S. 2756: Affordable Inhalers and Nebulizers Act of 2025
The Affordable Inhalers and Nebulizers Act of 2025 aims to reduce the out-of-pocket costs associated with inhaler products used by patients suffering from breathing disorders, including asthma and chronic obstructive pulmonary disease (COPD). The key aspects of the bill include provisions related to insurance coverage, cost-sharing limits, and a payment program for uninsured individuals.
1. Coverage Requirements
The bill mandates that group health plans and health insurance issuers provide benefits for specified inhaler products, including maintenance and rescue inhalers and related equipment used for administering these medications. The coverage must meet the following criteria:- **No Deductibles:** Insurance plans cannot impose a deductible on the specified inhaler products.- **Cost-Sharing Limit:** The cost-sharing requirement cannot exceed $15 for a 30-day supply of these products.2. Counting Costs Towards Deductibles and Out-of-Pocket Maximums
Any out-of-pocket costs incurred by patients under the mandated cost-sharing provisions must count towards the overall deductible and out-of-pocket maximums for the insurance plan, ensuring that patients' payments do not exceed regulatory limits.3. Definition of Specified Inhaler Products
The bill defines "specified inhaler products" to include a wide range of inhalation drugs such as:- Inhalation aerosols- Metered dose inhalers- Dry powder inhalers- Inhalation solutions- Bronchodilators- CorticosteroidsIt also covers necessary equipment for administration, such as nebulizers and spacers.4. Medicare Adjustments
The bill modifies Medicare coverage as follows:- **Part B:** For specified inhaler products provided on or after January 1, 2026, Medicare will pay 100% of the costs, minus the $15 copayment.- **Part D:** Similar stipulations apply, including no deductible for specified inhaler products and a maximum copayment of $15.5. Payment Program for Uninsured Individuals
To support uninsured individuals, the bill establishes a payment program where providers can submit claims for specified inhaler products. The Secretary of Health and Human Services will reimburse these providers, ensuring that uninsured patients do not have to pay more than $15 for a month’s supply of inhaler products.6. Effective Date
The provisions of the bill are set to take effect for plan years beginning on or after January 1, 2026.Relevant Companies
- PFE (Pfizer Inc.): As a manufacturer of respiratory medications, Pfizer could see changes in demand and purchasing behavior for their inhaler products.
- NVS (Novartis AG): Similar to Pfizer, Novartis may experience impacts on its inhaler product offerings due to changes in patient affordability and insurance coverage.
- GSK (GlaxoSmithKline): This company produces a number of inhalation treatments and could be affected by the bill's provisions regarding cost-sharing and accessibility.
- BIOX (Bioxiness Inc.): A smaller player in the inhaler market, any changes in the legislative landscape could either present opportunities or challenges in their market strategy.
This is an AI-generated summary of the bill text. There may be mistakes.
Sponsors
2 bill sponsors
Actions
2 actions
| Date | Action |
|---|---|
| Sep. 10, 2025 | Introduced in Senate |
| Sep. 10, 2025 | Read twice and referred to the Committee on Finance. |
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