Getting Ahead of Medicare Drug Price Reductions
Sharon Jhawar discusses the decision by SCAN, a Medicare Advantage plan, to drop co-pays to $0 or $11 on 13 drugs commonly used by seniors.
That plan is offered by the nonprofit SCAN Group to beneficiaries in California, Arizona, Texas and Nevada. About half of SCAN’s medications are on Medicare’s drug price negotiation list, which is made up of 10 single-source, brand-name drugs set to be negotiated with pharmaceutical companies, with prices effective Jan. 1, 2026.
Inflation across the U.S. has been going up dramatically. When we think about the average senior, they are living off $48,000 a year, and prescription medications play a huge role in how they live their life. We wanted to figure out where those additional opportunities are and invest there so we could truly try to help make over 65 be the golden years.
From an insurer’s perspective on the prescription side, before a consumer gets a medication, there’s like seven stops. From the manufacturer to the pharmacy dispensing it, there is too much cushion each step of the way, and the consumer is bearing the brunt of the cost. We just think that, because of the way the system works today, it’s our responsibility as an insurer not to wait a couple of years, or longer, for someone else like the government to step in.