, a boost of about $92 a month for the average retired worker, to help cover rising prices for gas and food.

FULL story: https://apnews.com/article/joe-biden-lifestyle-health-business-bernie-sanders-5a1cbff5b40ff8349535fdf542428423

[honest.abe]

1. I agree with Bernie on this one.

Something wrong with this system if one drug/one condition can have so much impact on the overall cost.

[TexasTowelie]

4. Aduhelm is a controversial medication

with conflicting test results as to its effectiveness. If the price is that expensive, then maybe the drug should not be included in the formulary for Medicare until their is more definitive proof that it has an effect on Alzheimer's.

[honest.abe]

5. Agree.

This drug does not sound like it should be included as a standard covered treatment under Medicare.

[Lonestarblue]

20. They agree. Approval should be withdrawn for this drug.

I just received my statement from Social Security announcing the 5.9% increase in benefits. The letter proceeded to then list all the charges for Medicare and drug coverage that will be subtracted from that monthly amount. I do have my Medicare supplement premium deducted, but with the increase in Medicare costs the net result is that I will now receive less per month than I got this year. I’m fortunate that I do not have to rely solely on SS, but its ridiculous for a 5.9% increase to be totally eaten up with cost increases.

[George II]

28. I don't think the increase is entirely attributable to this one drug.

[honest.abe]

30. According to the article it accounts for more than half the increase.

That’s just too much for one drug for one condition and that doesn’t actually cure the disease.

[George II]

31. That's the opinion of the one who wrote the article. Below are the contributors to the increase....

....and even the CMS isn't sure of the ultimate cost, which could be lower.

The increases in the 2022 Medicare Part B premium and deductible are due to:

- Rising prices and utilization across the health care system that drive higher premiums year-over-year alongside anticipated increases in the intensity of care provided.

- Congressional action to significantly lower the increase in the 2021 Medicare Part B premium, which resulted in the $3.00 per beneficiary per month increase in the Medicare Part B premium (that would have ended in 2021) being continued through 2025.

- Additional contingency reserves due to the uncertainty regarding the potential use of the Alzheimer’s drug, Aduhelm™, by people with Medicare. In July 2021, CMS began a National Coverage Determination analysis process to determine whether and how Medicare will cover Aduhelm™ and similar drugs used to treat Alzheimer’s disease. As that process is still underway, there is uncertainty regarding the coverage and use of such drugs by Medicare beneficiaries in 2022. While the outcome of the coverage determination is unknown, our projection in no way implies what the coverage determination will be, however, we must plan for the possibility of coverage for this high cost Alzheimer’s drug which could, if covered, result in significantly higher expenditures for the Medicare program.

https://www.cms.gov/newsroom/fact-sheets/2022-medicare-parts-b-premiums-and-deductibles2022-medicare-part-d-income-related-monthly-adjustment

[honest.abe]

32. From what you posted..

While the outcome of the coverage determination is unknown, our projection in no way implies what the coverage determination will be, however, we must plan for the possibility of coverage for this high cost Alzheimer’s drug which could, if covered, result in significantly higher expenditures for the Medicare program.

That's my point.. a single drug for a single condition should not significantly increase the cost of Medicare.

[TexasTowelie]

2. So the retirees will receive an increase of $70 a month after the adjustments for SS COLA and

increase in Medicare (where inflation also exists). Bernie is trying to get an extra $10-$12 a month to retirees. Since the retirees haven't received that money yet will they really notice the small difference or will they be grateful for the $70 increase instead? It's difficult to believe that $10-$12 per month is going to have a significant effect on the vast majority of retirees and it makes it look like Bernie is fighting the wrong battle.

[Elessar Zappa]

3. Any little bit helps.

I’m on SSDI and Medicare and I have to use every cent of my check to pay bills. Even a $10 reduction would be a big help to me.

[TexasTowelie]

6. I'm on SSI myself and don't even receive the maximum amount available

so I probably live on a tighter budget than almost everyone on DU. I wish that I was on SSDI because I would have $600-$700 more to spend each month. While it would be nice to get as much as possible, I can state that $10 per month is not going to have an impact on my quality of life.

I read some information about Aduhelm recently and there is some controversy as to whether it is effective. If there is concern about Medicare premiums, then the drug should be removed from the formulary of available medications until there is more evidence available as to the effectiveness.

So is Bernie asking Biden to make a choice as to whether to allow a controversial drug on the formulary? Are patients going to be deprived of a new medication that may have an effect on their disease?

[JohnSJ]

9. An interesting fact is sales of Aduhelm by Biogen, are dismal at best, so it isn't flying off the

shelves. Whether it should be removed from the formulary of available Medicare approved medications, I am not sure if that is a decision that should be made by a President.

case in point, when trump was pushing the FDA to approve hydroxychloroquine for Covid?

I would like to know if the sales of aduhelm actually justify the Medicare increase in premiums, and if the sales aren't there, then what is happening to justify the premium increase?

[TexasTowelie]

13. The article that I read is that they expected 500K patients to start therapy on the drug each year.

Considering that the drug has to be administered intravenously and multiple sessions are necessary, that number of patients appears unreasonable.

I'm reasonably certain that some of the increase in Medicare premiums is due to inflationary pressures and possibly even supply chain issues. The bottom line is that if Americans want this new drug to be available then they will have to pay the price the company demands. While it is not directly mentioned, it appears that Bernie wants price controls implemented and if that is the case then the drug may not be economical to manufacture.

I don't know what the actual price is to manufacture, but when you examine the chemical structure of C6472 H10028 N1740 O2014 S46 with a molecular weight of 145912.34 g/mol it does make me wonder how they stumbled on the drug in the first place.

