The Biden administration on Friday unveiled the next round of prescription drugs selected for Medicare price negotiations, including Ozempic, a blockbuster diabetes drug also used for weight loss. The drug has faced public backlash over its high price, spurring demand for cheaper alternatives.
The list includes 15 drugs, up from 10 last year, and is the first step in a negotiation process between Medicare and drugmakers that is expected to take place in the coming months. The new negotiated prices will not take effect until 2027.
Still, deliberations under the Inflation Reduction Act of 2022 face an uncertain future under the incoming Trump administration, which has remained mum on whether it supports the administration's plan.
The drugs chosen for negotiation are:
Juliette Cubanski, deputy director of the Medicare Policy Project at KFF, a nonprofit organization that studies health policy issues, said the risk for the government to reach a good deal this year is high.
A KFF survey released Friday found that more than half of the public said expanding the number of prescription drugs up for negotiation is a "top priority," including nearly half of Republicans.
Ozempic and similar drugs are in high demand, and costs to taxpayers are expected to increase as Medicare begins to cover FDA-approved drugs for other uses, such as heart disease risks. (Currently, Medicare prohibits coverage of weight-loss drugs.)
"Bringing a hard bargain to the bargaining table could save Medicare billions of dollars in the coming years," Cubanski said.
Drugmakers will have more than a month to agree to participate in negotiations or risk tax penalties. The only way to avoid the tax is to remove the drug from Medicare plans entirely, a move that would cost them huge market share.
A spokesman for Novo Nordisk, the maker of Ozempic and Wegovy, said in a statement that the drugmaker remains opposed to pricing talks. Nonetheless, the spokesperson said it would work with the incoming administration to "deliver meaningful solutions for patients."
About 5.3 million Medicare beneficiaries used these drugs between Nov. 1, 2023, and Oct. 1, 2024, according to the Centers for Medicare and Medicaid Services.
The 15 drugs selected collectively account for $41 billion, or 14%, of total Medicare Part D spending. Combined with the top 10 drugs that Medicare has negotiated, they account for one-third of all Part D spending, according to CMS data. Medicare Part D covers prescription drugs that people take on their own rather than in a facility, such as chemotherapy.
"We have an opportunity to negotiate a better deal for the American people," outgoing Health and Human Services Secretary Xavier Becerra said in a call with reporters. "This is a big deal. Some people have to put it into perspective." Halve the pills or skip a dose in the prescription to extend the validity of the prescription."
Last year, Medicare reached a deal to lower prices on 10 of the most expensive drugs. These include Eliquis, a blood thinner; Imbruvica, a blood cancer treatment; and NovoLog, a diabetes drug.
The new prices for these drugs will take effect in 2026.
Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee, said getting Ozempic included this year is "a big deal."
"This has significant budgetary implications for Medicare beneficiaries, Part D programs and taxpayers because over time it could significantly expand the use of these drugs among Medicare beneficiaries," Dusetzina said. “If eligible beneficiaries begin using these products to lose weight, this could result in increased premiums because these products require long-term use."
The pharmaceutical industry has vigorously fought the plan through lawsuits, but so far without success.