PLASMA Act

New Medicare discounts for plasma drugs

If enacted, this bill would change how Medicare Part D sets the "discounted price" for certain plasma-derived drugs. It would apply only to biological drugs made from human whole blood or plasma that were marketed by August 16, 2022 and dispensed to a Part D beneficiary. Starting in 2026, the discounted price would be a fixed percent of the plan's negotiated price. For beneficiaries who have not met the Part D out-of-pocket threshold the percent would be: 2026—99%; 2027—98%; 2028—95%; 2029—92%; 2030 and later—90%. For beneficiaries who have met the threshold the percent would be: 2026—99%; 2027—98%; 2028—95%; 2029—92%; 2030—90%; 2031—85%; 2032 and later—80%. The phase-in would not apply to drugs for low-income subsidy (LIS) beneficiaries or to drugs from certain small manufacturers.