Medicare Drug Price Negotiation Program Guidance

Dear Administrator Seshamani:
The National Hispanic Council on Aging (NHCOA) urges you to reconsider your released implementation guidance for the Drug Price Negotiation Program within the Inflation Reduction Act (IRA). This program adversely impacts medical innovation and access to critical medicines relied upon by countless seniors under Medicare Part D. Minority communities, including Hispanic seniors, would unduly suffer as a result of fewer medical breakthroughs. The IRA’s price-setting program works against the scientific community’s charge in bringing about new medicines that help underserved communities overcome barriers to higher-quality healthcare. As an organization dedicated to the well-being of older Hispanic Americans, our concerns with CMS’ implementation of the IRA are numerous.

For one, the guidance fails to take into account the health equity learnings in recent years. As we emerged from the COVID-19 pandemic, the unique health challenges faced by minority communities were made evident to many. In 2022, NHCOA conducted a poll of Black and Hispanic voters in which we found that half of voters of color experience barriers to care when it comes to our healthcare¹. Price setting provisions in the IRA would drastically disincentivize innovations in medicines, which can be helpful in overcoming barriers to care for certain conditions. Our country must work hard to ensure that minority communities, including Hispanic seniors, are able to better access the medicines they need. This guidance does not provide details on how it would remove barriers to care.

In addition, the language surrounding Medicare Part D, in particular, would greatly harm Hispanic seniors enrolled in the program. By artificially mandating drugs to be sold at a certain price, the ability of manufacturers to produce at levels to meet critical demands would be significantly strained. With fewer incentives to invest in innovation, research and development efforts would be reined in, and Medicare beneficiaries would ultimately have fewer treatment and therapy options available to them.

This disruption of Medicare Part D, as outlined, demonstrates a failure to recognize the true ways we can address the challenges older Hispanics face when it comes to healthcare. Our government ought to ensure that drug middlemen pass discounts and rebates to patients, that copay accumulators are eliminated, and that PBM price hiking practices are thwarted. If we are serious about helping seniors afford their treatments, implementing these meaningful solutions would be prioritized.

Once again, we urge you to reconsider the elements of this guidance and take into consideration the potential consequences it will have on communities of color, especially seniors. We urge you to work closely with stakeholder and patient groups to find ways to truly explore solutions to address the barriers to care in the healthcare system, particularly those of communities of color and older adults.