What Myeloma Patients Should Know About Pomalyst and Medicare Price Negotiations
The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) recently announced the selection of an additional 15 drugs for Medicare Part D price negotiations, including Pomalyst (pomalidomide). This development is significant for the myeloma community, as Pomalyst plays a critical role in treating relapsed or refractory multiple myeloma.
By Danielle Doheny
IMF Director of Public Policy and Advocacy
Here’s what this could mean for myeloma patients:
1. Important Steps Toward Affordability
Starting in 2025, Medicare beneficiaries will benefit from a $2,000 annual cap on out-of-pocket costs under Part D, providing much-needed financial relief. However, Pomalyst’s inclusion in price negotiations primarily reflects its significant cost within the Medicare program and the broader effort to reduce overall Medicare spending.
For myeloma patients who face high treatment costs, these measures could help alleviate financial strain, but the most immediate impact will likely be on Medicare’s budget
2. Ensuring Access to Life-Saving Treatments
While affordability is critical, it’s equally important to ensure that price negotiations do not unintentionally affect access to vital treatments. Pomalyst is a cornerstone therapy for many patients, and any changes must safeguard its availability for those who need it most.
This has been a controversial debate. As discussions about drug pricing have folded out, some experts have expressed concern about potential impacts on innovation and access to new therapies. While other analysts disagree with this assertion, pointing to the potential for negotiated pricing to balance affordability and access, the myeloma community will be watching closely to ensure that patient needs are protected.
3. What This Means for Myeloma Patients
Negotiations for Pomalyst and other selected drugs will begin in 2025, with new prices expected to take effect in 2027. While this process represents a significant effort to address rising costs, the outcomes could shape how therapies are covered and accessed under Medicare.
The myeloma community can trust that the International Myeloma Foundation (IMF) will continue advocating for policies that prioritize patient needs—ensuring affordability without compromising access to life-saving therapies like Pomalyst.
Looking Ahead
The inclusion of Pomalyst in this latest round of Medicare drug price negotiations reflects the critical role it plays in treating multiple myeloma and its substantial impact on Medicare spending. As the process moves forward, the IMF will remain committed to advocating for balanced policies that protect patients’ ability to access essential treatments while also addressing the financial burden they face.
If you have any questions or concerns, the IMF is always ready to help. Please feel free to reach out to our world-renowned IMF InfoLine team by emailing [email protected] or by calling 1-800-452 CURE (2873) (U.S. and Canada), or 1(818) 487-7455 (Worldwide).
Together, we can navigate these changes and ensure that the needs of the myeloma community remain front and center.
About Danielle Doheny
Danielle Doheny is the Director of Public Policy and Advocacy for the International Myeloma Foundation (IMF). She joined the IMF after a six-year career on Capitol Hill where she worked as an adviser to two members of Congress. As a Congressional staffer, Danielle’s primary focus was on healthcare and issues related to energy, the environment, science, and technology. In her role with the IMF, she advocates on behalf of the multiple myeloma community to the executive and legislative branches of the federal government. Danielle’s father is a multiple myeloma patient, and she has a unique passion for her work on behalf of patients and their families. Danielle graduated cum laude from Thiel College with a Bachelor of Arts degree in History.
