FILE - Many booths advertised help with Medicare at the Senior Strut health fair inside Lloyd Hall on October 17, 2025. (Kimberly Paynter/WHYY)
From Philly and the Pa. suburbs to South Jersey and Delaware, what would you like WHYY News to cover? Let us know!
Common medications for diabetes, heart disease and cancer are about to get cheaper for thousands of Pennsylvania seniors with Medicare Part D prescription plans.
The lower prices for 10 brand-name medications negotiated between the federal government and drug companies will take effect starting Jan. 1.
Aging residents and advocates hope this will make prescriptions more accessible and affordable for seniors who live on low fixed incomes and find themselves choosing between their medications and other daily expenses.
“Our neighbors, loved ones, are being forced to make impossible choices,” said Bill Johnston-Walsh, state director at AARP Pennsylvania. “Imagine having to decide between filling your gas tank or filling a prescription. This is the stark reality for way too many Pennsylvanians.”
More than 455,000 older residents in the state take one or more of the drugs marked for price reductions, according to AARP Pennsylvania.
The 2022 Inflation Reduction Act enabled the Medicare insurance program for people 65 and older to negotiate medication prices directly with drug companies in an effort to reduce costs for seniors as well as the federal government.
The first 10 drugs negotiated under the new law included Eliquis, used to prevent blood clots; Januvia, commonly prescribed for diabetes; Imbruvica, a treatment for blood cancers; and others.
Together, these drugs accounted for $56.2 billion in Medicare Part D covered prescription drug costs in 2023, according to the Centers for Medicare and Medicaid. Meanwhile, enrollees paid another $3.9 billion for their out-of-pocket share of the medication costs.
The new negotiated lower prices vary by drug, but would have saved the government about $6 billion and enrollees another $1.5 billion had they been in place in 2023, federal estimates show.
Pennsylvanians with Part D plans who rely on these medications are expected to see their out-of-pocket costs drop by 53% on average in 2026, according to a new AARP report.
“That’s real relief for older adults who have been stretched to the breaking point by high drug prices for far too long,” said Nancy LeaMond, AARP’s executive vice president and chief advocacy and engagement officer.
Diana DeVito, 84, of North Strabane Township, Pennsylvania, said she knows all too well about the struggle to afford what can be lifesaving medications.
Several years after being diagnosed with chronic lymphocytic leukemia, DeVito was prescribed Imbruvica to keep the blood cancer from progressing.
“I almost had a heart attack when I saw the first co-pay,” she said.
Her Medicare insurance plan was getting billed about $19,000 a month for the drug. DeVito estimated that she ended up paying about $56,000 out-of-pocket over a five-year period.
“My husband once asked me, ‘What happens if people can’t afford this drug? I guess they just die,’” she said. “Unfortunately, many people do not get the treatment that they need and probably do not survive. And this stays with me.”
Imbruvica will have a new list price of $9,319 for a 30-day supply of the medication in 2026. It’s a decrease from prices in previous years, but still remains an expensive drug.
However, aging advocates say that a new 2026 annual cap on out-of-pocket costs for Medicare enrollees will help keep costs down. Once seniors hit a $2,100 maximum, they will not have to pay anything for covered medications for the rest of the year.
“I think that it gives us hope that things will get better and it gives us a chance to relax a little bit, not worrying how we are going to pay for these expensive drugs,” DeVito said.
Lower prices on another 15 medications that were selected for negotiation, including Ozempic, Trelegy Ellipta and Linzess, are scheduled to take effect in 2027.
Get daily updates from WHYY News!
Sign up