The Medicare drug price negotiation list includes Ozempic

On Friday, the Biden administration announced the next 15 prescription drugs that will be subject to price negotiations Between manufacturers and Medicare, the second phase begins remarkable process It aims to make expensive drugs more affordable for the elderly.

Heads the list New Nordisk‘s blockbuster diabetes injection Ozempic, weight loss shot Wegovy and diabetes pill Rybelsus, is considered a product under negotiation. because they all contain the same active ingredient: semaglutide. These treatments have fueled the rise of the red-hot obesity market, and patient access has become difficult due to cost, insurance coverage, and supply limitations.

The agreed prices for the second wave of drugs are scheduled to enter into force in 2027.

Here are 15 drugs that were subject to preliminary discussions this year:

• Semaglutide (Ozempic, Wegovy, Rybelsus,) by Novo Nordisk is used for type 2 diabetes, weight management, and cardiovascular health.
• Trelegy Ellipta, made by GSK, is an inhaler used for chronic obstructive pulmonary disease and asthma.
• Xtandi, made by Pfizer, is used to treat prostate cancer in men
• Pomalyst, made by Bristol Myers Squibb, is used to treat multiple myeloma, a blood cancer that develops in people with HIV.
• Ibrance, made by Pfizer, is used to treat certain types of breast cancer
• Ofev, manufactured by Boehringer Ingleheim, is used to treat chronic lung disease in adults.
• Linzess, made by AbbVie and Ironwood Pharmaceuticals, is used to treat irritable bowel syndrome and chronic constipation.
• Made by AstraZeneca, Calquence is used to treat certain types of blood cancer
• Austedo, made by Teva Pharmaceuticals, Austedo XR is used to treat involuntary movements caused by tardive dyskinesia or Huntington’s disease.
• Breo Ellipta, developed by GSK and Theravance, is an inhaler used to treat chronic obstructive pulmonary disease.
• Tradjenta, made by Boehringer Ingelheim and Eli Lilly, is used to manage Type 2 diabetes.
• Xifaxan, made by Salix Pharmaceuticals, is used to treat diarrhea caused by travel or irritable bowel syndrome.
• Vrays, made by AbbVie, are used to treat schizophrenia, bipolar I disorder, and major depressive disorder.
• Janumet, Janumet XR, manufactured by Merck, is used to manage Type 2 diabetes
• Otezla tablet, made by Amgen, is used to treat psoriasis, psoriatic arthritis, and mouth ulcers.

President Joe Biden’s Inflation Reduction Act authorized Medicare to directly negotiate drug prices 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 care.

About 5.3 million people with Medicare Part D coverage used 15 drugs in the second round of negotiations between Nov. 1, 2023, and Oct. 31, 2024, to treat conditions as diverse as asthma, cancer and type 2 diabetes. A statement from the Department of Health and Human Services on Friday. The drug group also accounted for approximately $41 billion, or 14%, of Part D prescription drug spending during this period.

Combined with the 10 drugs selected for the first round of negotiations, the 25 products represent 36% of all Medicare Part D prescription drug spending during that period.

Medicines have been on the market for at least seven years without generic competitors, and 11 years for biological products such as vaccines.

Medicare has already completed negotiations for the first 10 drugs selected in the program, and the new prices will take effect next year. In August, the Biden administration said it expected those negotiated prices to save Medicare enrollees. 1.5 billion dollars out-of-pocket costs in 2026 only. The government also expects the prices to result in about $6 billion in net savings for the Medicare program in 2026or a net savings of 22% overall.

But it’s unclear if President-elect Donald Trump will try to change or scale back some of the law’s provisions after he takes office next week.

The negotiation program has also faced numerous – so far unsuccessful – legal challenges from the pharmaceutical industry, which sees the process as a threat to revenue growth, profits and drug innovation.

Medicare covers about 66 million people in the United States and 50.5 million Patients are currently enrolled in Part D plans, according to the health policy research organization KFF.

Last year, a senior administration official told reporters that almost 10% of Medicare enrollees age 65 and older and 20% of those younger than age 65 report having trouble affording drugs.

“Last year, we proved that negotiations on lowering the price of medicines work. Now we plan to build on it
“We reached a record high by negotiating lower prices for 15 additional essential drugs for seniors,” HHS Secretary Xavier Becerra said in a statement. “Today’s announcement is critical—the Inflation Reduction Act lowers prices for people on Medicare. HHS will continue to negotiate with Medicare in the best interests of people to get access to innovative, life-saving treatments at lower costs.”

Patient advocacy groups such as the nonprofit AARP welcomed Friday’s announcement.

“For too long, big drug companies have boosted their profits by setting exorbitant prices at the cost of American lives, forcing seniors to avoid prescriptions they can’t afford,” AARP said in a statement. “The first round of Medicare drug price negotiations made it clear that this process will lower the prices of these important products and generate billions of dollars in savings for Medicare and its beneficiaries.”

But drugmakers will have more opportunities to negotiate with Medicare final guidance released last year for the second round of price negotiations. The first optional negotiation meetings will take place after Medicare makes initial price offers for the 15 drugs to be covered. June 1.