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Senators Lobby to Protect Patient Access to Advanced Prescription Medications

Washington, D.C.—The Centers for Medicare & Medicaid Services (CMS) are facing opposition from Republican members of the U.S. Senate Finance Committee. These senators, led by Ranking Member Mike Crapo (R-Idaho), have addressed a letter to Administrator Chiquita Brooks-LaSure. They expressed concerns about the new rule proposed by CMS to alter Medicaid Drug Rebate Program (MDRP) operations in ways that don’t offer significant benefits for patients.

Senators’ Concerns about New Rule Proposal

The senators argue that many of the proposed changes defy the established statutory understanding and could impose costly obligations. This could create budgetary uncertainty for states and risk patient access to innovative therapies and cures. They caution against certain provisions of the proposal, including the “stacking” to determine the “Best Price” benchmark, as it could cause technical complications and compromise the policy’s key objectives by deterring larger price concessions.

Critique on Lack of Patient-Oriented Justification

Critically, the senators highlight the absence of a focused justification for patients in the proposal’s price verification survey. They note that the proposed rule aims to establish a survey process for certain “high cost” covered outpatient drugs, like cell and gene therapies, rather than addressing the access barriers flagged by states, patients, and providers.

The senators conclude their letter by urging CMS to maintain the MDRP’s statutory balance in line with Congress’s intent by retracting the misguided proposals that risk disrupting patient care. They offer their collaboration to improve the Medicaid program so that patients can continue to have access to cutting-edge, life-altering prescription drugs.

Signatures on the Letter

The letter is supported by Senators John Cornyn (R-Texas), John Thune (R-South Dakota), Tim Scott (R-South Carolina), James Lankford (R-Oklahoma), Steve Daines (R-Montana), Todd Young (R-Indiana), John Barrasso (R-Wyoming), Ron Johnson (R-Wisconsin), Thom Tillis (R-North Carolina) and Marsha Blackburn (R-Tennessee).

Read the full letter here or below: