Joseph Zambon
- Williams, Langworthy, and Tenney are MAGA Republicans representing Western and Central New York.
- None support lowering prescription drug prices for their constituents.
- Guess which one actually voted against lowering drug prices?
For years, Americans have struggled with the high cost of prescription drugs. Americans pay more for prescription drugs than any developed nation. While many countries negotiate directly with pharmaceutical companies to keep prices in check, Medicare has been legally prohibited from negotiating with big pharma for lower drug prices due to the Republican appeasement of the pharmaceutical industry. This situation is all the more infuriating since Americans paid for the basic research from which big pharma profits.
The Federal Government Funds Initial Development of New Drugs
One aspect of drug pricing that often goes unnoticed is the significant role federal funding plays in developing new medications. Many groundbreaking drugs start with basic research funded by the U.S. government, primarily through grants from agencies like the National Institutes of Health (NIH). These grants support the foundational science that eventually leads to new treatments, laying the groundwork for the development of innovative therapies.
Once this basic research has been completed, pharmaceutical companies conduct the clinical trials required by the Food and Drug Administration to prove that a drug is safe and effective. These trials can cost hundreds of millions of dollars and there is no guarantee that the outcome will be favorable. The drug companies risks millions of dollars in the hopes of bringing a blockbuster drug to market. But a blockbuster drug can be worth billions. AbbVie’s drug Humira for rheumatoid arthritis and other autoimmune diseases, generates annual sales of tens of billions of dollars.
Without federal funding for basic research, most of these drugs would never come to market. This partnership between public funding and private enterprise is a key driver of innovation in the pharmaceutical industry. But it also raises questions about how much companies should charge for drugs that were developed, in part, with taxpayer dollars.
The Debate Over Drug Pricing and Innovation
The pharmaceutical industry argues that high drug prices in the United States are necessary to fund the research and development of new medications that benefit people in the U.S. and throughout the world. That is, the exorbitant prices Americans pay for prescription drugs subsidize much lower drug prices in other countries. According to this view, lowering drug prices in the U.S. would reduce the incentive for big Pharma to invest in new drugs. Lower drug prices in the U.S., it is argued, would slow the pipeline of new drugs.
Critics argue that this idea needs to be revised. They point out that pharmaceutical companies are some of the world’s most profitable businesses. They spend significant sums on activities unrelated to drug development, such as marketing and executive compensation. Furthermore, they argue that other countries maintain robust pharmaceutical industries while paying much less for medicine.
Recent legislation enabling the federal government to negotiate drug prices directly addresses these concerns. By lowering drug costs, the government makes life-saving medications accessible to more patients without stifling innovation.
How Did We Get Here? The History of Drug Price Negotiation in the U.S.
To understand the significance of this new legislation, it’s important to look at the history of drug price negotiation in the United States.
Since 2006, the Department of Veterans Affairs (VA) has had the authority to negotiate drug prices directly with pharmaceutical companies. This power has allowed the VA to secure lower prices for the drugs it provides to veterans, making medications more affordable for millions who have served the country.
However, Medicare—the federal health insurance program primarily serving those aged 65 and older—had no authority to negotiate drug prices. This discrepancy stems from the 2003 Medicare Prescription Drug, Improvement, and Modernization Act, passed under a Republican-controlled Congress and signed into law by Republican President George W. Bush. This law’s “non-interference clause” prohibited Medicare from negotiating drug prices with pharmaceutical companies. This is the reason drug prices have soared in the U. S., placing a heavy financial burden on the government, seniors, and people with disabilities.
Landmark Legislation: The Inflation Reduction Act of 2022
The Inflation Reduction Act of 2022 marks a significant shift in U.S. prescription drug policy. For the first time, Medicare will negotiate directly with drug manufacturers, using its vast purchasing power to reduce the prices of the ten most expensive prescription drugs covered by Medicare, to start. The new negotiated prices will cut the list price of these drugs between 38% – 79%. This will save $1.5 billion in out-of-pocket costs in 2026 alone. According to the White House, “millions of seniors and others on Medicare will soon see their drug costs go down on some of the most common and expensive prescription drugs that treat heart disease, cancer, diabetes, blood clots, and more…The new prices will go into effect for people with Medicare Part D prescription drug coverage in 2026.”
This change goes beyond just cutting costs. It’s about ensuring that no American has to choose between buying groceries and filling their prescriptions.
"Claudia Tenney (R-NY24) voted against reducing drug prices for her constituents."
- Medicare Drug Price Negotiations: Starting in 2026, the Centers for Medicare & Medicaid Services (CMS) will be required to negotiate prices for the most expensive brand-name drugs under Medicare. The negotiations will focus on drugs without generic equivalents that cost Medicare the most.
- Scope of Negotiations: The CMS will negotiate the prices of a growing number of drugs each year, beginning with 10 drugs in 2026 and expanding to 20 drugs per year by 2029. The drugs will be among the top 50 in cost to Medicare.
- Manufacturer Compliance: Drug manufacturers must participate in these negotiations by providing cost information. If they don’t, they face significant financial penalties.
- Inflation Rebates: Drug manufacturers will pay rebates to Medicare if they increase the prices of brand-name drugs faster than the rate of inflation.
- Medicare Part D Changes: Starting in 2025, out-of-pocket expenses for Medicare Part D beneficiaries will be capped at $2,000 annually.
- Monthly Payment Option: Starting in 2025, Medicare beneficiaries can spread their out-of-pocket costs in monthly installments over the year.
- Insulin Cost Cap: Starting in 2023, the act caps out-of-pocket costs for insulin at $35 per month
- Free Vaccines: Vaccines, like those for flu and pneumonia, will be free. Co-pays are eliminated.
- Expanded Subsidies for Low-Income Seniors: Eligibility for full subsidies under Medicare’s low-income subsidy program will be expanded to 150% of the federal poverty line.
Altogether, the Inflation Reduction Act makes healthcare more affordable for older Americans by capping drug prices, lowering out-of-pocket costs, and providing additional financial protections against rising drug prices.
Here are the drugs that will have lower prices for Medicare part D recipients in 2026. The table below lists the drug name, the condition it treats, the number of Medicare enrollees taking the drug, the 2023 list price, the negotiated price, and the savings.
In 2025, the Inflation Reduction Act will also provide for a $2,000 cap on out-of-pocket spending. This will save 19 million beneficiaries $400 per year on average in addition to savings from the negotiated drug prices.
Republicans like Claudia Tenney voted against the Inflation Reduction Act. Tenney voted against lowering prescription drug costs, against capping out-of-pocket expenses to $2000, against $35 per month insulin cost, against free vaccines for seniors, and against expanded subsidies for low-income seniors.
The people in Tenney’s district need the assistance provided in the Inflation Reduction Act. The per capita income in her district is $39,924, well below the average income of $47,421 in New York State. One in five children in her district live in poverty and one in ten seniors.
Its incomprehensible that a representative would not vote to improve the lives of their constituents but by her “Nay” vote, that’s what Claudia Tenney did.