Medicare announced Friday that it had selected 15 drugs, including some very popular ones. Ozempic and Wigobyused for diabetes, weight lossas well as several blockbuster cancer drugs and other drugs, will enter a second round of price negotiations.
with first 10 drugs The Biden administration’s Medicare Drug Price Negotiation Program last year found that drugs now account for one-third of prescription drug spending in the government’s senior insurance program.
The prices negotiated in this second round of negotiations are expected to take effect in 2027. The Biden administration announced the following drugs on Friday:
Ozempic by Novo Nordisk. Libersus. Wegovy GSK’s Trelegy Ellipta Astellas and Pfizer’s Xtandi Bristol-Myers Squibb’s Pomalyst Pfizer’s Ibrance Boehringer Ingelheim’s Ofev AbbVie and Ironwood’s LinzessAstraZeneca’s CalquenceTeva’s Austedo. Breo Ellipta from Ørsted XRGSK Janumet from VraylarMerck from XifaxanAbbVie from TradjentaSalix from Boehringer Ingelheim. Janumet XRAmgen Otezla
Under the program’s timetable, drug companies have until February 28 to decide whether they want to remain covered by Medicare and Medicaid by participating in negotiations or facing higher taxes.
Nearly 2.3 million seniors enrolled in Medicare use semaglutide drugs under the brands Ozempic, Libersus, and Wigovy. novo nordisk. The drug received more than $14 billion in total coverage for the program last year, making it the most drug in this round, according to Medicare.
The next most expensive item was GSK’s asthma and chronic obstructive pulmonary disease drug Trelegy Ellipta, at about $5.1 billion. Approximately 1.25 million elderly people use the drug.
The White House says the first round of negotiations reduced the prices of some of Medicare’s most commonly used drugs by about 40% to 80% compared to list prices, but researchers say many We estimate that the actual savings on pharmaceuticals were significantly lower. These reduced prices will apply from next year.
President Biden is promoted the programCreated by inflation control law he signed into law in 2022, as one of the signature achievements of his term.
The drug company is seeking a halt to the process in court. Industry groups and Republicans have criticized the pricing system as unfair and stifling innovation.
Dispute over weight loss drug coverage
The new round of negotiations is being advanced by the Biden administration as follows. was also suggested Expand Medicare coverage to weight loss drugscurrently not allowed. It will be up to the incoming Trump administration to decide whether and how to finalize this move.
Medicare officials say the negotiated prices for these drugs would also apply to their use in obesity treatment if the incoming Trump administration decides to move forward with the proposed rule.
“Many in the health care industry now view obesity as a disease in itself, and that drove our decision-making. It’s the role of Medicare and Medicaid to cover the health care services that people need.” Centers for Medicare and Medicaid Services Director Chiquita Brooks-LaSure told CBS News.
A Novo Nordisk spokesperson said the company remains opposed to the talks, which it is suing to have over, and pledged to “work with the incoming administration” to address concerns.
“We are therefore deeply concerned about pricing processes that could negatively impact patients’ ability to access medicines and inhibit future scientific development of life-changing medicines,” the spokesperson said in a statement. mentioned in.
The drug company also criticized Medicare for grouping Wegovy, Ozempic, and Libersus together, arguing that each company was not entitled to participate in drug negotiations individually. “The law is very clear,” Brooks Rasul said, defending Medicare’s move to group the three.
“Wegoby, Ozempic, they all have the same active ingredient. That’s how the law was written and that’s what we implemented,” she said.
Can President Trump change or stop the process?
It’s unclear whether President-elect Donald Trump will try to change the drug of choice after taking office or cancel the talks. in Campaign trajectoryhe often vowed not to Medicare cuts After the Democrats tried to tie him to something. “Project 2025” suggestion Cancel the program.
Biden administration officials told reporters Thursday that the process of selecting drugs for use in the negotiation program is limited by law passed by Congress.
The law essentially requires Medicare to create a list of drugs covered by the program and then select those drugs. drugs They account for the top 15 Part D expenditures.
“That process, again, is clearly defined in the law. Policy makers don’t have the ability to say they like this drug better than that drug. The whole process depends on these data. based on this,” the official said.
A spokesperson for the president-elect did not respond to a request for comment.
Brooks Rasul said most of the staff working on the negotiation program are career staff who run negotiations, not political appointees who leave during the transition period.
“There’s a tremendous amount of technical information that goes around during negotiations, but it’s primarily done by the people who remain here,” Brooks Rasul said.
“We need to understand the cost of prescription drugs in this country, and it’s important that Medicare and CMS staff negotiate lower prices. It’s important for the people taking the drugs, and it’s important for the entire Medicare program. “It’s very important to us. We want to make sure this program is there for us and for our children,” she said.
Which drugs were chosen in the first round?
The Biden administration announced 10 drugs selected for the first round of the Medicare Drug Price Negotiation Program in August 2023, with an agreement reached in August 2024.
The negotiated price will take effect in 2026. The target medicines are as follows.
Merck Sharp Dohme’s Janubia Novo Nordisk’s Fiasp and Novolog Astrazeneca’s Facegeimnex’s Enbrel Boehringer Ingelheim’s Jardiens Janssen’s Stellara Janssen Charelt Bristol-Myers Squibb’s Eliquis Novartis’ Entresto Pharma Cyclic’s Imbruvica
CMS estimated last year that program-negotiated savings would save beneficiaries about $1.5 billion and the Medicare program about $6 billion.
