Tag: Chronic kidney disease

  • Biden administration chooses first 10 drugs for Medicare price negotiations

    Biden administration chooses first 10 drugs for Medicare price negotiations

    BY:  Ohio Capital Journal

    WASHINGTON — Medicare can now negotiate lower prices for 10 common high-price drugs, cutting out-of-pocket costs for an estimated 9 million seniors and saving taxpayers billions, the Biden administration said Tuesday.

    Medicare will begin this year to negotiate with the manufacturers of popular medications used to treat blood clots, diabetes, heart disease, rheumatoid arthritis, chronic kidney disease, psoriasis, blood cancers, Crohn’s disease, and ulcerative colitis.

    Enrollees will begin to see lower prices in 2026.

    The prescription drug negotiations are a result of last year’s Inflation Reduction Act, a massive spending package that contained measures to reduce prescription drug prices, subsidize climate change reduction technology and adjust the corporate tax rate.

    “For far too long, Americans have paid more for prescription drugs than any major economy. And while the pharmaceutical industry makes record profits, millions of Americans are forced to choose between paying for medications they need to live or paying for food, rent, and other basic necessities. Those days are ending,” President Joe Biden said in a statement Tuesday.

    About 9 million enrollees in Medicare’s Part D prescription drug coverage program spent $3.4 billion out of pocket in 2022 on the 10 drugs selected for negotiation, according to a report released Tuesday by the U.S. Department of Health and Human Services.

    The 10 drugs are: Eliquis, Enbrel, Entresto, Farxiga, Imbruvica, Januvia, Jardiance, multiple Fiasp and NovoLog insulin products, Stelara and Xarelto.

    Democrats hailed the announcement of the selected drugs. The party held majorities in both the House and Senate when Congress passed the Inflation Reduction Act along party lines in August 2022.

    “For years politicians promised to take on the big drug companies and empower Medicare to negotiate lower drug prices for consumers. With the Inflation Reduction Act Democrats have delivered. Soon millions of Americans will see lower prices on some of the most expensive and widely used prescription drugs,” Senate Majority Leader Chuck Schumer of New York said in a statement Tuesday.

    Sen. Jon Tester, a Montana Democrat, said in a statement that his constituents “should never have to make the choice between life-saving medication or putting food on the table.”

    “I am proud to have stood tough against large pharmaceutical corporations and successfully demand that they stop unnecessarily jacking up prices on folks across the state. Montanans sent me to Washington to deliver results, and I will continue to take on anyone to lower costs,” he said.

    Of the nearly 66 million Americans enrolled in Medicare, 52 million are enrolled in the Part D prescription drug coverage plan, according to the Centers for Medicare and Medicaid Services enrollment dashboard.

    The Inflation Reduction Act also made common adult vaccines, including shingles and TDAP, free for certain Medicare enrollees. Monthly insulin costs for Medicare enrollees were also reduced to $35 for Part D beneficiaries as part of the IRA, and beginning in 2025 annual out-of-pocket prescription drug costs will be capped at $2,000.

    The law’s prescription drug provisions, including the government’s new ability to negotiate what it pays for certain drugs, is expected to reduce the federal deficit by $129 billion by 2031, according to a Congressional Budget Office analysis.

    The government will choose 15 additional Part D-covered drugs in 2025 to negotiate lower prices beginning in 2027. Several more Part D and Part B drugs will be phased in for negotiations through 2029.


    Ashley Murray
    ASHLEY MURRAY

    Ashley Murray covers the nation’s capital as a senior reporter for States Newsroom. Her coverage areas include domestic policy and appropriations.

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  • High risk conditions for COVID-19 span far and wide in Ohio

    High risk conditions for COVID-19 span far and wide in Ohio

    Along with diseases known to increase risk, the CDC lists 12 other conditions that “might” increase the risk of people who have them. These include other massively common conditions like hypertension, liver disease, pregnancy, smoking and others.

    By Jake Zuckerman and Ohio Capital Journal Edited by Loveland Magazine

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    The underlying health conditions that lay a path for severe COVID-19 complications are widespread in Ohio, potentially affecting as much as half the population, according to experts, state data and government research.  

