Lankford Tackles High Prescription Drug Costs for Seniors

WASHINGTON, DC - US Senator James Lankford (R-OK), a member of the Senate Finance Committee, introduced the Ensuring Access to Lower-Cost Medicines for Seniors Act with Senator Maggie Hassan (D-NH) to address a key driver of high prescription drug costs, especially for seniors on Medicare.

The legislation ensures patients benefit from lower-cost options instead of unnecessarily paying more due to pricing practices by pharmacy benefit managers (PBMs), the drug pricing middlemen. It establishes clear pricing tiers separating low-cost generics and biosimilars from higher-cost brand-name drugs to lower out-of-pocket costs, increase competition, and incentivize investment in the generic and biosimilar markets.

"Most Oklahomans and Americans assume a generic drug will be cheaper at the pharmacy counter, but that's not always the case because of broken pricing practices. That's not right," said Lankford. "My bill makes sure lower-cost generics and biosimilars are actually cheaper than brand-name drugs at the pharmacy counter. It's a simple, commonsense fix to put patients first and end these pricing gimmicks."

The Ensuring Access to Lower-Cost Medicines for Seniors Act requires:

• Medicare Part D to cover a generic drug or biosimilar if it costs less than its name-brand counterpart.
• Generic drugs or biosimilars to be placed on a generic and biosimilar-only formulary pricing tier and name-brand drugs to be placed on a brand-only tier, with the generic tier having a lower insurance cost-sharing requirement for patients than the name-brand tier.
• The creation of a new tier for specialty generics or biosimilars that would also have a lower insurance cost-sharing requirement for patients.

Background

Lankford has led efforts to remove barriers in the prescription drug market and hold pharmacy benefit managers accountable. Earlier this year, provisions he championed targeting PBMs were signed into law to lower costs and increase transparency.

He also led colleagues in urging HHS and CMS to protect seniors' access to affordable medications, pressed for PBM accountability in Senate Finance Committee hearings, and called on Senate leadership to act to lower drug costs and protect rural pharmacies.

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