Washington, D.C. — Today, Congresswoman Annie Kuster (D-NH), alongside Reps. Mariannette Miller-Meeks, M.D. (R-IA), Doris Matsui (D-CA), and Neal Dunn, M.D. (R-FL), introduced legislation to ensure that patients can access lower-cost medications through their insurance coverage. Their Ensuring Access to Lower-Cost Medicines for Seniors Act will expand options for Medicare Part D beneficiaries by making more lower-cost generic and biosimilar drugs available.

Full bill text is available here.

“For too long, our seniors have been taken advantage of at the pharmacy counter and have been overcharged for name-brand medications when there are generic alternatives,” said Congresswoman Kuster. “I am proud to introduce this legislation to expand generic drug options for Medicare Part D beneficiaries and lower costs across the board.”

“Complex drug pricing antics obscure the marketplace leading to increased costs of medications instead of providing affordable lifesaving medications for patients,” said Congresswoman Miller-Meeks, M.D. “I am proud to join Congresswoman Kuster on the Ensuring Access to Lower-Cost Medicines for Seniors Act, which guarantees that seniors have access to lower-cost alternatives to expensive branded drugs.”

“For far too long, discriminatory incentive structures between manufacturers, middlemen, and insurance companies have driven up costs for seniors at the pharmacy counter,” said Congresswoman Matsui. “Generic and biosimilar drugs should stay predictably less expensive – with no behind-the-scenes, opaque pricing schemes. The Ensuring Access to Lower-Cost Medicines for Seniors Act puts patients first and ensures that seniors have the transparency and peace of mind to access the vital medications they need.”

“It is critical for seniors to have robust access to generic and biosimilar medicines. Many seniors in my district are struggling with inflation,” said Congressman Dunn, M.D. “The more money they save, the better. This common-sense bill will allow safe, effective, and lower cost medicines to be readily available on Medicare Part D plans.”

“We commend Congresswoman Kuster for introducing the Ensuring Access to Lower-Cost Medicines for Seniors Act. This legislation would ensure that patients have access to new generics and biosimilars and that patients do not spend more than necessary for low-cost generics. Further, the legislation would encourage head-to-head price competition and lower list prices that would benefit patients, taxpayers, and employers alike,” said David Gaugh, Interim CEO and President of the Association of Accessible Medicines, and Craig Burton, Executive Director of the Biosimilars Council.

“This bipartisan legislation is critical to delivering much-needed savings—through true competition—to patients at the pharmacy counter through lower copays, lower list prices, and lower cost sharing.  Biosimilar medicines have the potential to reduce the price of some of America’s most expensive medicines and save the government billions. This legislation is vital in meeting those needs and demands,” said David Sanders, Vice President of Government Affairs and Policy at Coherus BioSciences.

Biosimilar and generic drugs have huge potential for consumers to save money on their prescription drugs. There are FDA estimates that generic drugs can cost anywhere from 20% to 70% less than the brand-name/reference drug. This bill will ensure that these lower-cost options are available to seniors through their Medicare Part D coverage.

Specifically, the Ensuring Access to Lower-Cost Medicines for Seniors Act will: 

• Require Part D insurers to include generic and biosimilar drugs in a preferred position if: 
• The wholesale acquisition cost (WAC) is lower for the generic than the reference drug, or;
• The WAC is less for the biosimilar than the reference drug; and 
• Prohibit limitations on formulary access through utilization management such as step therapy and prior authorization.

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