Heart, Diabetes, Cancer Drugs on List for Medicare Price Negotiations, White House Says

TUESDAY, Aug. 29, 2023 (HealthDay News) -- The Biden administration on Tuesday named the first 10 medicines that will be subject to price negotiations between Medicare and participating drug companies as a first step in a landmark program aimed at reducing the government's drug spending and potentially U.S. drug prices in general.

"For far too long, pharmaceutical companies have made record profits while American families were saddled with record prices and unable to afford lifesaving prescription drugs," U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra said in an agency news release. "Although drug companies are attempting to block Medicare from being able to negotiate for better drug prices, we will not be deterred. The Biden-Harris administration will continue working to ensure that Americans with Medicare have access to innovative, lifesaving treatments at lower costs."

The initial 10 drugs include: Eliquis (apixaban); Jardiance (empagliflozin); Xarelto (rivaroxaban); Januvia (sitagliptin); Farxiga (dapagliflozin); Entresto (sacubitril/valsartan); Enbrel (etanercept); Imbruvica (ibrutinib); Stelara (ustekinumab); and Fiasp and NovoLog insulin products. Enrollees in the Medicare prescription drug program paid a total of $3.4 billion in out-of-pocket costs in 2022 for them, the HHS noted.

The U.S. Centers for Medicare & Medicaid Services selected these drugs because they account for the highest Medicare spending and have been on the market for years but do not face price competition from rivals, HHS said in a fact sheet. All told, the selected drugs represent more than $50 billion in Medicare prescription drug costs, about 20 percent of total Part D drug costs from June 2022 through May 2023.

Negotiations between the federal government and drug companies will take place in 2023 and 2024, with the new prices set to take effect in 2026. CMS will select up to 15 more drugs for negotiation for 2027, up to another 15 drugs for 2028, and as many as 20 more drugs for each year after that.

Drug makers now have until Oct. 1 to declare whether they will participate in negotiations with the government. Companies that decline to negotiate on pricing must either pay a large excise tax or withdraw all of their products from both Medicare and Medicaid, The New York Times reported. Six pharmaceutical manufacturers are already suing the Biden administration in an attempt to block the Medicare negotiation program, according to the Times; they include Astellas Pharma, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Johnson & Johnson, and Merck.

The New York Times Article