Medicare Announces Lower Prices on 10 Common, High-Cost Drugs

The Biden administration said on Thursday it had reached an agreement with drugmakers to reduce drug prices. top 10 most expensive prescription drugs under Medicare.

It’s part of the federal government’s first drug price negotiations, a cost reduction he says could help ease the financial burden on the estimated at 1 in 7 older adults in the US struggling to pay for their medications.

Here are the negotiated prices for medicines, based on a 30-day supply:

• Eliquis, a blood thinner from Bristol Myers Squibb and Pfizer: Negotiated price of $231, down from list price of $521.

• Xarelto, a blood thinner from Johnson & Johnson; Negotiated price of $197, down from list price of $517.

• Januvia, a diabetes drug from Merck: Negotiated price of $113, down from list price of $527.

• Jardiance, a diabetes drug from Boehringer Ingelheim and Eli Lilly: Negotiated price of $197, down from list price of $573.

• Enbrel, a rheumatoid arthritis drug from Amgen: Traded price of $2,355, down from list price of $7,106.

• Imbruvica, a blood cancer drug from AbbVie and Johnson & Johnson: traded price of $9,319, down from list price of $14,934.

• Farxiga, a diabetes, heart failure and chronic kidney disease drug from AstraZeneca: Negotiated price of $178, down from list price of $556.

• Entresto, a heart failure drug from Novartis: Negotiated price of $295, down from list price of $628.

• Stelara, a psoriasis and Crohn’s disease drug from J&J: Negotiated price of $4,695, down from list price of $13,836.

• Fiasp and NovoLog, Novo Nordisk’s diabetes drugs: Negotiated price of $119, down from list price of $495.

The new negotiated prices were compared to the list prices of medicines from 2023.

It’s important to note that these numbers do not represent a direct comparison between the new negotiated prices and what Medicare and enrollees would have originally paid, said Stacie Dusetzina, a professor of health policy at Vanderbilt University in Nashville, Tennessee. The list price is the full retail price of a drug and does not include any discounts or rebates that a pharmaceutical company may have offered.

Still, Dusetzina said, these are “very big discounts.”

“I think this shows that they are taking these negotiations very seriously and trying to get much lower prices,” she said.

The lower prices are the result of months of heated negotiations between the federal government and pharmaceutical companies over the expensive drugs.

The prices will only come into effect in 2026, but the measure is a milestone for Medicare. The federal government has never been able to negotiate directly with drug manufacturers over the prices of their prescription drugs.

“It’s a historic moment,” White House domestic policy adviser Neera Tanden said on a call with reporters Wednesday night. “Millions of seniors and others receiving Medicare will soon see their drug costs decrease for some of the most common and expensive medications that treat heart disease, cancer, diabetes, blood costs and more.”

Medicare provides health insurance coverage to more than 65 million people in the U.S.

On Wednesday’s conference call, administration officials said the new negotiated prices are projected to save Medicare enrollees $1.5 billion in out-of-pocket costs in the first year.

Negotiations – how required by the Inflation Reduction Act – began in earnest in January, when Medicare presented its opening prices to drug manufacturers.

The $1.5 billion comes on top of savings from other provisions of the Inflation Reduction Act, which include a $35 monthly cap on the out-of-pocket cost of insulin and an annual cap on the out-of-pocket costs of prescription drugs, the companies said. authorities. .

Officials said the negotiations are also expected to save Medicare $6 billion in the first year.

Health and Human Services Secretary Xavier Becerra described the negotiations as “intense” on Wednesday.

“I had the privilege of working closely with our HHS team to oversee the negotiations,” said Becerra. “It took both sides to reach a good agreement.”

Pharmaceutical companies fight against reduced prices

The federal government will have until March 2025 to publish an explanation of how it arrived at the negotiated prices. If a pharmacist refused to negotiate, they would face a tax penalty, which could be lifted if the pharmacist chose to withdraw their drug from the Medicare program.

All pharmaceutical companies subject to negotiations were asked to comment.

A Novartis spokesperson called the negotiations “unconstitutional.”

“It will have devastating and lasting consequences for patients by limiting access to medicines now and in the future,” the spokespeople said in a statement.

In a statement, Steve Ubl, president and CEO of Pharmaceutical Research and Manufacturers of America, the pharmaceutical industry trade group, said the Biden administration is using the talks to “drive political headlines.”

“There are no guarantees that patients will experience lower costs,” he said.

The administration plans to leverage negotiations to bolster Vice President Kamala Harris’ campaign ahead of the presidential election against former President Donald Trump. Harris and President Joe Biden are scheduled to appear together on Thursday to tout the program’s savings.

Wednesday’s call included Becerra, Tanden and Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services.

Worried about inaccessible medicines

ONE study published Wednesday in JAMA found that more than half of older adults reported being very worried about the costs of medical care and prescription drugs ahead of the election.

Nearly 9 in 10 adults ages 65 and older say they take at least one prescription medication, according to KFF, a nonprofit group that investigates health policy issues.

One Commonwealth Fund analysisa nonprofit health care research institute, found that U.S. retail prices—the prices that pharmacists charge patients or insurers before discounts or rebates—for the 10 drugs they selected were three to eight times higher in comparison with prices in other countries of similar size and wealth.

Together, the 10 selected drugs accounted for more than $50 billion in Medicare Part D spending from June 1, 2022, through May 31, 2023, or 20%, according to CMS.

Medicare beneficiaries spent $3.4 billion out-of-pocket on these drugs in 2022, with average out-of-pocket spending on the most expensive drugs reaching $6,497 per enrollee, according to the agency.

The 10 negotiated drugs are just the beginning: in 2027, negotiated prices will come into effect for 15 more drugs, followed by another 15 drugs in 2028 and 20 more in each subsequent year. It is possible that seniors will save even more in the coming years.

The outcome could be compromised if drug manufacturers are successful in their lawsuits to block the law, which have so far been unsuccessful.

“It’s a big deal that they reached an agreement with all 10 drug companies,” Dusetzina wrote in an email. “Nobody chose to abandon Medicare and Medicaid in protest over negotiated prices. That’s a success!”

Negotiations are limited to Medicare Part D drugs, which covers drugs used at home.

In the coming years, however, Medicare Part B drugs administered in medical facilities – such as chemotherapy drugs – will also be subject to negotiation.

This article was originally published in NBCNews. with