The Next 15 Drugs for Medicare Price Negotiations
In a landmark move aimed at reducing prescription drug costs, HHS has announced the new drugs for price negotiations. The list contains 15 drugs. This initiative, part of the Inflation Reduction Act (IRA), represents another step toward making life-saving medications more affordable for millions of Medicare beneficiaries.
What started the Medicare drug price negotiations
In the past, Medicare was prohibited from negotiating drug prices directly with pharmaceutical companies. However, in 2022 the IRA was signed into law and Medicare gained the authority to negotiate prices for some specific high-cost drugs covered by Medicare Part B and Part D. The object of this program is to lower out-of-pocket medication costs for beneficiaries and reduce healthcare spending.
The list of drugs for the second cycle of negotiations:
- Ozempic, Rybelsus, Wegovy
- Trelegy Ellipta
- Xtandi
- Pomalyst
- Ibrance
- Ofev
- Linzess
- Calquence
- Austedo, Austedo XR
- Breo Ellipta
- Tradjenta
- Xifaxan
- Vraylar
- Janumet, Janumet XR
- Otezla
More about the negotiations
The second cycle of the price negotiations allow drug companies with a selected drug until February 28, 2025 to make the decision weather or not to participate. CMS will consider the clinical benefits of the selected drug. It will also take into consideration how it meets medical needs as well as it’s impact on specific populations. CMS also considers the manufacturers’ Costs for research, development, production and distribution.
The first 10 drugs
The first 10 drugs chosen for negotiations were announced by the Dept. of HHS in August 2023. During the first cycle of negotiations, Medicare reached an agreement with the drug manufacturers on all 10 of the drugs. The new lower prices for those drugs is due to go into effect as of January 1, 2026.
The negotiated rates for the first 10 drugs will be between 38 to 79 % less than their current list prices. In 2026, could save Medicare beneficiaries about $1.5 billion in out of pocket costs.
Watch a quick YouTube video on the$2,000 drug cap
Moving forward, CMS plans to choose 15 more drugs in the third cycle of negotiations. After the third cycle, they plan to choose as many as 20 additional drugs for the subsequent cycles.
Leave a Comment