Medicare selects 15 drugs for second round of price negotiations, including semaglutide
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Key takeaways:
- Drugs to treat cancer and type 2 diabetes are among those selected by CMS for the second cycle of Medicare Part D price negotiations.
- Negotiated prices from the second cycle will take effect in 2027.
CMS has selected 15 new drugs for the next round of Medicare Part D price negotiations, according to a press release from HHS.
On Jan. 17, CMS announced it will commence negotiations with pharmaceutical companies to lower prices for Medicare Part D coverage for a wide range of drugs to treat multiple forms of cancer, type 2 diabetes, asthma and more. Negotiations will take place this year, with negotiated prices going into effect in 2027.
“Today, I’m proud to announce that my administration has selected the next 15 drugs for Medicare drug price negotiation,” President Joe Biden said in a statement. “The drugs treat conditions such as diabetes and cancer, and seniors across the country rely on them. These 15 drugs, together with the 10 drugs that Medicare already negotiated, represent about a third of Medicare Part D spending on prescription drugs, which means the lower prices my Inflation Reduction Act is delivering will put money back in seniors’ pockets across the country.”
The 15 drugs for which CMS has selected for price negotiations include:
- acalabrutinib (Calquence, AstraZeneca);
- apremilast (Otezla, Amgen);
- cariprazine (Vraylar, AbbVie);
- deutetrabenazine (Austedo/Austedo XR, Teva Pharmaceuticals);
- enzalutamide (Xtandi; Astellas, Pfizer);
- fluticasone furoate; umeclidinium bromide; vilanterol trifenatate (Trelegy Ellipta, (GlaxoSmithKline);
- fluticasone furoate; vilanterol trifenatate (Breo Ellipta, GlaxoSmithKline);
- linaclotide (Linzess, AbbVie/Ironwood);
- linagliptin (Tradjenta, Boehringer Ingelheim);
- metformin hydrochloride; sitagliptin phosphate (Janumet/Janumet XR, Merck);
- nintedanib (Ofev, Boehringer Ingelheim);
- palbociclib (Ibrance, Pfizer);
- pomalidomide (Pomalyst, Bristol Myers Squibb);
- rifaximin (Xifaxan, Salix Pharmaceuticals); and
- semaglutide (Ozempic/Rybelsus/Wegovy, Novo Nordisk).
According to the release, approximately 5.3 million Medicare Part D beneficiaries used the 15 drugs selected for price negotiations from November 2023 to October 2024. The listed drugs accounted for 14% of Medicare Part D’s total gross prescription drug costs during that time.
Drug companies from the selected drugs will have until Feb. 28 to determine whether they would like to participate in negotiations. During negotiations, CMS will consider the drug’s clinical benefit, the extent to which it addresses an unmet medical need and its impact on specific populations, among other considerations, according to the release.
As Healio previously reported, the Inflation Reduction Act signed into law in 2022 allows Medicare to negotiate prescription drug prices for high-priced, single-source medications that do not have generic or biosimilar competition. In August 2024, CMS announced price reductions for 10 drugs that were part of the first cycle of negotiations with pharmaceutical companies. The price cuts from the first cycle will take effect in 2026.
“Last year we proved that negotiating for lower drug prices works. Now we plan to build on that record by negotiating for lower prices for 15 additional important drugs for seniors,” HHS Secretary Xavier Becerra said in a press release. “Today’s announcement is pivotal — the Inflation Reduction Act is lowering prices for people on Medicare. HHS will continue negotiating in the best interest of people with Medicare to have access to innovative, life-saving treatments at lower costs.”
The number of drugs CMS can select for price negotiations will continue to rise in the future. CMS will again select up to 15 drugs in the third cycle of negotiations and up to 20 drugs for every subsequent cycle.
Reference:
Statement from President Joe Biden on the next fifteen drugs selected for Medicare drug price negotiation. https://www.whitehouse.gov/briefing-room/statements-releases/2025/01/17/statement-from-president-joe-biden-on-the-next-fifteen-drugs-selected-for-medicare-drug-price-negotiation. Published Jan. 17, 2025. Accessed Jan. 17, 2025.
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