Major Drug Price Negotiations Significantly Impact Medicare Costs

NEW YORK (AP) — Among the 15 high-cost medications set for negotiation under Medicare is a selection of crucial treatments for Type 2 diabetes, HIV, and arthritis, marking a significant effort by the Trump administration to decrease the financial burden of healthcare on seniors and taxpayers.

Those chosen drugs represent the highest expenditures under Medicare, paving the way for deals that could lead to significant savings starting in 2028.

Dr. Mehmet Oz, Administrator of the CMS, emphasized, For too long, seniors and taxpayers have paid the price for skyrocketing prescription drug costs...CMS is taking strong action to negotiate fair prices on the most expensive medications under Medicare. This ensures the healthcare system is designed for patients rather than special interests.

All negotiations must be announced by February 1, under a 2022 law empowering Medicare to negotiate prices for the most commonly prescribed medications for older Americans. This program has already seen pricing negotiations for 25 prescription drugs, including widely used diabetes and weight-loss drugs such as Ozempic and Wegovy.

This year additionally represents a landmark shift as drugs covered under Medicare Part B are now included, allowing outpatient medications, such as those administered in a doctor's office, to be influenced by the negotiation process.

The announced drugs include Trulicity for diabetes, Biktarvy for HIV, and Botox for migraine treatment, alongside medications for chronic conditions such as psoriasis, ulcerative colitis, chronic lung disease, and various cancers.

Approximately 1.8 million Medicare recipients have utilized these drugs over the past year, which accounted for about 6% of the total spending in Medicare Part B and D according to the administration's data.

AARP praised the announcement as a crucial step towards making drugs more affordable for older Americans, while PhRMA expressed concerns about government-imposed price settings.

The full list includes Anoro Ellipta, Biktarvy, Botox, Cimzia, Cosentyx, Entyvio, Erleada, Kisqali, Lenvima, Orencia, Rexulti, Trulicity, Verzenio, Xeljanz, and Xeljanz XR among others.