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HHS Unveils Fresh Data Revealing Over 10 Million Medicare Beneficiaries Received Complimentary Vaccines Under President's Initiative to Curb Inflation | US Healthcare News | iPharmaCenter

More than 10 million individuals enrolled in Medicare Part D received no-cost vaccines in 2023 due to the Inflation Reduction Act, a significant increase from the 3 million recipients in 2021.


President Biden's legislation aimed at reducing prescription drug expenses, dubbed the Inflation Reduction Act, is aiding millions of seniors and families in cutting down healthcare and prescription costs. This law confronted major pharmaceutical companies to enable direct negotiations between Medicare and participating drug manufacturers for covered prescription drugs, capped insulin prices at $35 for seniors, and made recommended vaccines free for Medicare Part D participants. Today, the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a fresh report indicating that in 2023, over 10 million Medicare Part D beneficiaries benefited from cost-free vaccines under the legislation – a stark rise from the 3.4 million individuals receiving covered vaccines in 2021.


Effective January 1, 2023, the Inflation Reduction Act eradicated cost-sharing for all adult vaccines covered under Part D that are endorsed by the Advisory Committee on Immunization Practices (ACIP). In 2021, 3.4 million people received vaccines under Part D, and the annual out-of-pocket expenses amounted to $234 million. In comparison to the 2021 ASPE vaccine utilization data, the latest 2023 data depicts significant increases in vaccine usage, resulting in millions of dollars in reduced out-of-pocket costs for seniors:


In 2023, approximately 3.9 million Medicare enrollees received shingles vaccines, up from about 2.7 million in 2021, marking a rise of over 42 percent.

Nearly 1.5 million Medicare enrollees received Tdap vaccines in 2023, compared to about 700,000 enrollees in 2021, indicating an increase of over 112 percent.

Furthermore, RSV vaccines, newly recommended for adults aged 60 and above in consultation with their healthcare provider in June 2023, were accessed by 6.5 million Medicare Part D enrollees free of charge in 2023.


Today, the Centers for Medicare & Medicaid Services (CMS) also issued preliminary guidelines for public feedback on the second phase of negotiations under the Medicare Drug Price Negotiation Program (Negotiation Program). The negotiations concerning the initial set of 10 prescription drugs are progressing successfully, and this second phase of negotiations will include up to 15 additional drugs chosen for negotiation, enhancing access to innovative, life-saving treatments for Medicare beneficiaries and reducing costs for Medicare and taxpayers. In accordance with the law, CMS will announce up to 15 additional drugs selected for potential negotiation for 2027 by February 1, 2025. This second round of negotiations will take place during 2025, and any negotiated maximum fair prices will be effective for this second set of drugs beginning January 1, 2027.


The Biden-Harris Administration has made the reduction of prescription drug expenses and enhancement of access to innovative therapies a top priority. The preliminary guidance released today outlines the requirements and parameters for the second phase of negotiations, which build upon the policies established in the revised guidance for the initial negotiation cycle.


Additionally, CMS is introducing policies detailing how manufacturers must ensure that eligible Medicare beneficiaries have access to the negotiated maximum fair prices for 2026 and 2027, including the procedures applicable to drug companies, Medicare Part D plans, pharmacies, mail-order services, and other dispensing entities providing drugs covered under Medicare Part D. CMS will collaborate with a Medicare Transaction Facilitator (MTF), which will serve as the infrastructure aimed at facilitating data exchange between pharmaceutical supply chain entities to verify the eligibility of an individual receiving a selected drug at its negotiated maximum fair price.


CMS is also seeking feedback on options for the MTF to support the optional facilitation of retrospective payments from participating drug companies to participating dispensing entities to aid in ensuring access to the negotiated maximum fair price for Medicare prescription drug coverage recipients.

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