10 expensive prescription drugs will cost less under Medicare

[MUSIC PLAYING] CATHY WURZER: This morning, we learned that a set of popular and expensive prescription drugs will soon cost less under Medicare. The Biden administration announced that Medicare has negotiated with drug companies for discounts between 38% and 79%. Patients taking 10 different drugs for common conditions, including diabetes, heart disease, and rheumatoid arthritis, will start to see lower costs, starting in 2026, when the new prices go into effect.

The state of Minnesota also has a new board created to bring down the cost of some drugs. Jessica Intermill is one of the patient representatives on the board's advisory council, and she's testified before the state legislature about the impact of expensive treatments for rheumatoid arthritis on her own life. And she's on the line. Jessica, thank you for taking the time.

JESSICA INTERMILL: Thank you so much, Cathy. It's great to join you.

CATHY WURZER: Likewise. Thanks for being with us. I think we should start with your own personal story for a few minutes. How does having rheumatoid arthritis affect your day-to-day life.

JESSICA INTERMILL: Well, my story started when I was a healthy 31-year-old. My husband and I decided to have children. And just about four weeks into our pregnancy, something went wrong. My fingers started hurting. My joints started swelling. Every day got just a little bit worse until one day I couldn't even make a fist.

So I was about seven months pregnant when I saw my first rheumatologist. And by then, my disease was so bad that he took just one look at me from across the room and told me that I have rheumatoid arthritis. I went home. I cried. 22 days later, I delivered our child.

And I have required care for every day of the 12 years since because if I don't have the medications that I need, I can't turn a key in a lock. I can't stand long enough to make dinner for my family. And I can't be the Minnesotan that I want to be, who is a small business owner and a mom and a neighbor.

CATHY WURZER: Hm. So what drugs are you taking right now for rheumatoid arthritis?

JESSICA INTERMILL: My list is about a dozen long, but the one that is the really big-ticket spender is Actemra. And that one, it is-- its wholesale price, if it doesn't have any discounts, is a little over $9,000 per month. And with insurance, the drug company only charges my insurance company about $4,000 per month, which works out to be about $150 per day at an insured rate.

CATHY WURZER: Hm. And you have private insurance.

JESSICA INTERMILL: I do.

CATHY WURZER: You're too young for Medicare at this point. Right.

JESSICA INTERMILL: Yep.

CATHY WURZER: So what do you think the impact of today's announcement for Medicare recipients who are on some of the drugs you're on or the other drugs under this new agreement-- how much might this affect them?

JESSICA INTERMILL: Honestly, Cathy, when I heard that the Congress had passed the law to be able to negotiate prices with Medicare-- and let's just pause on that for a bit, that Medicare, the largest purchaser of prescription drugs in the country, could not even ask for a lower price than what the manufacturer set. When I heard that Congress allowed that, I actually cried because even though I'm about 20 years from Medicare eligibility, what that means is that, as a taxpayer, I don't have to pay the ransoms that prescription drug companies charge for Americans to live their lives.

CATHY WURZER: Hm. I'm wondering, for an individual like yourself, who pays with private insurance, somewhere along the line, I wonder if there could be some indirect effects of these price cuts on what you are paying.

JESSICA INTERMILL: Well, absolutely. When we were testifying at the Minnesota legislature about the Prescription Drug Affordability Board, the prescription drug manufacturers would say, well, we set these crazy, bonkers-high prices, but that's just a starting point. And then you have these pharmacy benefit manufacturers that negotiate lower prices. And of course, insurance companies come in, and they demand lower prices. And so really, that's just these astronomical prices are just a starting point.

Well, now that Medicare has said, OK, we're coming down from that starting point, if I'm a consumer or a large employer who is working with a pharmacy benefit manufacturer and my insurance company, I'm going to say, OK, step up. It's time for you to negotiate lower prices for our members too, so that, even when they're privately insured and not Medicare-eligible, other consumers, other Minnesotans, can access those price savings.

CATHY WURZER: By the way, for folks not familiar-- and I was trying to remember, if I recall the debate around the Prescription Drug Affordability Board, what does it have the power to do exactly?

JESSICA INTERMILL: So the Prescription Drug Affordability Board just was passed in 2023. And what the board can do is it's empowered to look at a set of drugs and say these prices are just not reasonable and they can set upper payment limits on drugs that are specifically priced out of whack with what the market is.

And there's a companion Prescription Drug Affordability Council, Advisory Council, that I sit on. It will bring consumer perspectives, industry perspective. All of these different players can put direct input into that process so that, really, all across the table, we can have Minnesota industries, Minnesota consumers, other interests like large employers, small employers-- we can all talk about what, so far, we just hadn't talked about. And that's that these prices are so tremendous.

They are such a huge sector of health care spending that it's not just about what each person pays for their own drug. It is what every Minnesotan pays in our premiums and in our deductibles and in our insurance industry just to be able to afford healthy life.

CATHY WURZER: I'm going to make an assumption here, Jessica, that the drug companies probably not excited about the Prescription Drug Affordability Board. Can they challenge the authority in court, do you know?

JESSICA INTERMILL: I am certain that they will, and they actually might already have. They certainly-- if I was making gajillions of dollars, billion over a billion per day, I wouldn't like this law, either. And I can tell you that, as a Minnesotan, I want everybody to be able to afford their lives because I need those people in my life.

I need my mom and my dad. I need my husband. I need my daughter. I need the person at the grocery store to be healthy to sell me food. I need all of these people in place. And it's much more important to me that people are able to afford these drugs and that they are reasonable than it is that out-of-state and even international corporations make billions and billions of dollars.

CATHY WURZER: Say, before you go, your experience here advocating for yourself-- what are the lessons that you've learned as being an advocate that you might want to pass on to others?

JESSICA INTERMILL: I think I can tell you that people who have power and people who have money and corporations that have power and money don't like to give it up. But when we have elected leaders who are listening to people instead of corporations, we are able to make really tremendous change that makes real impacts for Minnesotans and Americans.

CATHY WURZER: Say, and final question, how are you feeling?

JESSICA INTERMILL: I am doing really well. When I'm able to access my medication, it can be under control. It can be in remission. And I so appreciate your asking because when I have these medications, I am able to advocate for myself, for others, and be a mom to my kiddo.

CATHY WURZER: Jessica, thank you. Best of luck. I appreciate your time.

JESSICA INTERMILL: Thank you so much, Cathy. Take care.

CATHY WURZER: You too. Jessica Intermill is a patient representative on Minnesota's new Prescription Drug Affordability Advisory Council.