    Take obesity: Ohio Department of Health 2017 survey data estimates that 34% of Ohioans are obese. Similarly, more than 74,000 Ohioans were diagnosed with cancer that same year.

    Dr. Peter Pronovost (Photo by University Hospitals)

    “The statistics are about 60% of the public has one or more chronic diseases,” said Dr. Peter Pronovost, a University Hospitals physician. “Four in 10 have two or more diseases.”

    The ubiquity of chronic disease in Ohio complicates any policy response when there’s no easy-to-draw line between people at low-risk for COVID-19 and those at higher risk levels.

    It also illuminates the reality of a “herd immunity” strategy, as reportedly offered by an influential adviser to President Donald Trump. This would entail allowing the virus to run its course through the population unimpeded, purportedly allowing healthier people to develop antibodies at a large enough volume to break down chains of transmission.

    The CDC lists eight diseases known to increase risk of severe illness from COVID-19. The list, coupled with data from the Ohio Annual Cancer Report, Behavioral Risk Factor Surveillance System annual report from 2018, and other state and federal sources, shows how deep chronic disease runs in the Buckeye state.

    • Cancer: 74,000 cases diagnosed in 2017
    • Chronic kidney disease: About 15% of U.S. adults have chronic kidney disease, per the CDC
    • COPD (chronic obstructive pulmonary disease): 8.3% of Ohio adults have COPD
    • Immunocompromised state from solid organ transplant: 1,916 Ohioans received organ transplants in 2019
    • Obesity: 34% of Ohio adults are obese. An additional 34% are overweight
    • Serious heart conditions: Heart disease is the leading cause of death in Ohio
    • Sickle cell disease: Not tracked population wide, but 181 newborns in 2019 tested for the disease, and another 3,444 newborns are carriers
    • Type 2 diabetes: 11.3% of Ohio adults are diabetic — about 1 million people

    According to recent CDC research analyzing survey data from more than 3,000 U.S. counties, nearly half the population had at least one condition placing them at high risk for COVID-19 complications.

    In rural counties, it’s even higher.  

    Dr. Nirav Vakharia (Photo by the Cleveland Clinic)

    “When we go beyond age as a risk factor … if we’re just thinking about these chronic diseases, they’re so prevalent, it’s hard to isolate a young, healthy cohort,” said Dr. Nirav Vakharia, a physician from the Cleveland Clinic.

    Health care groups in Ohio are undertaking different efforts to help residents with some of these conditions to stay at home.

    LifeCare Alliance, an in-home health care agency, has seen a spike in the number of meals it has delivered to the homes of its diabetic patients since the pandemic began.

    “If you have diabetes, the chances of you having a mild case of the coronavirus is much less — you’re gonna have a harder case, because your immune system just can’t fight it off,” said CEO Charles Gehring. “Patients have been scared to death by coronavirus.”

    Similarly, Pronovost, the chief clinical transformation officer with University Hospitals, said the health care network recently accelerated its efforts to provide proactive care for people with chronic diseases.

    He said staff is reaching out to patients to ensure they’re properly managing and controlling their diseases, like keeping insulin or blood pressure at healthy levels.

    “The idea is we want to make sure chronic disease people are doing all they can to avoid being hospitalized and avoid needing to go to the [emergency room],” he said.

    Early data shows the network reduced hospital admissions of certain chronic disease patients by 28%, and emergency visits by 79%, he said. 

    “The idea is we want to make sure chronic disease people are doing all they can to avoid being hospitalized and avoid needing to go to the [emergency room],” he said.

    Along with diseases known to increase risk, the CDC lists 12 conditions that “might” increase the risk of people who have them. These include other massively common conditions like hypertension, liver disease, pregnancy, smoking and others.

    As of Wednesday, COVID-19 has killed 4,176 Ohioans. The virus has infected nearly 120,000 state residents and put more than 13,500 in the hospital.

    Jake ZuckermanJake Zuckerman is a statehouse reporter. He spent three years chronicling the West Virginia Legislature for The Charleston Gazette-Mail after covering cops and courts for The Northern Virginia Daily.