[JohnSJ]

16. As I understand it, it only brought in 300,000 dollars in third quarter sales, which isn't very much

https://www.drugdiscoverytrends.com/aduhelm-sales-sputter-in-q3/

[TexasTowelie]

21. The pharmaceutical salesmen are going to have to bring in a lot of goodies

to the physician's offices to convince them to prescribe this medication. Hopefully both the physicians and the patients will resist the high pressure tactics to prescribe this medication when the benefits are dubious. At minimum it should at least put the physicians in an ethical dilemma to prescribe the medication.

[JohnSJ]

23. I agreee

[Karma13612]

10. When you are getting very little

Every little bit helps. It can go towards an increase in some utility or insurance hike.

Even help out if you want to splurge on a special food item.

[TexasTowelie]

19. As I said above, I'm probably living on less income than almost all DUers.

$10 a month is not going to change my lifestyle. The question is whether people want the medication or not. If there is demand for the medication, then accordingly people should expect to pay for it. Perhaps we should get some comments from Alzheimer's patients to get their perspective as to whether they feel that the medication is worth the cost?

BTW, what insurance hike are you referring to? They are already on Medicare which is automatically deducted from the SS check each month. Considering that we only recently found out the SS COLA, I doubt that anyone has planned ahead to spend that extra $10 each month. Just like the private sector, when I received pay raises there was also an increase in insurance premiums. I think the wiser recipients in SS are pragmatic and realize that if their retirement checks go up, then expenses will also rise.

I also suspect that if Bernie is going to push for price controls on this new medication that it will have a detrimental effect on the pharmaceutical industry because they know that if price controls are implemented on one drug, then price controls can be implemented on any other drugs coming down the pipeline. The one lesson that we should have learned from the 1970s is that price controls do not work and it may prevent new medications reaching the public so it becomes a lose-lose situation.

[George II]

22. That's the biggest increase in SS benefits in 40 years.

[myohmy2]

7. thanks Bernie...

...your politics is a reflection of how you think...

...I like the way Bernie thinks...

...

[JohnSJ]

8. Why can't Sanders just talk to Biden. He feels the need to write a letter, and then announce it in

a news conference

Between Manchin, Sanders, and the other Democrats who feel so motivated to use the press as their communication vehicle to negotiate various issues among themselves, I don't think this helps anything

[Karma13612]

11. I don't think it hurts

And it let’s the public know that there is still a chance that the full hike maybe won’t happen. And more will know that the size of the hike is because of one single drug with questionable efficacy. Helps us fight for getting negotiated drug prices as well. In my opinion, the more FACTS the public have at their disposal, the better.

We should know all the inner workings of our government.

[JohnSJ]

17. The way drug prices will be effectively be negotiated will be through Congress

[George II]

26. Quite honestly, the public knows that there isn't a chance the full hike won't happen WITHOUT....

....action from Congress.

The increases in both Social Security benefits (2022 is the largest in 40 years) and Medicare premiums are set forth in legislation and rules already established.

Instead of demanding that Biden do something that he probably can't do, he could be working within the Senate with his colleagues to reduce the increase.

[NurseJackie]

12. Agreed. I've always believed that when politicians do this...

I don't think this helps anything

Agreed. It doesn't. I've always believed that when politicians do this it's a tactic that's less productive and a bit self-serving. To me, when any politician engages in public negotiations or public advice-giving, it indicates a position of weakness or that previous attempts at personal negotiating have been unproductive. But I've noticed that other politicians who lean-in to these types of public communications will also use them for future fundraising emails. Perhaps that explains it.

[TexasTowelie]

14. Agreed, I don't see how this letter changes anything

and it seems more like a way for Bernie to keep his name in the headlines.

[mjvpi]

25. With all due respect, this is obvious. The news conference let's us voters know that, tag we're it.

Time to contact our Congress critters. The specifics of a $10 increase will indeed be negligible, but the big picture of a $56,000 a year medicine being approved, without the American people being allowed to negotiate the price and then charging everybody on Medicare $10, to me, is the issue.

My mother died with dementia. I’m glad that there are companies working to fight it.

[George II]

27. We knew about this increase a month ago. It was big news early in November when first announced.

[Skittles]

33. it's his usual schtick

zzzzzzzzzzzzzzzzzzzz

[betsuni]

34. +1

[George II]

15. It's not in the hands of the President. There are ways to try to roll back the increase other than..

...a public demand of the President.

Did he mention in his "letter to the President" anything about the fact that the increase in Social Security in 2022 is more than double any other year all the way back to 2008, and the largest in 40 years (1982)?

[Biophilic]

18. I, for one, am thankful someone is publicly arguing for this.

My drug plan went up 3x (yes I searched truly to find a plan that covered what I needed) and my monthly medicare payments are also going up. That is a big bit out of the budget. Someone with a large bull horn needs to be broadcasting this. Take a small billion out of the defense budget to cover these increases. Yeah, I'm being flippant, but I'm not a happy camper about these increases. I don't blame Biden, but I wish someone would care. I don't care if Sanders is grand standing. I appreciate his voice. It's much louder than mine.

[cstanleytech]

24. What really should happen if we had more adults running this country is

that we should have affordable healthcare and that is completely free for most Americans.
Not to mention we would not be spending as much on Defense as the top 10 biggest spenders combined are spending on it which would free up tons of money for infrastructure (which is vital for defense btw) as well as additional monies for the disabled and elderly to live on rather than the poverty level amount many of them are given every month.

[George II]

29. This is the key:

"If Biden agreed and found a way to do it...."

There IS no way Biden can do this, and Sanders should know that.

Plus, the premium increase he's talking about is for Medicare Parts A and B, it does NOT apply to any prescription drug coverage. So the increase isn't entirely attributable to the Alzheimer's drug he talks about.