A box of Ozempic and its contents sit on a table in Dudley, North Tyneside, England, on October 31, 2023.
George Frey | Reuters
The Biden administration on Friday unveiled the next 15 prescription drugs that will be subject to price negotiations between manufacturers and Medicare, launching the second phase of a landmark process to make older adults Expensive medications are more affordable.
Topping the list is Novo NordiskBlockbuster diabetes injection Ozempic, weight loss injection Wegovy and diabetes drug Rybelsus are all considered to be among the products under negotiation Because they all have the same active ingredient: semaglutide. These treatments have fueled the booming obesity market, but are difficult for patients to access due to cost, insurance coverage and supply constraints.
Agreed prices for the second wave of medicines are scheduled to come into effect in 2027.
Here are 15 drugs in preliminary negotiations this year:
President Joe Biden's Inflation Lowering Act gives Medicare the power to negotiate drug prices directly with manufacturers for the first time in the federal program's nearly 60-year history. Some congressional Democrats and consumer advocates have long pushed for the change as many seniors across the country struggle to afford health care.
According to statistics, between November 1, 2023 and October 31, 2024, approximately 5.3 million people with Medicare Part D coverage used these 15 drugs in their second round of interviews to treat various conditions, such as Asthma, cancer and type 2 diabetes. a news release from the Department of Health and Human Services on Friday. The release added that this group of drugs also accounted for approximately $41 billion, or 14%, of total Part D prescription drug costs during that period.
Combined with the 10 drugs selected in the first round of negotiations, these 25 products accounted for 36% of all Medicare Part D prescription drug costs during that period, the release said.
The drugs have been on the market without generic competitors for at least seven years, and in the case of biologics such as vaccines, 11 years.
Medicare has completed negotiations on the first 10 drugs selected for the program, with new prices set to take effect next year. In August, the Biden administration said it expected these negotiated prices to save Medicare enrollees about $1.5 billion in out-of-pocket costs in 2026 alone. The government also projects that price increases will result in net savings to the Medicare program of approximately $6 billion by 2026, or 22% of overall net savings.
But it's unclear whether President-elect Donald Trump will try to change or scale back parts of the law when he takes office next week.
The negotiating plan also faces a series of legal challenges (so far unsuccessful) from the pharmaceutical industry, which sees the process as a threat to its revenue growth, profits and drug innovation.
Medicare covers about 66 million people in the United States, with 50.5 million patients currently enrolled in Part D plans, according to KFF, a health policy research group.
A senior government official told reporters last year that nearly 10% of Medicare enrollees age 65 and older and 20% of those under 65 said they faced difficulties purchasing medications.
"Last year we proved that negotiating lower drug prices works. Now we plan to build on that
U.S. Department of Health and Human Services Secretary Xavier Becerra said in a press release that a record number of 15 important drugs for seniors were negotiated to lower prices. “Today’s announcement is critical – the Inflation Reduction Act is lowering prices for people with Medicare.” HHS will continue to negotiate in the best interests of Medicare patients to achieve lower costs Get innovative, life-saving treatments. "
Patient advocacy groups including the nonprofit American Association of Retired Persons applauded the news Friday.
"For too long, Big Pharma has boosted profits by setting outrageous prices at the expense of American lives, forcing seniors to give up prescription drugs they can't afford," AARP said in a statement. "Sec. A round of Medicare drug price negotiations made clear that this process will lower prices for these important products and save Medicare and its beneficiaries billions of dollars."
Drugmakers have until February 28 to decide whether to participate in the program. If a drugmaker refuses to negotiate, it must pay an excise tax of up to 95% of its drug's U.S. sales or withdraw all its products from the Medicare and Medicaid markets.
Those involved will engage in a lengthy negotiation process involving months of back-and-forth quotes with Medicare. The federal program uses information such as sales volume data, the level of federal financial support for drug development, and pending or approved patent applications and exclusivity data to determine the initial offer price for each drug.
After the second round, Medicare can negotiate prices for 15 more drugs that will go into effect in 2028. Starting in 2029, the number of negotiated medicines will increase to 20 per year.
The government will select only Medicare Part D drugs for the first two rounds of negotiations. By 2028, it will add more specialized drugs covered by Medicare Part B, which are typically administered by a doctor.
But under final guidance from the second round of price negotiations released last year, drugmakers will have more opportunities to negotiate with Medicare. The first optional negotiation meeting will be held after Medicare makes preliminary offers for 15 drugs, which must be submitted by June 1.