Marshall Legislation Tackles Prescription Drug Prices, Encourages New Treatments

(Washington, D.C., June 23, 2021) – U.S. Senator Roger Marshall, M.D. joined his colleagues in reintroducing the Lower Costs, More Cures Act (LCMCA) to lower prescription drug prices, bring greater transparency to the prescription drug industry, and encourage American ingenuity in the development of new treatments and cures. The legislation comes on the heels of President Biden recently signing into law Senator Marshall’s bipartisan bill to lower prescription drug prices, the Ensuring Innovation Act.

“Congress must pass legislation that will lower out-of-pocket patient spending, provide access to life-saving medicines, increase transparency and champion competition,” said Senator Marshall.  “The Lower Costs, More Cures Act strikes the right balance of improving access to medicine while encouraging innovators to be pioneers and develop the next breakthrough treatments and cures.  Both sides of the aisle can agree that this is a big win for American health care, and I look forward to these life changing solutions becoming law.”

Senator Mike Crapo (R-Idaho) and Richard Burr (R-North Carolina)led the legislation alongside Senators Marshall, Steve Daines (R-Montana), Tim Scott (R-South Carolina), Jim Risch (R-Idaho), Thom Tillis (R-North Carolina), and Joni Ernst (R-Iowa).

The Lower Costs, More Cures Act, among other things, would:

  • Modernize payments for drugs delivered in the doctor’s office under Medicare Part B;
  • Incentivize lower-cost alternatives, or biosimilars;
  • Establish an annual out-of-pocket cap of $3,100 for Medicare Part D enrollees and allow certain patients to pay in monthly installments;
  • Decrease beneficiary cost sharing from 25 percent to 15 percent of costs before the out-of-pocket cap is reached;
  • Allow prescription drug plan sponsors to offer, at minimum, up to four Part D plans per region, spurring competition and innovation;
  • Make permanent the Center for Medicare and Medicaid Innovation model that enables Part D enrollees taking insulin to limit out-of-pocket costs to $35;
  • Allow state Medicaid programs to enter in outcomes-based agreements to pay for life-saving gene therapy treatments;
  • Provide the HHS Secretary with the authority to require drug manufacturers to provide pricing information on all direct-to-consumer advertising;
  • Codify a Trump Administration regulatory action that classifies insulin and other treatments for chronic conditions as preventative care so that high deductible health plans can cover costs before the patient reaches the deductible; and
  • Create a trade negotiator solely dedicated to putting American patients first in government trade negotiations related to medicines in order to prevent foreign free-loading off America’s investment.

Full text of the LCMCA can be found HERE, and a section-by-section can be found HERE.